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- W1514090497 abstract "To the Editor: Saliva plays an important role in aiding normal speech and chewing food and in oral phase digestion, overall digestion, and swallowing.1 It is important to consider the abnormalities in salivation caused by stroke and to establish a rehabilitative therapeutic regimen for treatment of this condition.2 The effects of 2 weeks of twice daily use of gum-chewing therapy on saliva secretion were studied in 10 stroke patients. Ten patients (mean±standard deviation 48.8±3.6; mean duration after onset 3.8±2.4 months) who had suffered a stroke (brain hemorrhage, n=7; cerebral infarction, n=3) admitted as inpatients of Kirishima Rehabilitation Center between September and November 2003 were studied. All patients were diagnosed with unilateral brain damage based on neurological findings and diagnostic imaging (computed tomography or magnetic resonance imaging scans). Patients with dental and oral diseases or receiving drugs that affect salivation were excluded from the study.3, 4 Written informed consent was obtained from all subjects, and approval for the study was obtained from the ethical committee of Kagoshima University Hospital. Salivary secretion samples were measured during the prestimulated (basal) and acid-stimulated (citric acid) condition. We used the modified swab method for sialometry of Ahlner and Lind5 for measurement of whole-mouth salivary secretion. One hour before measurement, the teeth and surface of the tongue were sufficiently cleaned with a toothbrush, and subjects were given 200 mL of water. After removal of remaining saliva with a sheet of gauze, two cotton balls (approximately 30 mm diameter, 0.9 g each) were then immediately placed in the bilateral upper vestibules at the opening of the parotid gland, and one piece was placed under the tongue close to the submaxillary orifice. The three cotton balls remained in place for exactly 2 minutes and were then removed and immediately placed into a sealed plastic bag. Twenty minutes later, 0.2 mL of 5% citric acid was dropped on the tongue, and following the same procedures, acid-stimulated salivary secretion was then measured. The difference between the weight of the bag measured using an electric balance before and after each measurement period was used to calculate the volume (mL/min) of saliva secreted (1 g=1 mL). The reliability of this modified cotton swab method between first and second measurement within 3 to 5 days after the first measurement, showed a high correlation for measurements made in the basal (correlation coefficient (r)=0.95, P<.01) and acid-stimulated (r=0.87, P<.01) conditions. Basal and acid-stimulated salivary secretion volumes were measured before and after participation in a 2-week gum-chewing therapy protocol. Patients chewed one piece of lemon-flavored gum (Free Zone gum, LOTTE Corp., Tokyo, Japan) for 30 minutes twice daily, morning and noon, for 2 weeks. Statistical analysis was performed using an unpaired or a paired t test. Correlation coefficient was calculated using Pearson's correlation coefficient. Statistical significance was set at the P<.05 level. As shown in Figure 1, after the gum-chewing therapy, basal salivary secretion volume increased nonsignificantly from 0.35±0.2 mL to 0.46±0.3 mL (P<.07), whereas acid-stimulated secretion increased significantly from 1.16±0.9 mL to 1.5±1.2 mL (P<.05). The volume of acid-stimulated secretion was significantly higher than that produced during the basal condition before and after gum-chewing therapy (P<.01). Data indicate that 2 weeks of gum-chewing therapy improved salivary secretion in the basal and acid-stimulated condition. The effects of 2 weeks of gum-chewing therapy on salivary volume in stroke patients. Gum-chewing therapy for 2 weeks improved salivation in stroke patients. It is possible that the reduction in food intake and swallowing after stroke elicits a dysfunction in the salivary glands through disuse. Even if some salivary secretory nerves are damaged, healing of the injured area through gum chewing may increase salivary secretion. Activation of many areas within the brain by gum chewing, including the primary sensorimotor areas, insula, and striatum, may contribute to improvements in salivary gland function.6 It is also possible that salivary gland function improved because of an increased taste sensation from the masticatory stimulus provided through gum-chewing therapy. These data indicate that masticatory stimulation through gum-chewing therapy is a useful rehabilitative treatment for the reduction in salivary secretion after stroke. Along with oral care, close attention should be paid to various functions that may deteriorate after stroke in addition to improving those functions through rehabilitation. Financial Disclosure: No commercial party having a direct financial interest in the result of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which author(s) is/are associated. Author Contributions: Tetsuo Kawasaka: preparation of letter. Tetsuo Kawasaka, Megumi Shimodozono, Atsuko Ogata, and Kazumi Kawahira: design and methods and data collection and analysis. Sponsors' Role: None." @default.
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- W1514090497 date "2006-05-01" @default.
- W1514090497 modified "2023-10-18" @default.
- W1514090497 title "THE EFFECTS OF GUM-CHEWING THERAPY ON SALIVATION IN STROKE PATIENTS" @default.
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- W1514090497 doi "https://doi.org/10.1111/j.1532-5415.2006.00721.x" @default.
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