Oral Health’s Transformative Impact on Diet and Systemic Health Outcomes

The 2020-25 Dietary Guidelines for Americans identified dental caries as a major diet-related chronic disease of public health concern and suggested in the section for adults over 60, “Good dental health is critical to overall health, as well as the ability to chew foods properly." Poor oral health can lead to chronic diseases and impede one’s ability to chew fruits, vegetables, whole grains, and other nutrient-rich foods across the life span. Almost 90 percent of adults ages 20 to 64 years and 96 percent of those over 65 years of age have dental caries. The overall prevalence of complete tooth loss is 2.2 percent among adults ages 20 to 64 years and jumps to 17.3 percent for those over age 65. As a result of COVID-19, some seniors are not seeking regular oral health services, which increases the need for preventive oral health practices and consuming a healthy dietary pattern recommended in the new Dietary Guidelines. Recent research will underscore the importance of saliva and oral health in cancer patients on radiation and in other chronic diseases. Saliva has also been shown to reduce specific infections that are related to influenza and HIV. Participants in this session will gain understanding of factors linking poor oral health and nutrition practices to chronic diseases and guidance on critical preventive oral health practices to increase saliva flow and decrease dental caries through all stages of the life cycle. Promoting oral health is the responsibility of the interdisciplinary team overseeing older adults.

Nutrition, Oral Health, and Chronic Diseases Inextricably Linked

The 2020-25 Dietary Guidelines identified dental caries as a diet-related chronic disease of major importance. Preventing dental caries and other oral infectious diseases is critical to maintaining an individual’s capacity to chew food, consume nutrient-rich diets, and sustain optimal nutrition status. Pain and infection from dental caries complicates consumption of adequate amounts of fruits, vegetables, dairy, and lean protein recommended in the Dietary Guidelines. Nutrition and dietary intake can affect the development and integrity of oral cavity and progression of oral diseases. Increased snacking throughout the day in place of three-meals daily raises the risk of obesity and dental caries throughout the life cycle. Older adults who make routine oral health preventive practices, such as brushing, cleaning between teeth, drinking fluoridated water, and chewing sugarfree gum to increase saliva flow can reduce dental caries and oral infectious diseases. Professionals must also consider the impact of sugar-sweetened beverages and sugar intake.

Evaluation of Realistic Sensation Using Biological Reaction Measurements for Food Videos Presented by KMMD

We have prototyped a KANSEI multimedia display (KMMD) that is able to release scent through the screen in order to realize collaboration between images and scents. Two types of “sukiyaki” food videos were presented to subjects using this device, and a method for objectively evaluating the realistic sensation of the food videos was examined using biological reaction measurements. The sukiyaki scent was added to one type of video to improve appetite. Viewers’ saliva flow rate, line of sight, pupil diameter, autonomic nerve activity, and cerebral blood flow were measured at the same time, and changes in these measured values were analyzed. As a result, the scent was effective in improving the sensation, as if the food was present in front of the eyes and increasing the saliva flow rate. Additionally, in a realistic scene, it was found that the line of sight follows the performer’s eating behavior as if the viewers themselves are eating. The sympathetic nervous system temporarily increases, mydriasis occurs, and the frontal lobe is activated. Furthermore, the possibility of objective evaluation of realistic sensations was demonstrated by the correlation between appetite, accompanied by salivary sensation, and the biological reaction measurement results.

Polysaccharide From Laminaria Japonica Attenuates Radiation-Induced Xerostomia In Mice Via Activation of Nrf2 Signaling Pathway

Background：Xerostomia is one of the most common complications during radiotherapy for head and neck cancer patients that seriously affects their quality of life. However, optimal treatment for radiation-induced xerostomia is currently unavailable. Therefore, this study aimed to investigate the protective effects of Laminaria Japonica Polysaccharide (LJP) on radiation-induced xerostomia and decipher its underlying mechanism in mice.Methods：Male eight-week-old mice were randomly divided into four groups：normal control group, LJP control group, irradiation group, and irradiation with LJP treatment group. LJP (40mg/kg) was intraperitoneally injected at 1 day before irradiation once daily for consecutive 5 days．The mice irradiated received a single radiation dose of 15Gy. Body weight, daily food and water intake were measured at 28 days post irradiation. Oxidative stress parameters (ROS and MDA) and antioxidant enzyme (MnSOD) in submandibular glands (SMG) were also assessed post irradiation. In addition, histopathology, function and weight of SMG were detected after irradiation. The expressions of Nrf2 pathway-related genes (Nrf2, HO-1 and NQO1) were measured using immunofluorescence or immunohistochemical staining and real-time PCR method. Results：Compared with the control group, irradiated mice showed increases in the levels of oxidative stress parameters (ROS and MDA), water intake and expression levels of Nrf2 pathway-related genes (Nrf2, HO-1, and NQO1), and decreases in body weight, food intake, saliva flow. Nevertheless, LJP treatment significantly increased body weights, food intake, and saliva flow in irradiated mice, markedly downregulated oxidative stress levels, improved the morphology and structure of SMG, and further promote expressions of Nrf2 pathway-related genes.Conclusion: LJP treatment alleviated radiation-induced SMG oxidative stress injury through activating Nrf2 signaling pathway, implying that LJP might be a novel agent for treating radioactive xerostomia in the future.

Aging-Related Metabolic Dysfunction in the Salivary Gland: A Review of the Literature

Aging-related salivary dysfunction commonly induces the poor oral health, including decreased saliva flow and dental caries. Although the clinical significance of the salivary glands is well-known, the complex metabolic pathways contributing to the aging-dysfunction process are only beginning to be uncovered. Here, we provide a comprehensive overview of the metabolic changes in aging-mediated salivary gland dysfunction as a key aspect of oral physiology. Several metabolic neuropeptides or hormones are involved in causing or contributing to salivary gland dysfunction, including hyposalivation and age-related diseases. Thus, aging-related metabolism holds promise for early diagnosis, increased choice of therapy and the identification of new metabolic pathways that could potentially be targeted in salivary gland dysfunction.

