How to drain the saliva in dental surgery game

If the analysis is to be performed immediately, specimens can be stored at room temperature maximum min However, the paper published by Thomadaki K et al. It is always best to aliquot and freeze the samples to avoid repeated freeze-thaw cycles. Other storage and specimen processing approaches, including snap-freezing in liquid nitrogen and the use of enzyme inhibitors, are explained in previous studies 31 , Various reports suggest that psychological stress induce salivary alpha-amylase and cortisol levels and these stressors may include public speaking, watching suspense movies, dental procedures, examinations, sports competition, doing adventures e.

Moreover, salivary amylase level was observed to react more rapidly than cortisol during psychological stress, which could be a better indicator of stress However, stress during dental treatment showed significant changes in the salivary cortisol and sIgA levels than alpha-amylase During acute stress, salivary nitrate and nitrite are significantly increased which play a significant role in stress-induced gastric injury protection.

This study was demonstrated in bungee jump-induced acute stress Another interesting study suggests the stress role in salivary secretion during sports competition where high mental alertness is required to face the opponent.

During the study, the researchers found that the winners were having higher levels of salivary cortisol before the competition, indicating psychophysiological arousal and managed to control the stress during mid-competition with the indication of higher salivary flow rate and higher sIgA secretion A previous study revealed a significant elevation in salivary cortisol, which was observed in chronic study and exam preparation and acute examination situations of the learning behavior In addition, salivary and serum cortisol levels are influenced by various stressors including insomnia, depression, and fatigue.

The fatigue led by insomnia or other factors may be influenced by circadian rhythms Salivary amylase has also been identified as a biomarker for sleep deprivation in Drosophila and humans. The mRNA levels of amylase increase steadily during waking conditions despite no changes in salivary volume total protein In case of premenstrual syndrome PMS , women embrace psychosomatic changes, depression and breast pain during or before menstruation 48 , The concentration of sIgA was found to be significantly elevated during the premenstrual or menstrual phase when compared with the postmenstrual phase.

In contrast, the higher level of sIgA was observed more in women having dysmenorrhea as compared to women without dysmenorrhea. However, there was no correlation between PMS and cortisol level Different profile of mood states POMS also makes a change in salivary cortisol and alpha-amylase In addition, researchers have also demonstrated the stress-induced cortisol elevation on strategic behavior during the beauty contest game Dynamic changes such as cortisol concentrations, intraoral pH and total protein concentration were observed to be influenced in public speaking-induced acute stress without altering salivary fluoride concentration Based on above reports, we can anticipate that the salivary flow and secretory proteins can get varied in the healthy individuals.

These variations may be either from POMS e. So, during saliva collection, we need to confirm from healthy volunteers that they are free from these kinds of psychological stress, which directly affect the saliva volume or salivary proteins. We need to categorize in different groups or exclude such volunteers to limit statistical errors. Noncompliance-induced errors may significantly diminish the post-analysis results. Each participant should complete a questionnaire to provide information regarding their condition and severity.

Moreover, history of certain diseases, age, and sex need to be recorded before the participant completes the questionnaire The sections are shown below in tabulated form. Each item should be answered as 'yes' or 'no. Participants should be selected based on the following criteria. Participants should be aged 18 years or older.

Note: Individuals younger than 18 years might not understand the questionnaire, might not understand the consent form, might not correctly fill out the consent form, or might not follow the guidelines. Moreover, individuals aged 60 years or older should not participate in the study. Although these individuals might be otherwise healthy, the incidence of hyposalivation in older individuals is higher than in younger individuals Volunteers should be disease-free, specifically with respect to the salivary glands and oral mucosa Individuals who answer 'yes' to the dryness-related question.

These individuals are considered positive for xerostomia and cannot participate in the study. Participants who complain of dry mouth or dry eyes Patients with oral lesions or other contact sensitivity Patients suffering from autoimmune diseases such as Sjogren's syndrome, rheumatoid arthritis, systemic lupus erythematosus, or progressive systemic sclerosis, since individuals with these autoimmune inflammatory diseases exhibit persistent xerostomia 58 , Individuals with acute or chronic use of medications known to cause oral dryness These include drugs such as anti-histamines, anti-psychotics, and anti-depressants 58 , The possibility of sampling error is highest during saliva collection and processing.

Incorrect methods of saliva collection also result in sampling error The investigator should use questionnaire answers to select eligible volunteers. It is better to select the intermediate scoring population to minimize potential variations in salivary flow rate.

