Saliva as a primary biological marker

Background:Saliva is the main biological oral environment in which the oral cavity processes take place. Its presence has a role in maintaining healthy oral tissues and protecting dental tissues.Aim:The aim is to make an up-to-date reading of the studies of Bulgarian and foreign authors and to summarize the data from scientific literature and from own researches in order to reveal the clinical potential of saliva for its full use.Materials and Methods:In Google scholar, Web of Science, PubMed, Scopus and ScienceDirect a search is conducted for a period of 31 years. The keywords are: "saliva", "research", "biological marker", "oral health".Results:Saliva has many advantages - one of the largest is the presence therein of substances that come from the gingival fluid, and the local blood flow of the salivary glands. Therefore changes in its components are proportional to those in the blood serum. It is the most affordable and non-invasive biofluid the human body. Saliva offers many advantages as a diagnostic fluid - it can easily be assembled, no special device or device is required and it contains serum components.Conclusion:Saliva has clinical potential for its full use in many areas of medicine. This is the future development of dental science - good synergy and cooperation between it and medicine. This will improve not only the oral but also the general health of the people

Evaluation of the oral status in patients with diabetes mellitus

Често срещащите се орални прояви при ЗД водят и до по-често използване на стоматологична помощ. Денталните лекари трябва да контролират диабета на пациентите, защото лечението на заболяванията на устната им кухина ще бъде по-успешно, ако те поддържат кръвната си захар в норма.Слюнката се сектретира от жлезите и е жизнено важна за оралното здраве, тъй като подпомага поддържането на оралната хомеостаза. Тя съдържа: протеини, ензими, глюкоза, неорганични съставки и хормони в различни концентрации, всяка от които има своя собствена функционална роля и значимост. При диабетици изследването на слюнката показва важни промени. В последните години оценката на нейните съставки се превърна във важно диагностично и терапевтично средство.С оглед по-добра превенция и управление норалните заболявания при диабетици е необходимо да се направи цялостна оценка. Тя включва клинични методи за оценка на денталния статус и лабораторно-диагностични методи. Клиничните методи за оценка на денталния статус са преглед и оценка на (зъбния) оралния статус чрез: DMFT индекс (СЗО критерий), без да се отчита загуба на зъби поради травматични и ортодонтски причини; OHI-S индекс на Greene и Vermilion за орална хигиена; DI-S (debris index simplified); CI-S (calculus index simplified); BOP (Bleeding on Probing); PBI (papilla-bleeding index); CPITN (Community Periodontal Index for Treatment Needs); PSR (Periodontal Screening and Recording) за оценка на необходимостта от пaродонтално лечение.Лабораторно-диагностични методи за оценка на денталния статус включват изследване на биохимични параметри в слюнка на диабетици: глюкоза; имуноглобулини: sIgA, Ig G и Ig M; микроелементи; нитрати и нитрити; цитозолни ензими - AST, ALT, ALT, GGT и LDH. Микробиологичен анализ на слюнка: наличие или липса на Candida, Str. Mutansи др. видове патогени. Оценка на функцията на слюнните жлези (нестимулирана и стимулирана слюнка) - ниво на хидратация; консистенция; количество; рН на слюнка; буферен капацитет. Изследване на вкуса - нару-ен вкус за захароза (dysgeusia) и изследване на халитоза.Often occurring oral manifestations in DM lead to more frequent use of dental care. Dentists need to monitor diabetes patients because the treatment of diseases of the oral cavity will be more successful if they keep their blood sugar normal.Saliva is produced by glands and is vitally important for oral health as it helps maintain the oral homeostasis. It contains: proteins, enzymes, glucose, inorganic substances and hormones in different concentrations, each of which has its own functional role and significance. In diabetic patients, the study of saliva shows important changes. In recent years, the evaluation of its components has become an important diagnostic and therapeutic agent.In order to achieve a better prevention and management of oral diseases in diabetics, it is necessary to make an overall evaluation. It includes clinical methods for evaluation of dental status and laboratory diagnostic methods. Clinical methods for evaluation of dental status are examination and evaluation of (dental) oral status by: DMFT index (WHO criterion) without considering the loss of teeth due to trauma and orthodontic reasons; OHI-S index Greene and Vermilion oral hygiene; DI-S (debris index simplified); CI-S (calculus index simplified); BOP (Bleeding on Probing); PBI (papilla-bleeding index); CPITN (Community Periodontal Index for Treatment Needs); PSR (Periodontal Screening and Recording) to assess the need periodontal treatment.Laboratory diagnostic methods for the evaluation of the dental status include a study of biochemical parameters in the saliva of diabetics: glucose; immunoglobulins: sIgA, Ig G and Ig M; microelements; nitrates and nitrites; cytosolic enzymes - AST, ALT, ALT, GGT, and LDH. Microbiological analysis of saliva is performed: the presence or absence of Candida, Str. Mutans and other types of pathogens. Evaluation the function of salivary glands (unstimulated and stimulated saliva) is conducted - level of hydration; consistency; quantity; the pH of the saliva; buffering capacity. Examination of taste is also part of the process - impaired taste of sucrose (dysgeusia) and research on halitosis

