• The Journal of Internal Korean Medicine
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• v.41 no.5
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• pp.838-847
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• 2020

Objectives: The aim of this study was to investigate the clinical characteristics of patients with Burning Mouth Syndrome (BMS) due to hyposalivation (HS). Methods: We reviewed the clinical records of 39 BMS patients who visited the Department of Digestive Diseases of Kyunghee Korean Medicine Hospital from March 1st, 2020 to July 31st, 2020. The subjects were classified according to the presence or absence of hyposalivation and both groups were compared for the proportion of coated tongue, heart rate variability (HRV), Ryodoraku, and the numeral rating scale (NRS) score of tongue pain results. Results: The BMS with Hyposalivation (HS group) and the BMS without Hyposalivation (Non-HS group) showed a significant difference in the proportion of coated tongue and the NRS score for tongue pain. The NRS score was significantly higher in the Non-HS group and the proportion of coated tongue was lower. However, no significant differences were noted in several HRV parameters between the two groups. The most frequent accompanying symptoms were xerostomia and dyspepsia. Conclusions: The results of this study suggest that hyposalivation might be one of the main causes of tongue pain, the key complaint in BMS patients. Sympathetic/parasympathetic imbalance might not be a main contribution of hyposalivation in BMS. Instead, factors such as the number of medications taken seem to correlate with hyposalivation in BMS. This results could be useful in the management of BMS patients with hyposalivation in clinical practice.

• The Journal of Internal Korean Medicine
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• v.43 no.3
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• pp.387-395
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• 2022

Objectives: This study was designed to investigate the difference between genuine and pseudo-halitosis in terms of clinical characteristics. Methods: We recruited 51 halitosis patients who visited the halitosis clinic at Kyung Hee University Korean Medicine Hospital from March 2020 to March 2022. We classified the halitosis patients into two groups, genuine and pseudo halitosis, based on oral chroma and evaluated the status of hyposalivation using the drainage method, stress levels using heart rate variability (HRV) parameters, and Ryodoraku. Results: Comparing the genuine halitosis group and the pseudo halitosis group, there was no significant difference in the status of hyposalivation and HRV parameters. However, Ryodoraku was significantly different between genuine and pseudo halitosis. Compared to the genuine halitosis group, the pseudo halitosis group showed a significantly higher value of total average (TA) of Ryodoraku. Conclusion: The results of this study suggest that there is a significant difference in Ryodoraku between genuine halitosis and pseudo halitosis, so when approaching pseudo halitosis patients, we should consider their excitability of the sympathetic nervous system and metabolic function status.

• Journal of Korean Dental Science
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• v.16 no.1
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• pp.9-22
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• 2023

Xerostomia is defined as the subjective complaint of dry mouth with or without hyposalivation, which is insufficient salivary secretion from salivary gland. Xerostomia can lead to multiple oral symptoms such as dental caries, halitosis, burning mouth syndrome, and oral candidiasis, which can significantly impact the well-being of patients, especially in geriatric patients who may already have compromised health. Clinical findings of xerostomia include decreased salivary flow and alterations in salivary composition. These changes can lead to various oral health problems such as dental caries, periodontitis, swallowing and speaking difficulties, taste disturbances, halitosis, mucosal diseases, and burning mouth syndrome. Recognizing these clinical manifestations is essential for early diagnosis and appropriate management. Although several reasons and risk factors have been suggested for xerostomia such as aging, chemo-radiation therapy, systemic disease, and Sjögren's syndrome, the polypharmacy is recently highlighted especially in elderly patients. Understanding the etiology and risk factors associated with xerostomia is crucial for effective management. To manage xerostomia patients, a multidisciplinary guideline should be established beyond dental care. Through this literature review, we summarized consideration for diagnostic, therapeutic, nursing essentials for the clinical guideline. By addressing the underlying causes and implementing appropriate treatment strategies, healthcare professionals can improve the quality of life for individuals suffering from xerostomia.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.24.1-24.5
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• 2019

Background: Conventionally, indirect radiography has been used to diagnose salivary gland diseases. However, with the development of sialendoscopy, diagnosis and treatment of salivary gland diseases have become more effective. Herein, we report a case of sialolithotomy treated with sialendoscopy and compare it with the existing methods through a literature review. Case presentation: Two patients with a foreign body sensation under the tongue and dry mouth visited the Anam Hospital, Korea University. Radiographic examination revealed salivary stones inside the right Wharton duct, and the patients underwent sialolithotomy under local or general anaesthesia. The stones were totally removed, and there were no postoperative complications such as bleeding or pain. Conclusion: The development of sialendoscopy has enabled better definitive diagnosis of salivary gland diseases compared with the conventional methods; better treatment outcomes can be obtained when sialendoscopy is used in appropriate cases.

