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      Dental erosive wear and salivary flow rate in physically active young adults

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          Abstract

          Background

          Little attention has been directed towards identifying the relationship between physical exercise, dental erosive wear and salivary secretion. The study aimed i) to describe the prevalence and severity of dental erosive wear among a group of physically active young adults, ii) to describe the patterns of dietary consumption and lifestyle among these individuals and iii) to study possible effect of exercise on salivary flow rate.

          Methods

          Young members (age range 18-32 years) of a fitness-centre were invited to participate in the study. Inclusion criteria were healthy young adults training hard at least twice a week. A non-exercising comparison group was selected from an ongoing study among 18-year-olds. Two hundred and twenty participants accepted an intraoral examination and completed a questionnaire. Seventy of the exercising participants provided saliva samples. The examination was performed at the fitness-centre or at a dental clinic (comparison group), using tested erosive wear system (VEDE). Saliva sampling (unstimulated and stimulated) was performed before and after exercise. Occlusal surfaces of the first molars in both jaws and the labial and palatal surfaces of the upper incisors and canines were selected as index teeth.

          Results

          Dental erosive wear was registered in 64% of the exercising participants, more often in the older age group, and in 20% of the comparison group. Enamel lesions were most observed in the upper central incisors (33%); dentine lesions in lower first molar (27%). One fourth of the participants had erosive wear into dentine, significantly more in males than in females (p = 0.047). More participants with erosive wear had decreased salivary flow during exercise compared with the non-erosion group (p < 0.01). The stimulated salivary flow rate was in the lower rage (≤ 1 ml/min) among more than one third of the participants, and more erosive lesions were registered than in subjects with higher flow rates (p < 0.01).

          Conclusion

          The study showed that a high proportion of physically active young adults have erosive lesions and indicate that hard exercise and decreased stimulated salivary flow rate may be associated with such wear.

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          Most cited references29

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          The diagnostic applications of saliva--a review.

          This review examines the diagnostic application of saliva for systemic diseases. As a diagnostic fluid, saliva offers distinctive advantages over serum because it can be collected non-invasively by individuals with modest training. Furthermore, saliva may provide a cost-effective approach for the screening of large populations. Gland-specific saliva can be used for diagnosis of pathology specific to one of the major salivary glands. Whole saliva, however, is most frequently used for diagnosis of systemic diseases, since it is readily collected and contains serum constituents. These constituents are derived from the local vasculature of the salivary glands and also reach the oral cavity via the flow of gingival fluid. Analysis of saliva may be useful for the diagnosis of hereditary disorders, autoimmune diseases, malignant and infectious diseases, and endocrine disorders, as well as in the assessment of therapeutic levels of drugs and the monitoring of illicit drug use.
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            Risk factors in dental erosion.

            Dental erosion and factors affecting the risk of its occurrence were investigated with a case-control approach. One hundred and six cases with erosion and 100 randomly selected controls from the same source population were involved in the study. All cases and controls were evaluated by the recording of structured medical and dietary histories and by examination of the teeth and saliva. Erosion was classified according to pre-determined criteria. The relative importance of associations between factors and erosion was analyzed by a logistic multivariable model. Adjusted odds ratios (AOR) were estimated. There was considerable risk of erosion when citrus fruits were eaten more than twice a day (AOR 37), soft drinks were drunk daily (AOR 4), apple vinegar was ingested weekly (AOR 10), or sport drinks were drunk weekly (AOR 4). The risk of erosion was also high in individuals who vomited (AOR 31) or exhibited gastric symptoms (AOR 10), and in those with a low unstimulated salivary flow rate (AOR 5).
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              Saliva composition and exercise.

              Little attention has been directed toward identifying the changes which occur in salivary composition in response to exercise. To address this, our article first refers to the main aspects of salivary gland physiology. A knowledge of the neural control of salivary secretion is especially important for the understanding of the effects of exertion on salivary secretion. Both salivary output and composition depend on the activity of the autonomic nervous system and any modification of this activity can be observed indirectly by alternations in the salivary excretion. The effects of physical activity (with reference to factors such as exercise intensity and duration, or type of exercise protocol) on salivary composition are then considered. Exercise might indeed induce changes in several salivary components such as immunoglobulins, hormones, lactate, proteins and electrolytes. Saliva composition might therefore be used as an alternative noninvasive indicator of the response of the different body tissues and systems to physical exertion. In this respect, the response of salivary amylase and salivary electrolytes to incremental levels of exercise is of particular interest. Beyond a certain intensity of exercise, and coinciding with the accumulation of blood lactate (anaerobic threshold or AT), a 'saliva threshold' (Tsa) does indeed exist. Tsa is the point during exercise at which the levels of salivary alpha-amylase and electrolytes (especially Na+) also begin to rise above baseline levels. The occurrence of the 2 thresholds (AT and Tsa) might, in turn, be attributable to the same underlying mechanism, that of increased adrenal sympathetic activity at high exercise intensities.
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                Author and article information

                Journal
                BMC Oral Health
                BMC Oral Health
                BMC Oral Health
                BioMed Central
                1472-6831
                2012
                23 March 2012
                : 12
                : 8
                Affiliations
                [1 ]Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
                Article
                1472-6831-12-8
                10.1186/1472-6831-12-8
                3353235
                22443448
                f59a4d58-1fc6-4e1f-9fce-02724decf9e6
                Copyright ©2012 Mulic et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 23 June 2011
                : 23 March 2012
                Categories
                Research Article

                Dentistry
                saliva,prevalence,dental erosion,exercise,diet
                Dentistry
                saliva, prevalence, dental erosion, exercise, diet

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