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- Almståhl, Annica, 1973, et al.
(författare)
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A prospective study on oral microbial flora and related variables in dentate dependent elderly residents.
- 2012
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Ingår i: Gerodontology. - : Wiley. - 1741-2358 .- 0734-0664. ; 29:2
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Tidskriftsartikel (refereegranskat)abstract
- Gerodontology 2011; doi: 10.1111/j.1741-2358.2011.00599.x A prospective study on oral microbial flora and related variables in dentate dependent elderly residents Objective: Oral microorganisms and related variables were followed over a 1-year period in dentate dependent elderly. Background: For nursing personnel, oral hygiene for the dependent elderly is demanding. It requires good knowledge of how to carry out preventive oral health measures and to judge when help is needed. Previous studies indicate low levels of knowledge, which might be reflected in the oral health of dentate residents. Material and methods: Twenty-one subjects participated at baseline and 14 one year later. Microbial samples were analysed using cultivation technique. The labial minor gland secretion rate was measured using the Periotron(®) method, and oral clinical data were registered. Results: Low labial mucosal flow rates were seen for 95% of the participants. At baseline, visibly thick plaque was seen in 48% and 1year later in 57%. Both frequency and number of bacteria associated with caries and frequency of microorganisms associated with oral soft tissue infections were high. One year later, a decrease in bacteria associated with good oral health and a tendency to an increase in aciduric microorganisms were seen. Conclusion: Poor oral health, tending to further deteriorate over time, advocates regular professional supplementary support when elderly dentate dependent residents need assistance with their oral care.
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| 2. |
- Almståhl, Annica, 1973, et al.
(författare)
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Acid-producing capacity from sugars and sugar alcohols among Lactobacillus isolates collected in connection with radiation therapy
- 2017
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Ingår i: Archives of Oral Biology. - : Elsevier BV. - 0003-9969. ; 84, s. 82-88
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate the acid-producing capacity from sugars and sugar alcohols of oral Lactobacillus collected in connection with radiation therapy (RT) to the head and neck region. Design Lactobacillus were collected from the tongue, buccal mucosa and supragingival plaque in 24 patients before, during, and after RT. The acid-producing capacity of Lactobacillus isolates (n = 211) was analyzed using a colorimetric fermentation test in microtiter plates. Solutions containing 2% sugars (sucrose, glucose, fructose, lactose) or sugar-alcohols (sorbitol and xylitol) were used. After 24 h of incubation, bacterial acid-producing capacity was determined as strong (pH < 5), weak (pH ≥5–≤ 6) or low/absent (pH > 6). Data regarding intake frequency of sugar-rich products and products with sugar-alcohols was collected. Results The highest acid-producing capacity using the sugars was seen for isolates collected during RT. Sorbitol was fermented to a higher extent during and post RT, especially among isolates from plaque. Lactobacillus fermenting xylitol showed the highest acid-producing capacity during RT (p < 0.05). No statistically significant correlations between stimulated whole salivary secretion rate and acid-producing capacity, or between the intake frequency of sugar-rich products or sugar-alcohol containing products and Lactobacillus acid-producing capacity, were found. Conclusion The results suggest that Lactobacillus isolates, collected from the tongue, buccal mucosa and supragingival plaque, have a higher acid-producing capacity using sugars and sugar-alcohols during RT than one year post RT. © 2017 Elsevier Ltd
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| 4. |
- Almståhl, Annica, 1973, et al.
(författare)
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Explorative study on mucosal and major salivary secretion rates, caries and plaque microflora in head and neck cancer patients
- 2018
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Ingår i: International Journal of Dental Hygiene. - : Wiley. - 1601-5029. ; 16:4, s. 450-458
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To analyse mucosal and major salivary secretion rates, caries and plaque microflora in connection with treatment for cancer in the head and neck region. Methods: Thirty-three patients were included and the number of teeth, filled surfaces and caries lesions registered. The labial and buccal gland secretion and stimulated whole salivary secretion rates were determined. Supragingival plaque microflora was analysed using cultivation technique. Data were collected pretreatment, during treatment and 6 months, 1 year and 2 years post-treatment. Results: Two years post-treatment, 36% had new caries lesions, which had been restored. The labial secretion was comparable with pretreatment, while the buccal secretion was lower (P < .001). The stimulated secretion rate was lower compared with pretreatment (P < .001) and was 0.7 mL/minute for 50%. Growth of lactobacilli increased during treatment (P < .001) and remained increased (P < .001), while growth of mutans streptococci was decreased (P < .01) 2 years post-treatment. Growth of Candida increased over time and was higher 2years post-treatment compared with pretreatment (P < .001) while growth of Prevotella was lower (P < .01). Conclusions: Two years post-treatment, the stimulated salivary secretion rate was substantially decreased, acid-tolerant lactobacilli and Candida increased, acid-sensitive microorganisms decreased, and the caries prevalence was low.