• International Journal of Oral Biology
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• v.42 no.3
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• pp.99-106
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• 2017

Type1 diabetes mellitus (DM) is generally known to be caused by destruction of insulin-producing pancreatic ${\beta}$ cells or an immune-related problem. Polydipsia is a representative symptom of DM, and it has been reported that this condition is closely related to xerostomia and is considered that hyposalivation from the salivary gland results in this phenomenon. Although various studies have reported that induction of diabetes reduces endogenous stem cells in other organs (heart, brain etc.), diabetes-related changes in endogenous stem cells in the salivary gland have not yet been well established. Therefore, in this study, to verify the change in salivary gland stem cells after diabetes, salivary gland tissues in the control and diabetes-induced groups were processed by histochemistry (Masson's trichrome staining) for morphological analysis, TUNEL assay for cell death, and immunohistochemistry (Ki-67 and c-Kit) for cell proliferation and maturation. Diabetes induced by STZ leads to vacuolization, apoptosis, and reduction in proliferating cells/salivary gland stem cells in salivary glands of rats. This result suggests that diabetes may be associated with reduction in salivary gland function such as degeneration and inhibition of regeneration in the salivary gland.

• Journal of Korean Dental Science
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• v.16 no.1
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• pp.47-62
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• 2023

Purpose: We aimed to investigate the objective cutoff values of unstimulated flow rates (UFR) and stimulated salivary flow rates (SFR) in patients with xerostomia and to present an optimal machine learning model with a classification and regression tree (CART) for all ages. Materials and Methods: A total of 829 patients with oral diseases were enrolled (591 females; mean age, 59.29±16.40 years; 8~95 years old), 199 patients with xerostomia and 630 patients without xerostomia. Salivary and clinical characteristics were collected and analyzed. Result: Patients with xerostomia had significantly lower levels of UFR (0.29±0.22 vs. 0.41±0.24 ml/min) and SFR (1.12±0.55 vs. 1.39±0.94 ml/min) (P<0.001), respectively, compared to those with non-xerostomia. The presence of xerostomia had a significantly negative correlation with UFR (r=-0.603, P=0.002) and SFR (r=-0.301, P=0.017). In the diagnosis of xerostomia based on the CART algorithm, the presence of stomatitis, candidiasis, halitosis, psychiatric disorder, and hyperlipidemia were significant predictors for xerostomia, and the cutoff ranges for xerostomia for UFR and SFR were 0.03~0.18 ml/min and 0.85~1.6 ml/min, respectively. Conclusion: Xerostomia was correlated with decreases in UFR and SFR, and their cutoff values varied depending on the patient's underlying oral and systemic conditions.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.10 no.1
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• pp.26-30
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• 2014

Prader-Willi syndrome (PWS) is a rare neurodevelopmental disease caused by abnormality of chromosome 15q11-13. The estimated prevalence of PWS is 1/10,000-30,000. Most common features of this disease are feeding problems characterized by poor sucking habit related with neonatal or infantile hypotonia and obesity due to early childhood hyperphagia involved with lack of satiety. In the orodental findings, enamel hypoplasia, rampant caries, delayed eruption, poor oral hygiene, hypodontia, supernumerary teeth, increased tooth wear, decreased salivary flow and change in saliva composition were reported. This case report describes the dental treatment of 3-year-9-months-old male patient with PWS. Periodic check-ups and conservative treatments were followed, however, rapid dental caries progression caused by estimating hyposalivation was observed. Because of lack of patient cooperation, dental procedures were performed under general anesthesia.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.39.1-39.6
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• 2019