Food and drinks should be restricted during saliva collection. However, in certain cases, food can be eaten up to 30 min 32 to 1 h before spitting 9. Clear and comprehensible labeling is necessary for proper sample identification and handling. Permanent markers or bar-coded labels are highly recommended for long-term storage Before collection, the optimal sample collection technique as mentioned in sections 3.

Participants should be instructed precisely regarding the optimal placement and duration of the device or swab in order to ensure analyte measurement accuracy. The collected saliva should be free of contamination from particulate matter or other interfering substances Sample contamination can be prevented by wearing gloves and using clean collection materials After collection, the specimen should be stored or processed appropriately as described in section 3.

Some salivary analytes such as dehydroepiandrosterone, estradiol, and progesterone are very sensitive to freeze-thawing, so multiple freeze-thaw cycles should be avoided Other influencing factors include age, sex distribution, and living environment. The duration and time-slot of sample collection have been shown to affect analyte concentration, mainly for stress markers such as cortisol, secretory immunoglobulin A, and chromogranin A Saliva collection from healthy volunteers is like an observational study, where the participants should be selected based on questionnaire responses, detailed histories, and complete clinical examinations, if applicable.

The different aspects of compliance for saliva collection from healthy volunteers can all minimize sampling error. To overcome sample-to-sample variation, the salivary output of each individual needs to be measured. Specifically, each individual should be classified as secreting a high, medium, or low volume of saliva. The salivary flow rate varies among healthy individuals This variation directly influences the total concentration and enzymatic activity of proteins such as salivary alpha amylase in healthy young individuals, even in the absence of a stressful stimulus 4.

Salivary flow rate, total salivary protein concentration, and saliva osmolality are potential markers of whole body hydration status and can fluctuate during acute dehydration Normalization factors for example, creatinine concentration of urine samples 77 for saliva samples have not yet been established; however, measurement of total protein concentration is consistently used to normalize the concentration of the salivary analytes, since various stimulations can affect the total protein concentration in saliva 78 , According to a previous study, the increment in salivary flow rate actually decreased the total protein concentration of salivary samples However, in one study, the authors found that the protein concentration in saliva samples was not strongly associated with salivary volume, but was associated with salivary CRP concentration.

This finding is thought to be important in the neonatal population where the variation of salivary volume is high Circadian and circannual rhythms also influence the unstimulated salivary flow rates 81 , 82 , in addition to sodium and potassium concentrations Therefore, to ensure that consistent results are obtained, individuals should be selected based on their salivary flow rate not saliva volume.

Only individuals whose saliva secretion is in the medium range should be included in the study. Moreover, the baseline specimen collection time should be set at approximately the same time every day for all individuals in order to minimize variability Another method for reducing sample variability is to try collecting samples on multiple days. Participants should be asked to collect the specimen on different days e. Specimens can be collected either at home or at a collection center.

Total specimens are collected, and primary biomarkers such as salivary flow rate, total protein concentration, and salivary enzymes e. This method helps determine the extent to which the participants adhered to the relevant guidelines For any type of drug trial, the results must be compared between patients with disease and healthy individuals; this step is included in the next phase of the clinical trial. We developed a strategic protocol for the collection of saliva from healthy volunteers.

Various studies have examined the efficacy of interventions for treating xerostomia and other dryness-related complications. In clinical trials, statistical analyses are performed to compare results of healthy participants with those of patients. Proper collection of saliva from healthy volunteers is necessary to minimize sampling error.

An optimized protocol for evaluating saliva samples from healthy individuals has not yet been developed, and the National Institutes of Health is still recruiting healthy volunteers for salivary evaluation Moreover, many studies of healthy volunteers have not included detailed questionnaires, thereby increasing the sampling error.

Furthermore, inadequate questionnaires might not obtain sufficient information for selecting eligible individuals. We aimed to collect this information by adding a questionnaire that facilitates the determination of whether the healthy volunteers satisfy the inclusion or exclusion criteria. Saliva contamination from blood or other substances could interfere with post-collection immunoassays. Research participants who donate saliva should be aware of several factors. First, consumption of alcohol less than 12 hours before saliva collection could affect saliva composition.

Volunteers should also be screened for oral hygiene, oral injuries, and brushing habits. In addition, use of medications and nicotine should be documented Another factor responsible for sampling error is the collection device.

As described in section 2, several methods and devices have been developed for saliva collection. In addition, the Muddler was developed recently This device can be used with both infants and adults and can effectively collect a constant volume of saliva. Furthermore, this device is very advantageous for stress-related and immunity-related studies and other salivary biomarker analyses However, special attention should be paid to sample storage prior to analysis If saliva is handled wisely, salivary biomarkers such as enzymes and proteins e.