Patients on methadone therapy and sleep apnea

Introduction: Methadone is an opioid, which is prescribed for the treatment and management of opioid addiction. Despite its frequent use, caution should be exercised as it has side effects. Assessment of the patient's clinical condition may be influenced and exacerbated by respiratory side effects. Sleep apnea is one of the side effects, which are observed in patients, treated with methadone.Aim: The aim of the study is to see if there are interactions between methadone treatment and sleep apnea and if so - to determine how much methadone affects sleep.Materials and Methods: In this study, we examined 36 patients, addicted to drugs and treated with methadone. To compare the results we received, we used database articles from Medline, Cochrane Database of Systematic Reviews, Google Scholar, PubMed, Springer Link, Journals of Sleep Medicine and Anesthesia and Analgesia, as well as other non-indexed pages. Results: From the survey we established: 80.6% (29) of patients on methadone therapy have problems with sleep; 9 (25%) have insomnia; 38.9% (14) feel morning fatigue; 16.1% (13) experience daytime sleepiness and 36.1% have a change in mood; 19.4% (7) of respondents say that their sleep is short and 16.7% report snoring; 75% do not have problems with falling asleep and 30.6% wake up frequently during the night.Conclusion: Our study found that the majority of drug addicts reported poor sleep quality. In the treatment of patients with sleep apnea as a result of opioids, collaboration between specialists, monitoring of patients and a combination of different types of sleep apnea treatment is extremely important

Working with addicted patients - meaning, recognition and management

Introduction: Drug abuse is common and is on the rise. Addiction usually occurs among younger people. The risk of dealing with drug addicts is high.Aim: The purpose is to analyze the risks, importance and guidelines in management when dealing with drug addicted individuals, which determines the approach and specifics of their treatment.Materials and Methods: A critical analysis has been made on the available scientific literature over the past 10 years. The results of articles published in Pubmed, Google Scholar, PubMed Central, and ScienceDirect were analyzed and compared. Our own study was conducted among 47 patients on methadone treatment.Results: Opiate addiction, most commonly heroin, is one of the forms of drug abuse that is considered to be potentially harmful. Other commonly used drugs are the stimulants amphetamines, cocaine and methamphetamines. Dependent individuals lead a chaotic lifestyle, neglecting nutrition, health and personal hygiene, incl. oral hygiene. Very often, drug users are at great risk, such as overdose, infectious diseases and subsequent complications of non-treatment.Conclusion: A proper approach to drug addicts is needed to protect doctors and patients, and in order to achieve a better physical, mental and emotional, incl. oral health. Recognizing drug addicts and treating them properly are key points in good management

Oral health in diabetics

Захарният диабет е хронично протичащо заболяване на обмяната на веществата, породено от абсолютен или относителен дефицит на инсулин. Честотата на захарния диабет в света се изчислява на 2.8% за 2000 година и прогнозата за 2030 година е да засегне до 4.4% от населението на света. Връзката между заболяването и промените в устната кухина при пациенти със захарен диабет е двупосочна. Резултатите от много проучвания сочат, че хората с диабет имат много по-чести орални усложнения от здравите индивиди. В потвърждение на това, пародонталните заболявания се считат за шестото най-често услoжнение на диабета. Затова е важно да се познават оралните промени при пациенти с диабет.Diabetes mellitus is a chronic metabolic disease caused by absolute or relative insulin deficiency. The incidence of diabetes is estimated at 2.8% globally in 2000 and the forecast for 2030 is that it would affect up to 4.4% of the world population. The relation between the disease and any pathological changes in the oral cavity of patients with diabetes mellitus is reciprocal. Many studies have shown that people with diabetes mellitus have more oral complications than healthy individuals. As a confirmation of this, periodontal disease is considered to be the sixth most common complication of diabetes. It is therefore essential to be familiar with the oral pathological changes in patients with diabetes

