Odor identification in young and elderly African-Americans and Caucasians

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72304/1/j.1754-4505.1995.tb00501.x.pd

Stimulated parotid salivary flow rates in normotensive, hypertensive, and hydrochlorothiazide-medicated African-Americans

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75004/1/j.1600-0714.1994.tb00060.x.pd

Comparison of stimulated parotid salivary gland flow rates in normotensive and hypertensive persons

Although hypertension is a prevalent condition among the elderly, little is known with respect to the influence of hypertension on oral health and function. Therefore a study was conducted that compared stimulated parotid salivary flow rates in elderly persons (65 years and older) from two diverse populations who are normotensive, mild, and severe hypertensive. The normotensive group consisted of 45 healthy subjects with systolic blood pressures of less than 140 mm Hg and diastolic pressures less than 90 mm Hg. The mildly hypertensive group consisted of 14 otherwise healthy subjects with either systolic pressures greater than 140 mm Hg or diastolic pressures greater than 90 mm Hg. The severely hypertensive group consisted of 10 otherwise healthy subjects with either systolic pressures greater than 180 mm Hg and/or diastolic pressures greater than 100 mm Hg. All three groups were not taking any prescription or nonprescription medications. Samples of 2% citrate-stimulated parotid saliva were collected from each subject. The results showed no significant differences in stimulated parotid flow between normotensive, mildly hypertensive, and severely hypertensive subjects. These results suggest that hypertension per se has no influence on stimulated parotid salivary gland flow rates in otherwise healthy, elderly unmedicated white and African-American persons.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/31510/1/0000432.pd

A characterization of major salivary gland flow rates in the presence of medications and systemic diseases

The purpose of this study was to characterize the effects of medications and systemic diseases on major salivary gland flow rates. Unstimulated and 2% citrate-stimulated parotid and submandibular salivas were collected from 293 subjects of the oral physiology component of the Baltimore Longitudinal Study of Aging. The influence of the number of medications and diseases on salivary flow rates was determined by separate one-way ANOVA tests. There was an overall decrease in both parotid and submandibular flow rates with increasing numbers of medications and systemic diseases. However, this was significant (p < 0.05) only for unstimulated submandibular flow rates (with increasing numbers of systemic diseases) and stimulated submandibular flow rates (with increasing numbers of systemic diseases and medications). Unstimulated flow rates rapidly approached zero with increasing numbers of medications and diseases. These results suggest that the submandibular gland may be more sensitive to physiologic permutations than the parotid gland. In addition, individuals being treated for multiple systemic diseases and taking numerous medications may be more susceptible to salivary hypofunction.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30580/1/0000217.pd

Salivary Gland Sparing and Improved Target Irradiation by Conformal and Intensity Modulated Irradiation of Head and Neck Cancer

The goals of this study were to facilitate sparing of the major salivary glands while adequately treating tumor targets in patients requiring comprehensive bilateral neck irradiation (RT), and to assess the potential for improved xerostomia. Since 1994 techniques of target irradiation and locoregional tumor control with conformal and intensity modulated radiation therapy (IMRT) have been developed. In patients treated with these modalities, the salivary flow rates before and periodically after RT have been measured selectively from each major salivary gland and the residual flows correlated with glands’ dose volume histograms (DVHs). In addition, subjective xerostomia questionnaires have been developed and validated. The pattern of locoregional recurrence has been examined from computed tomography (CT) scans at the time of recurrence, transferring the recurrence volumes to the planning CT scans, and regenerating the dose distributions at the recurrence sites. Treatment plans for target coverage and dose homogeneity using static, multisegmental IMRT were found to be significantly better than standard RT plans. In addition, significant parotid gland sparing was achieved in the conformal plans. The relationships among dose, irradiated volume, and the residual saliva flow rates from the parotid glands were characterized by dose and volume thresholds. A mean radiation dose of 26 Gy was found to be the threshold for preserved stimulated saliva flow. Xerostomia questionnaire scores suggested that xerostomia was significantly reduced in patients irradiated with bilateral neck, parotid-sparing RT, compared to patients with similar tumors treated with standard RT. Examination of locoregional tumor recurrence patterns revealed that the large majority of recurrences occurred inside targets, in areas that had been judged to be at high risk and that had received RT doses according to the perceived risk. Tangible gains in salivary gland sparing and target coverage are being achieved, and an improvement in some measures of quality of life is suggested by our findings. Additional reduction of xerostomia may be achieved by further sparing of the salivary glands and the non-involved oral cavity. A mean parotid gland dose of ≤ 26 Gy should be a planning objective if significant parotid function preservation is desired. The pattern of recurrence suggests that careful escalation of the dose to areas judged to be at highest risk may improve tumor control.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41298/1/268_2003_Article_7105.pd

Clinician`s Guide Oral Health in Geriatric Patiens

xi. 114 hal.; 21 c

The Importance of Oral Health in the Older Patient

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111106/1/j.1532-5415.1995.tb06624.x.pd

Old age in health and disease : Lessons from the oral cavity

It is not clear if aging distinctions can be made at the level of an organ or organism. The purpose of this study was to determine if a general definition of systemic aging, primary aging (influence of the passage of time), versus secondary aging (influence of extrinsic factors), can be used to discriminate the functional status of an individual organ system, the oral cavity. Thirty healthy, nonmedicated subjects (that is, those who exhibit primary aging) and 42 persons being treated for medical problems and taking prescription medications (that is, those who exhibit secondary aging), aged 75 to 96 years, from the oral physiology component of the Baltimore Longitudinal Study of Aging were evaluated. A standardized examination assessed gingival, periodontal, dental, and oral mucosal tissues. There were few substantive differences in oral health and function between primary and secondary aging subjects. Thus use of broad definitions of aging in an organism did not lead to meaningful predictions of the health or function of an individual organ system. Furthermore, the similarity in the oral condition between both groups studied here suggests substantial resiliency of the oral cavity during aging.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30688/1/0000333.pd

Stimulated parotid gland flow rates in healthy, elderly dentulous and edentulous individuals

The use of dentures has been associated with increased stimulated parotid salivary flow rates (SPFR). A comparison of SPFRs was made between dentulous subjects having 20+ teeth (n = 190) and edentulous individuals (n = 67). Two different populations were selected, a white group from the Baltimore Longitudinal Study of Aging and an African-American group from the Washington Village Medical Center in Baltimore. Each group was healthy and unmedicated and had a mean age of 70.2 years. SPFR was determined with a Carlson-Crittenden cup and 2% citrate for stimulation. The edentulous subjects did not wear their dentures during salivary collection. The results indicated a significantly lower SPFR in dentate individuals compared with edentulous subjects (p p < 0.04). In addition, a pre- and postsurgical evaluation of 10 individuals who underwent full mouth tooth extractions revealed no differences in SPFR. These results suggest that edentulism per se does not have a deleterious effect on stimulated parotid salivary flow rates.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30397/1/0000016.pd