Post on 14-Jan-2016
transcript
Xerostomia, Xylitol &
Xylophones!
By: Christian Brennan, Kenia Pereda,
and Wendy Li
Learning objectivesXylitol – What is it?
Research on efficacy and MOA
Video
Xerostomia – What is it?
Research on artificial saliva substitute and causes
OTC products available
Quiz!!!!
Xylitol: What is it?
It is a 5 carbon alcohol, sugar sweetener
Derived from various tree bark, plants, and in fruit fibers
Naturally produced in our bodies
Literally means “wood” in greek
How Xylitol WorksXylitol bacterial uptake inhibits metabolismthrough cell structure incorporation (energy consuming process)
Xylitol anticariogenic effects:1. Inhibits growth of strep mutans2. Reduces dental plaque accumulation3. Reduces acid formation
Effect of chewing gums containing xylitol or probiotic bacteria on salivary mutans streptococci and lactobacilli By: Çaglar E, Kavaloglu S, Kuscu O, Sandalli N, Holgerson P, Twetman S, 2007
Purpose: - Xylitol chewing gum effects on MS and LB bacteria
- Anti-cariogenic effects of xylitol
- Synergistic effect of xylitol with probiotics
Oral mutans streptococci levels following use of a xylitol mouth rinse: a double-blind, randomized, controlled clinical trial
By: Gary Hildebrandt, DDS, MS; Ignatius Lee, DDS, MS; James Hodges, PhD, 2010
Clinical Efficacy and Effects of Xylitol Wipes on Bacterial Virulence By: L Zhan, JD Featherstone, J Lo, et al. 2012
Results from the Xylitol for Adult Caries Trial (X-ACT)
By: James D. Bader, William M. Vollmer, Daniel A. Shugars, et al. 2013
The Trick is….
To consume around 6-10g of xylitol throughout your day, NOT all at once.
Only effective when used continuously
Only an adjunct therapy with fluoride
What is it?
Medical term used for “dry mouth”
Occurs when there is a reduced or absent salivary flow
May lead to speech and eating difficulties, halitosis, and an increase in dental caries!
Who suffers the most?
Side effect of many medications (cardiovascular, antidipressants, diuretics, antihistamines, etc.)
Radiation therapy
Sjogren syndrome
Diabetics, smokers, elderly…
Signs and Symptoms of
Xerostomia
- Bad breath- Cheilitis- Cracked lips- Cracking and fissuring of the oral mucosa- Dryness in mouth- Dysgeusia (taste disorders)- Fungal infections in mouth (i.e. Thrush)- Glossodynia (painful tongue)- Increased need to drink water, especially at night
- Inflammation of the tongue, tongue ulcers- Lipstick sticking to teeth- More frequent gum disease- More tooth decay and plaque- Problems with speech- Problems swallowing and chewing- Sialadenitis (salivary gland infection)- Sore throat- Sticky and/or stringy saliva
Effects of carboxymethylcellulose (CMC)-based artificial saliva in patients with xerostomia.By: D. Oh, J. Lee, Y. Kim, H. Kho.,2008
Purpose:
- Assess the effects of CMC-based artificial saliva in patients
- Standardized questionnaire and measurements of salivary flow rates.
Statistically significant differences in questionnaire: - oral dryness at night or on awakening- oral dryness at other times of the day- effect of oral dryness on daily life
Dry mouth symptoms improved after the use of the CMC-based artificial saliva
Implications of the study: - not asking enough information to assess dry mouth - salivary flow rate was not attainable from certain patients- the CMC-based saliva did not affect all symptoms
Results and Conclusion
Major salivary gland output differs between users and non-users of specific medication categoriesBy: Andy Wolff, Limor Zuk-Paz and Ilana Kaplan, 2008
Xerostomia ProductsACT Dry Mouth Rinse, $7.78 Walmart
Indications for use: Patients with dry mouth
Directions:Rinse 10 ml twice a day, one-minute after brushing. Do not eat for 30 minutes after use
Product safety information:If swallowed, contact Poison ControlCenter right away
Contra-indications: None
Xylitol ProductsDr. John’s Sugar Free Xylitol Lollipops, $12.49/lb Amazon
Indications for use: Patients with high caries risk
Directions:Take the therapeutic dose of 6-10g daily, throughout the day, after meals
Product safety information:Supervise young children to prevent any choking hazards
Contra-indications: May cause slight GI disturbance
References
Hildebrandt G, Lee I, Hodges J. Oral mutans streptococci levels following use of a xylitol mouth rinse: a double-blind, randomized, controlled clinical trial. Spec Care Dentist. 2010 Mar; 30(2):53-58.
L Zhan, JD Featherstone, J Lo, et al. Clinical Efficacy and Effects of Xylitol Wipes on Bacterial Virulence. IADR. 2012 Sep; 24(2):117-22.
Bader JD, Vollmer WM, Shugars DA, et al. Results from the Xylitol for Adult Caries Trial (X-ACT). J AM DENT ASSOC. 2013 Jan; 144(1):21-30.
Wolff A, Zuk-Paz L, Kaplan I. Major salivary gland output differs between users and non-users of specific medication categories. Gerodontology. 2008 Dec; 25(4):210-6
Çaglar E, Kavaloglu S, Kuscu O, Sandalli N, Holgerson P, Twetman S. Effect of chewing gums containing xylitol or probiotic bacteria on salivary mutans streptococci and lactobacilli. Clinical Oral Investigations [serial online]. December 2007;11(4):425-429.
Oh D, Lee J, Kim Y, Kho, H. Effects of carboxymethylcellulose (CMC)-based artificial saliva in patients with xerostomia. International Association of Oral Maxillofacial Surgeons, 2008.
Darby ML, Walsh MM. Dental Hygiene Theory and Practice. 3rd ed. St. Louis (MO): Saunders; c2010. p. 579-598.
National Instituted of Dental and Craniofacial Research. Dry Mouth (Xerostomia) [Internet]. Bethesda (MD.): NIH; 2013 Mar 6 [cited 2013 Mar 6]. Available from: http://www.nidcr.nih.gov/oralhealth/topics/drymouth/
Images from: Google
Quiz time!
Name at least 3 signs and symptoms suffered by the old man in the video.
Quiz time!
Name at least 3 signs and symptoms suffered by the old man in the video.
Is xylitol as effective as fluoride and why? What is xylitol’s mode of action?