title: Impact of wearing an intra-oral lubricating device on oral health in dry mouth patients.
abstract: OBJECTIVE
  To establish whether an intra-oral lubricating device for dry mouth alters the oral environment.
  
  
  METHODS
  A single-blind randomized cross-over study.
  
  
  METHODS
  Twenty-nine dentate subjects from the Sjogren's syndrome clinic attended on five occasions at 4-week intervals. They were randomized, having the device fitted on either the second or the fourth visit for the experimental period, whilst using their preferred method of lubrication throughout the rest of the study. The preferred methods of lubrication were either water (group 1, n = 10) or saliva substitute (group 2, n = 9) or sugar-free chewing gum (group 3, n = 10). At each visit microbiological, unstimulated and stimulated saliva samples were collected. Dry mouth score, speech test and periodontal indices were recorded.
  
  
  RESULTS
  The water lubrication group (1) had a resting salivary flow greater than lubrication groups (2 and 3) by post-ANOVA contrasts (P < 0.001). The postdevice data also demonstrated a salivary flow greater than lubrication group (3) by post-ANOVA contrasts (P < 0.05). The epithelial cell count using the Spearman correlation was high, possibly reflecting increased viscosity of the saliva (P = 0.044). The speech test indicated that the experimental subjects had difficulty in speaking (P = 0.001). This was slightly easier postdevice wear. Streptococcus mutans (P = 0.009) and Lactobacillus (P = 0.058) increased in the saliva after wearing the device. Salivary flow rate, Candida albicans, oral dryness, speaking and periodontal indices were unchanged.
  
  
  CONCLUSIONS
  The oral environment was altered by wearing a lubricating device with an increase in the numbers of Strep. mutans and Lactobacillus. Clinical dryness and speech test correlated with the mean whole salivary flow suggesting a screening method for xerostomia.
authors.affiliation: GKT Dental Institute, King's College, London, UK. dfdrymouth@aol.com
authors.forename: P M
authors.initials: PM
authors.lastname: Frost
authors.forename: P J
authors.initials: PJ
authors.lastname: Shirlaw
authors.forename: S J
authors.initials: SJ
authors.lastname: Challacombe
authors.forename: L
authors.initials: L
authors.lastname: Fernandes-Naglik
authors.forename: J D
authors.initials: JD
authors.lastname: Walter
authors.forename: M
authors.initials: M
authors.lastname: Ide
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002638:Chewing Gum; D018592:Cross-Over Studies; D016503:Drug Delivery Systems / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007778:Lactobacillus / Q000302:isolation & purification; D008153:Lubrication; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D012463:Saliva / Q000378:metabolism / Q000382:microbiology*; D012464:Saliva, Artificial / Q000008:administration & dosage*; D016037:Single-Blind Method; D018709:Statistics, Nonparametric; D013295:Streptococcus mutans / Q000302:isolation & purification; D011795:Surveys and Questionnaires; D014867:Water; D014987:Xerostomia / Q000628:therapy*
chemical_list: D002638:Chewing Gum; D012464:Saliva, Artificial; D014867:Water