Patient’s Perception of Pain and Discomfort Towards Orthodontic Treatments

Background: Patient undergoes orthodontic treatment with removable and fixed appliances will usually complaint of pain and discomfort. The level of pain and discomfort experience by patient will determined the cooperation and compliance towards the treatment. This study explores the perception of pain and type of discomfort experience by patients when undergoes orthodontic treatment. Material and method: This cross-sectional study involve a set of questionnaires regarding patient social demographic and factors contributing to pain and discomfort among patients with removable and fixed appliances. Result: This study shows that the most common discomfort experienced by patients with removable appliance are increased in saliva flow, interferes with mastication and altering speech. Apart from that, ulcers, pain in the mouth and appliance breakages are the most common pain experience by the patients with fixed appliances. Conclusion: In conclusion, majority of patients will experience some form of pain and discomfort during orthodontic treatments. Thus, information regarding pain and discomfort during orthodontic treatment should be clearly convey during the first initial appointment to prepare patient mental and physically.

Effects of an Acute Bout of Exercise on Salivary Lactoferrin Responses among Smokers and Non-Smokers

Smoking can weaken immune function as reported in previous studies. However, benefits of exercise in reducing negative effects of smoking on salivary lactoferrin responses is scarce to date. Hence, the purpose of this study is to determine the effects of an acute bout of exercise on salivary lactoferrin responses among smokers and non-smokers. Eighteen sedentary men were recruited; nine smokers (age = 22.4 ± 1.4 years; BMI = 22.1 ± 1.1 kg/m2) and nine non-smokers (age = 22.1 ± 0.7 years old; BMI = 22.5 ± 1.9 kg/m2). In this study, participants cycled at an intensity of 60% maximum heart rate for 60 minutes. Participants were given cool water as much as 3 ml/kg body weight at minutes 20 and 40 during the exercise session. Participants’ body weight and saliva samples were collected at pre and post-exercise. Heart rate and rate of perceived exertion (RPE) were recorded at pre, during and post-exercise. Mixed ANOVA was used to measure significant differences between groups and within group. The results showed that saliva flow rate, lactoferrin concentration and lactoferrin secretion rate were not significantly different (p>0.05) between smokers and non-smokers groups and also between pre and post-exercise within each group. Heart rate and RPE showed significant increased (p<0.05) during the exercise session in both groups. As a conclusion, acute bout of exercised does not affect salivary lactoferrin responses among sedentary smokers and non-smokers men.

The Effects of an Integrated Supportive Programme on Xerostomia and Salivary Characteristics in Patients With Head and Neck Cancer Undergoing Radiotherapy: a Randomized Controlled Trial

Aim: This study evaluates the effect of an integrated supportive programme on xerostomia and saliva characteristics at a one-year follow-up of patients with head and neck cancer (HNC) undergoing radiotherapy (RT).Methods: Participants were randomly allocated to an intervention group (n=47) or a control group (n=45). The intervention group received usual care and an integrated supportive programme, which included three steps: face-to-face education; face-to-face coaching at one-month post RT; and four telephone coaching sessions at 2-, 3-, 6-, and 9-months post RT. The face-to-face education consisted of oral hygiene instruction, oral self-care strategies, facial and tongue muscle exercises, and salivary gland massage. Adherence to the intervention was evaluated using a questionnaire completed during the nine-month follow-up. The control group received usual care. The unstimulated saliva flow rate, saliva pH, buffering capacity, and xerostomia were assessed in both groups.Results: A total of 79 participants (40 in the intervention group and 39 in the control group) completed the 12-month follow-up. There were statistically significant differences between the groups in level of xerostomia at the 3- and 12-month follow-up (P=0.027 and P<0.001, respectively) and in the mean value of unstimulated saliva flow rate at the 12-month follow-up (P=0.035), with better outcome in the intervention group. The adherence of the intervention was good but decreased slightly during the follow-up. Conclusion: This integrated supportive programme with good adherence relieved xerostomia and had a positive effect on unstimulated saliva flow rate among patients with HNC during the 12-month follow-up.

Intratracheal Poly(I:C) Exposure Accelerates the Immunological Disorder of Salivary Glands in Sjogren's-Like NOD/ShiLtJ Mice

Evidences have suggested that Sjogren's syndrome (SS) is associated with viral infection. The aim of this study was to investigate the involvement of respiratory viral poly(I:C) in the pathogenesis of SS and potential mechanisms using a SS-like NOD/ShiLtJ (NOD) mouse model. 5-week female NOD mice were intratracheally administered poly(I:C) every other day for 5 times to mimic viral infection. Pilocarpine induced saliva secretion was determined every 8 days. Submandibular glands (SMG) and lungs were harvested for the detection of pathological changes. We found that intratracheal administration of poly(I:C) significantly advanced and enhanced the reduction of saliva flow rate in NOD mice. Furthermore, poly(I:C) treatment aggravated the histopathological lesions and inflammatory cells infiltration in SMG. Accompanied by elevated expression of IFN cytokines and IL-33, Th1 activation was enhanced in SMG of poly(I:C)-treated NOD mice, but Th17 cells activation was unchanged among the groups. In addition, intratracheal poly(I:C) exposure promoted the expression of IL-33 and increased T cells proportion in the lung, which were consistent with the change in SMG. Therefore, intratracheal poly(I:C) exposure aggravated the immunological and function disorder of SMG in NOD mice.