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| 5. |
- Almståhl, Annica, 1973, et al.
(författare)
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Explorative study on quality of life in relation to salivary secretion rate in head and neck cancer patients treated with radiotherapy.
- 2016
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Ingår i: Head & neck. - : Wiley. - 1097-0347 .- 1043-3074. ; 38:5, s. 782-791
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Tidskriftsartikel (refereegranskat)abstract
- Background: Radiation therapy (RT) to the head and neck (H&N) region often results in oral complications. In this explorative study, the pretreatment and posttreatment (6 months and 12 months) quality of life (QoL) was analysed for patients with H&N cancer. The associations between QoL and salivary secretion rates were analysed. Methods: In 29 patients (19 men and 10 women, mean age 59±8 years), the stimulated whole salivary secretion and buccal minor gland secretion were measured. The patients completed the European Organisation for Research and Treatment of Cancer Quality of Life questionnaires (QLQ-C30 and H&N35) and the Hospital Anxiety and Depression scale (HADS). Results: One year after the completion of radiotherapy, subjects with hyposalivation (≤ 0.7 ml/min) reported clinically meaningful, but not statistically significant differences, in cognitive functioning, insomnia, swallowing, social eating, dry mouth, sticky saliva and use of painkillers. Statistically significant differences were found for emotional functioning, sticky saliva and dyspnea (p<0.05). Thirtythree percent of them had a HADS score suggesting anxiety problems compared to 8% for those with whole stimulated salivary secretion rates > 0.7 ml/min. Conclusion: Radiotherapy in the H&N region, also using intensity-modulated radiotherapy, is associated with many aspects of life such as cognitive functioning, insomnia, dry mouth and sticky saliva, especially for those with hyposalivation. This article is protected by copyright. All rights reserved.
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| 6. |
- Almståhl, Annica, 1973, et al.
(författare)
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Explorative study on quality of life in relation to salivary secretion rate in head and neck cancer patients treated with radiotherapy up to 2 years post treatment.
- 2019
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Ingår i: International journal of dental hygiene. - : Wiley. - 1601-5037 .- 1601-5029. ; 17:1, s. 46-54
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to analyse quality of life (QoL) pretreatment and up to 24months post radiation therapy (RT) in patients with head and neck (H&N) cancer.Twenty-nine patients (19 men and 10 women) with a mean age of 59±8years were included. The stimulated salivary secretion was measured and the patients completed the European Organisation for Research and Treatment of Cancer Quality of Life questionnaires (EORTC QLQ-C30 and H&N35) and the Hospital Anxiety and Depression scale (HADS) pretreatment and at 6, 12 and 24months post RT.At all time-points after RT (6, 12, and 24months), patients with hyposalivation (stimulated secretion rate ≤0.7mL/min) reported clinically significant differences (> 10 points) regarding insomnia, swallowing, social eating, dry mouth, and sticky saliva. Statistically significant differences were found for emotional functioning and insomnia at 12months (P<0.05 for both) and for sticky saliva at both 12 and 24months (P<0.05 and P<0.01). The number of clinically significant differences increased from 10 at both 6 and 12months post-RT to 14 functioning/symptom scales and single items at the 24months follow-up. At 24months post RT, 21% of patients with hyposalivation had HADS scores suggesting anxiety problems compared to 7% for those with stimulated salivary secretion rates >0.7mL/min.Patients with hyposalivation showed deterioration in health related quality of life (QoL) at 24months compared with 12months post RT. Most pronounced were problems with insomnia, swallowing, social eating, dry mouth, and sticky saliva.