The effect of the prolonged use of narcotic substances on oral health

Introduction: Drug use is a socially significant problem, involving different groups regardless of their age, gender, race and religion. The significant growth of drug abusers worldwide requires the development of a model and algorithm for the diagnosis, treatment and behavior of dental practitioners in regard to these patients. Aim: The aim of this article is to summarize the data from the scientific literature, reading the current studies of Bulgarian and foreign authors, in order to identify variations in oral pathology induced by drug abuse.Materials and Methods:A search has been conducted, using Google Scholar, Web of Science, PubMed, Scopus, and ScienceDirect. The keywords were: "drugs", "research", "patients", "oral health", "effect", "oral pathology".Results:After a thorough study of available literature, we were able to summarize results showing that patients with long-term drug abuse had significantly worse oral health. Drug addicts had a much higher DMFT than control group scores. The periodontal status of patients showed reduced oral hygiene habits, resulting in elevated levels of Streptococcus mutans, actinomycetes and others; as well as xerostomia.Conclusion:The study has allowed us to conclude that continued use and abuse of narcotic drugs has a bad effect on patients' oral health.Introduction: Drug use is a socially significant problem, involving different groups regardless of their age, gender, race and religion. The significant growth of drug abusers worldwide requires the development of a model and algorithm for the diagnosis, treatment and behavior of dental practitioners in regard to these patients. Aim: The aim of this article is to summarize the data from the scientific literature, reading the current studies of Bulgarian and foreign authors, in order to identify variations in oral pathology induced by drug abuse.Materials and Methods:A search has been conducted, using Google Scholar, Web of Science, PubMed, Scopus, and ScienceDirect. The keywords were: "drugs", "research", "patients", "oral health", "effect", "oral pathology".Results:After a thorough study of available literature, we were able to summarize results showing that patients with long-term drug abuse had significantly worse oral health. Drug addicts had a much higher DMFT than control group scores. The periodontal status of patients showed reduced oral hygiene habits, resulting in elevated levels of Streptococcus mutans, actinomycetes and others; as well as xerostomia.Conclusion:The study has allowed us to conclude that continued use and abuse of narcotic drugs has a bad effect on patients' oral health

Comparison of the effectiveness of low-level laser therapy in the control of oral pain conditions

Introduction: Pain, which accompanies the everyday life of dentists and their patients, can have various features—it can be spontaneous or provoked, with clear or vague etiology, iatrogenic, psychogenic or neuropathic one. Our main goal as professionals is to control pain and improve our patients’ personal and social life. Two of the oral pain conditions are still a challenge for us—burning mouth syndrome (BMS) and dentin hypersensitivity (DHS). Low-level laser therapy (LLLT) has been considered as a suitable treatment approach for both of them.Aim: Our purpose is to compare the effectiveness of low-level laser therapy in the control of two different oral pain conditions.Materials and Methods: Individuals with different oral pain conditions are object of the study. They are divided into two groups—patients with primary BMS and patients with dentin hypersensitivity. Both genders and all age groups are included.Diode laser with two different wavelengths (λ = 904 nm and λ = 658 nm) is used for the treatment protocol. The BMS cases are irradiated 10 times, and DHS cases—6 times. Pain is evaluated through visual analogue scale (BMS) or a specific 4-point scale (DHS).Results: There is an improvement of symptoms in both studied groups; however, LLLT seems to be slightly more effective in the treatment of BMS.Conclusion: Low-level laser therapy is effective, safe, easily applicable and relatively cheap treatment method for oral pain conditions

Oral cavity changes in the course of infectious diseases, during childhood

Introduction: A number of infectious diseases, occurring in childhood take its clinical course with typical changes in the oral cavity. Those changes are pathognomonic sign of the disease or increase the clinical thinking about the concrete disease. Aim: In the present review we introduce the infectious diseases in childhood that cause different changes in the mouth. In accordance with it we set some tasks: to introduce pathophysiological mechanisms for mucosa damage and its role about diagnosis.Materials and methods: We based on literature data about that problem. It is discussed in four aspects: diseases with enanthem, changes in the tongue, stomatitis and pharyngitis. Examples and pictures are given.Conclusions: Our review presents that the throat inspection in the children with infectious diseases is important stage of clinical examination, should not be missed and the changes have to be recognized in details because of their great diagnostic and differential diagnostic significance