Background: Radioiodine therapy has been widely used for thyroid disease patients, but hyposalivation and xerostomia may occur in 10~30% of patients. Sialocentesis is a procedure that removes inflammatory substances in the salivary duct and expands the duct for the secretion and delivery of saliva. In this study, thyroid disease patients treated with radioactive iodine were selected among the patients with xerostomia who visited the hospital, and the effect of sialocentesis was compared and analyzed. And then, comparison between the radioiodine therapy-experienced group and the non-radioiodine therapy-experienced group was conducted. Results: In this study, we studied xerostomia patients who underwent radioiodine therapy due to thyroid diseases and who underwent sialocentesis at the Korea University Anam Hospital. Sialocentesis is conducted by one surgeon. The study also compares the clinical symptoms before and after the surgery. After the procedure, the discomfort due to xerostomia was reduced, and the symptom was improved effectively. Conclusions: The results of this study showed that sialocentesis has a clinical effect in the treatment of xerostomia, which is a side effect of radioiodine therapy. In addition, the possibility of further clinical application of sialocentesis in the future is found.

• Journal of Korean society of Dental Hygiene
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• v.17 no.3
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• pp.527-537
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• 2017

Objectives: The purpose of this study was to examine the practice of oral hygiene behaviors and oral health status of long-term care facility residents and to analyze the factors related to salivary hemoglobin level which can predict active periodontal disease. Methods: From 30th October 2015 to 7th January 2016, a questionnaire was provided to 63 participants and their dental plaque and saliva samples were collected to assess the levels of salivary hemoglobin and dental plaque acidogenicity. In order to analyze the factors related to salivary hemoglobin level, multiple linear regression analysis was performed. Results: Toothbrushing was most frequently performed by the participants themselves (98.4%) and toothbrushing was performed after eating breakfast (81.3%). 68.8% of participants reported brushing their tongue. 35.9% of participants perceived having bad teeth, and 87.5% had high dental caries activity. The percentages of participants with hyposalivation and ${\geq}0.20{\mu}g/ml$ salivary hemoglobin level were 45.3% and 59.4%, respectively. The salivary hemoglobin level was significantly higher in the group in which stimulated salivary flow rate was ${\leq}0.70ml/min$, dental plaque acidogenicity was superior, and perceived having bad teeth (p<0.05). There was also a tendency for the salivary hemoglobin level to increase with age (p<0.05). Conclusions: Oral health status of the long-term care facility residents was still not improved, and the characteristics of salivary volume and dental plaque were important factors affecting salivary hemoglobin level. Therefore, it is necessary to operate an oral hygiene intervention program by oral health professionals in such facilities in order to provide residents with effective oral care aligned with their respective needs. Furthermore, it is necessary for caregivers to complete mandatory oral health education to improve the oral hygiene status of the long-term care facility residents.

• The Journal of Internal Korean Medicine
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• v.43 no.1
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• pp.53-67
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• 2022

Objectives: This study aimed to identify the characteristics of the heart rate variability (HRV) index in patients with burning mouth syndrome (BMS) and to evaluate the predictive value of HRV for Korean medical treatment responsiveness to tongue pain in BMS. Methods: Among BMS patients who visited the Oral Diseases Clinic of Kyung Hee University Korean Medicine Hospital from January 1, 2018, to May 31, 2021, we reviewed the clinical records of 217 women aged 50 years and over. HRV and unstimulated saliva flow rate (USFR) measurements were carried out, and all patients were asked to indicate their degree of tongue pain using the visual analog scale (VAS). The subjects were classified into subgroups according to the presence or absence of hyposalivation and VAS improvement, and each subgroup was compared using the HRV index. Logistic regression analysis was conducted to confirm whether cause-effect relationships were present between statistically significant values. Results: BMS patients had lower LF and HF than healthy people. Subgroup analysis demonstrated that there were some statistically significant differences in the HRV index according to salivation rate and degree of pain. In addition, as the LF/HF ratio increased, the pain improvement rate decreased after treatment. Conclusion: The autonomic nerve activity of BMS patients was lower than that of healthy people; however, autonomic balance was not impaired. In addition, tongue pain in BMS patients responded more favorably to Korean medical treatment when patients fell within a normal range of the LF/HF ratio, suggesting that autonomic imbalance could be used as one of the predictable factors in clinical practice.