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| 7. |
- Almståhl, Annica, 1973, et al.
(författare)
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Fermentation of sugars and sugar alcohols by plaque Lactobacillus strains
- 2013
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Ingår i: Clinical Oral Investigations. - : Springer Science and Business Media LLC. - 1432-6981 .- 1436-3771. ; 17:6, s. 1465-1470
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Tidskriftsartikel (refereegranskat)abstract
- Objective The objective was to analyse the ability of Lactobacillus strains isolated from supragingival plaque of subjects with hyposalivation and from healthy controls to ferment sugars and sugar alcohols. Material and methods Fifty strains isolated from interproximal plaque from subjects with radiation-induced hyposalivation (25 strains), subjects with primary Sjögren’s syndrome (16 strains) and from subjects with normal salivary secretion rate (9 strains) were tested. Growth and pH were determined after 24 and 48 h of anaerobic incubation in vials containing basal media with 1 % of glucose, fructose, sucrose, mannitol, sorbitol or xylitol. Results No differences between strains isolated from hyposalivated subjects and controls were detected. All strains lowered the pH to <5.0 from fructose and the majority of the strains from glucose and sucrose. A pH of <5.5 was seen for 52 % of the strains using mannitol, 50 % using sorbitol and 36 % using xylitol. The ability to produce acids from sugars and sugar alcohols was highest among strains of Lactobacillus rhamnosus, Lactobacillus casei and Lactobacillus paracasei and lowest among Lactobacillus fermentum strains. Conclusion A large number of Lactobacillus strains are able to ferment not only sugars but also the sugar substitutes mannitol, sorbitol and xylitol to pH levels critical for enamel demineralisation. Clinical relevance Our findings suggest that products containing mannitol, sorbitol and/or xylitol may contribute to the acidogenic potential of the dental plaque and especially in hyposalivated subjects with high numbers of lactobacilli.
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| 8. |
- Almståhl, Annica, 1973, et al.
(författare)
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Lactobacillus species in supragingival plaque in subjects with hyposalivation
- 2004
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Ingår i: International journal of dental hygiene. - : Wiley. - 1601-5029 .- 1601-5037. ; 2:3
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Konferensbidrag (refereegranskat)abstract
- The aim was to analyse frequency and proportion of Lactobacillus species in supragingival plaque in subjects with hyposalivation and the Lactobacillus species ability to ferment sucrose, mannitol, sorbitol and xylitol.Material and methods: Ten subjects treated with radiation therapy (RT), 10 subjects with primary Sjogren's syndrome (pSS), and matched controls were included. Supragingival plaque was collected interproximally 12-13 and 15-16 and analysed using cultivation technique. Lactobacillus colonies were randomly selected and stored at -70 degrees C. The Lactobacillus strains fermentation pattern was analysed using basal medium with 1% of respective carbohydrate/sugar alcohol added.Results: Lactobacilli were more frequent at site 15-16 than at site 12-13. Lactobacilli were about twice as frequent in the pSS and RT groups than in their respective control group. For those harbouring lactobacilli, the proportion of the total count at site 15-16 was 13 +/- 27% for the RT group and 0.003 +/- 0.003% for their controls, 3.2 +/- 5.8% for the pSS group and 0.06 +/- 0.2% for their controls. We have further analysed 28 of 114 collected Lactobacillus strains. All strains gave a pH <6.0 and at 95% a pH <5.5 at sucrose fermentation. Mannitol could be fermented by 82% of the strains, sorbitol by 75% and xylitol by 64%. A pH <5.5 was obtained for 82% of the strains with mannitol, 75% with sorbitol and 32% with xylitol.Conclusion: Subjects with hyposalivation have a marked increase in lactobacilli. Of the strains analysed this far 95% gave a pH <5.5 at sucrose-fermentation. A pH <5.5 was obtained for 82% of the strains with mannitol, 75% with sorbitol and 32% with xylitol. As those sugar substitutes are included in tooth pastes, chewing gums and saliva-stimulating tablets and sprays, it is likely that the lactobacilli are further promoted in subjects with hyposalivation.
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