Additionally, analytes such as hormones, steroids, antibodies, growth factors, cytokines, chemokines, nucleic acids, and proteins related to different systemic diseases, psychological research, autoimmune diseases, and oral diseases caused by fungus, viruses, and bacteria can be successfully implemented in diagnostic applications National Center for Biotechnology Information , U.

Int J Med Sci. Published online May Find articles by Hyung-Ryong Kim. Author information Article notes Copyright and License information Disclaimer. Competing Interests: The authors have declared that no competing interest exists. Received Jan 25; Accepted Apr This article has been cited by other articles in PMC.

Abstract Salivary bioscience technologies such as electrophoresis are widely applied for diagnosing systemic health status. Keywords: Saliva collection, healthy volunteers, salivary proteomics, psychological stress, sampling errors, risk management.

Introduction Saliva is an important specimen in dental research and in the oral physiology field due to its suitability as a non-invasive diagnostic tool. Importance of salivary proteomics in biomedical technology Research based on saliva proteomics is currently emerging due to interest in identifying prognostic biomarkers for several physiological and pathological conditions.

Sampling considerations Sample collection requirements While saliva collection does not require extensive preparation, eligible participants need to receive appropriate instructions. Selection based on age and gender Saliva is comprised of many components including water, electrolytes, enzymes, and antimicrobial agents. Significance of mouth position during saliva collection The different pairs of salivary glands include parotid glands, submandibular glands, sublingual glands, and numerous minor salivary glands.

Measurement of salivary volume before the trial of interest in a placebo trial: Select only the intermediate scoring individuals To eliminate errors in clinical trials using saliva from healthy volunteers, collection procedures must be standardized. Provide detailed information regarding the method of saliva collection Various methods are available for the collection of whole saliva.

Sample storage If the analysis is to be performed immediately, specimens can be stored at room temperature maximum min Does psychological stress make a change in salivary protein secretion? Questionnaire Each participant should complete a questionnaire to provide information regarding their condition and severity. Table 1 Demographic features and personal information.

Open in a separate window. Table 2 Medical history. Questionnaire Response References Do you have a systemic disease? Type of drugs 55 , 59 , 60 For female volunteers, does your period occur normally? Table 3 Tobacco and alcohol habits. Questionnaire Response References Do you smoke? Table 4 Oral hygiene. Questionnaire Response References Do you have an oral lesion s e. Table 5 Other. Questionnaire Response References Does your mouth feel dry when eating a meal? Inclusion criteria Participants should be selected based on the following criteria.

Participants should be able to read, complete, and sign the consent form. Participants should understand and answer the questionnaire. Participants should not have dry mouth or dry eye sensations. Exclusion criteria Participants who are less than 18 years of age.

Participants who cannot read or understand the consent form. Pregnant women. Patients undergoing radiotherapy mainly for head and neck cancer treatment. Individuals with chronic medical illness, if it is not well controlled. Sampling error and management The possibility of sampling error is highest during saliva collection and processing. Figure 1. Figure 2. Specimen collection saliva process to minimize inter-individual variability.

Discussion and conclusions We developed a strategic protocol for the collection of saliva from healthy volunteers. References 1. Saliva as a diagnostic tool for oral and systemic diseases. Journal of oral biology and craniofacial research. Ixeris dentata extract regulates salivary secretion through the activation of aquaporin-5 and prevents diabetes-induced xerostomia.

Journal of experimental pharmacology. International journal of molecular sciences. Salivary alpha-amylase activity and salivary flow rate in young adults. The open dentistry journal. Explaining sex differences in dental caries prevalence: saliva, hormones, and "life-history" etiologies. American journal of human biology: the official journal of the Human Biology Council. Dawes C. Effects of diet on salivary secretion and composition.

Journal of dental research. Influence of age and gender on salivary flow rate in completely edentulous patients. Clinical and translational medicine. Salivary flow and alpha-amylase: collection technique, duration, and oral fluid type. Factors influencing measurement of human salivary lysozyme in lysoplate and turbidimetric assays.

Journal of clinical microbiology. Salivary biomarkers and proteomics: future diagnostic and clinical utilities. Acta otorhinolaryngologica Italica: organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale.

Potential uses of human salivary protein and peptide analysis in the diagnosis of disease. Archives of oral biology. Salivary proteomics for oral cancer biomarker discovery. Clinical cancer research: an official journal of the American Association for Cancer Research. NF-kappaB dependent cytokine levels in saliva of patients with oral preneoplastic lesions and oral squamous cell carcinoma.

