Kumar Narendra, Dhiman R K, Arora Vimal, Baranwal V K, Krishnaprasad K R, Pearl Bahri
Officer Commanding, Military Dental Centre, Gaya, Bihar, India.
Dy Commandant, Command Military Dental Centre, Kolkatta, India.
Med J Armed Forces India. 2019 Jul;75(3):288-292. doi: 10.1016/j.mjafi.2018.07.016. Epub 2019 Feb 26.
This study was aimed to evaluate the changes in salivary output and its effect on dental caries among Indian troops after 6 months of stay at high-altitude area (HAA).
All troops undergo mandatory dental checkup during acclimatization phase before deployment at HAA. Two thousand troops who fulfilled inclusion and exclusion criteria were selected, and consent for the study was obtained. Stimulated and unstimulated salivary samples were collected, the decayed, missing, and filled teeth (DMFT) index was evaluated, and required dental treatment was completed. The same salivary samples were collected after 6 months (on deinduction) to evaluate the salivary output. The DMFT index was re-evaluated to check the initiation of caries.
The mean values of unstimulated and stimulated saliva at the initial visit were 4.105 and 17.03 gm, respectively, whereas the mean values of unstimulated and stimulated saliva after 180 days were 3.034 and 15.831 gm, respectively. Salivary flow was found to be significantly decreased after 6 months both in unstimulated and stimulated saliva. The mean DMFT at the time of induction of the study was 6.18 ± 3.03, and on deinduction, it was 7.22 ± 3.45 with p < 0.001, which was highly statistically significant.
A decrease in body fluids and changed sympathetic and parasympathetic at HAA lead to decreased salivary secretions. Low water intake, high carbohydrate solid diet, negligible supply of fresh food, difficulty in maintenance of oral hygiene, and overall stress due to loneliness are all contributory factors for an increase in dental caries. It clearly demonstrates that prolonged stay at HAA affects salivary volume outflow, both stimulated and unstimulated, which has a corresponding effect on new caries.
本研究旨在评估印度军队在高海拔地区(HAA)停留6个月后唾液分泌量的变化及其对龋齿的影响。
所有部队在部署到HAA之前的适应阶段都要接受强制性牙科检查。选择了2000名符合纳入和排除标准的部队,并获得了他们对该研究的同意。收集刺激和未刺激的唾液样本,评估龋失补牙(DMFT)指数,并完成所需的牙科治疗。6个月后(退役时)收集相同的唾液样本以评估唾液分泌量。重新评估DMFT指数以检查龋齿的发生情况。
初次就诊时未刺激和刺激唾液的平均值分别为4.105克和17.03克,而180天后未刺激和刺激唾液的平均值分别为3.034克和15.831克。发现6个月后未刺激和刺激唾液的流量均显著下降。研究开始时的平均DMFT为6.18±3.03,退役时为7.22±3.45,p<0.001,具有高度统计学意义。
高海拔地区体液减少以及交感神经和副交感神经的变化导致唾液分泌减少。低饮水量、高碳水化合物固体饮食、新鲜食物供应极少、口腔卫生维护困难以及因孤独感产生的整体压力都是龋齿增加的促成因素。这清楚地表明,在高海拔地区长时间停留会影响刺激和未刺激唾液的流出量,这对新发龋齿有相应影响。