Cancer detection and prevention. Cancer investigation. Salivary proteomics and biomarkers in neurology and psychiatry. Proteomics Clinical applications. Age-related changes in salivary biomarkers. Journal of Dental Sciences. The salivary flow rate and composition of whole and parotid resting and stimulated saliva in young and old healthy subjects. Biochemical medicine and metabolic biology. Age-related changes in mucins from human whole saliva. Proteomic analysis of salivary acidic proline-rich proteins in human preterm and at-term newborns.

Journal of proteome research. Age-dependent modifications of the human salivary secretory protein complex. Pay attention to pain in the face or mouth. Salivary glands are located in a number of areas in the mouth: under the tongue, inside the cheeks, and at the floor of the mouth.

The pain may come and go, but typically gets worse as time goes on. Look for swelling of the face or neck. When saliva cannot exit a blocked gland, swelling will occur. You may notice swelling below the jaw or ears, depending on which gland is blocked.

This swelling may be accompanied by pain in the area, which may make it difficult to eat and drink. Watch for increased pain while eating or drinking.

Another main issue that accompanies a blocked salivary duct is difficulty eating and drinking. Some people with this condition experience a sharp and stabbing pain right before or during meals. The pain may be present while chewing or when you open your mouth. You may also have trouble swallowing when a salivary duct is blocked.

Be aware of signs of infection. Untreated salivary blockage can cause infection in the salivary gland. When saliva is trapped in the gland, bacteria are more likely to develop and spread. Signs of infection include redness and pus around the stone.

Fever is another sign of infection. They can quickly treat it and prescribe antibiotics to clear it up. Method 2. Drink a lot of water to keep the mouth hydrated. One of the first steps you should take if you have a blocked salivary glad is to increase your water intake. Drinking water can help you to stay hydrated and increase saliva flow, which may relieve dry mouth.

Keep a bottle of water at your side and sip some throughout the day to ensure you stay hydrated. Of course, this all depends on your activity level, environment, and weight. If you exercise frequently, live in a hot and humid environment, or are overweight, plan to drink more water.

Take over-the-counter medications to relieve pain and swelling. Some common medications to alleviate pain and inflammation include ibuprofen and acetaminophen. Make sure to follow the instructions when taking these medications so you know when and how often to take it. Suck on citrus fruits or hard candies to dislodge a stone. A great way to unclog a blocked salivary duct is to suck on something sour, such as a lemon wedge or sour candies.

Make sure to suck on the candy or fruit for as long as possible, instead of chewing and swallowing it right away. Massage the salivary gland with your fingers. Another remedy for a blocked salivary is to massage the affected area. A gentle massage with the fingers can help to relieve pain and encourage the stone to pass through the duct.

To correctly perform the massage, locate the exact area where the duct is blocked. It may be in the cheek area right in front of your ear or under the jaw close to your chin.

Place your index and middle finger on the area you feel pain or swelling and gently apply pressure as you move them forward along the gland. Massage your salivary gland as many times as you need to until the blocked duct is cleared.

Stop the massage if it becomes too painful. Apply warm compresses to your neck to ease pain and swelling. Apply the compress for 10 minutes at a time and repeat throughout the day as needed. You can either make a warm compress at home or purchase one at your local drug store. You'll know it's too hot if it is uncomfortable or painful to the touch. Take a clean washcloth and submerge it completely in the water. Then, wring it out until it is just damp.

Fold it, put it on the painful area, and leave it on for several minutes. When the washcloth gets cold, repeat this process with a new, clean washcloth and bowl of warm water.

Method 3. If all attempts to remove the blockage on your own have failed, you need to contact your doctor, especially if you are experiencing a lot of pain.

If a doctor is unable to remove the stone, they may refer you to the hospital for surgery. Consider a sialendoscopy to remove salivary gland stones. A sialendoscopy is a less invasive method of removing salivary gland stones.

In this method, an endoscope is inserted into the opening of the duct and a small wire is used to remove the stone. This procedure takes about minutes to complete and patients heal and recover very quickly. The only major side effects are pain and swelling of the salivary gland that generally does not last very long. They are more likely to do this procedure if the stone is small. Undergo surgery to remove large salivary stones. Stones that are smaller than 2 millimetres 0.

However, stones larger than that are harder to remove, and surgery may be your only option. Surgery for salivary stone removal involves making a small incision in the mouth. Did you know you can get answers researched by wikiHow Staff?

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