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Oral dysfunctions are common in the elderly but the literature lacks a multidisciplinary approach on the relationship between polypharmacy, saliva flow, xerostomia, taste, and swallowing complaints. This cross-sectional study included 204 non-institutionalized elderly (>60 years; 123 women/81 men), free of severe disabilities and non-alcohol/tobacco consumers, from whom specific pharmacological therapies were evaluated, as well xerostomia (Xerostomia Inventory-XI) and swallowing complaints (EAT-10 questionnaire), salivary flow rate and gustatory sensitivity. Statistical analysis included Chi-square, Mann-Whitney, Two-way ANCOVA, and linear multiple regression. Polypharmacy (≥5 drugs daily), hyposalivation, and severe taste dysfunction were found in 18, 46, and 10% of the participants, respectively. Polypharmacy was related with xerostomia (p = .041) and swallowing complaints (p < .001; power = 94%), but not with taste dysfunction. Dry mouth complaint and higher risk of swallowing disorders were found in 50 and 12% of the elderly, respectively, and angiotensin-converting enzyme (ACE) inhibitors users (n = 36) showed higher EAT-10 scores (p = .038). Regression models showed that stimulated salivary flow rate was dependent on gender and diuretic use, while xerostomia scores were dependent on the number of medications and unstimulated saliva flow (p < .001). In conclusion, the results draw attention to the high frequency of oral and maxillofacial dysfunctions found in non-institutionalized elderly, especially polypharmacy, xerostomia and swallowing complaints, and the side effects of drugs that can disturb the oral functions, the acceptance of food, and the adherence to oral therapies.

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As sucking habits and eating behavior may be interrelated and also associated with taste, body composition, and sociodemographic factors, the objective was to perform an exploratory analysis to identify groups of children with a high degree of association between intragroup subjects, providing explanation and interpretation of the data. The study initially included 352 prepubertal children (197 girls; 7- to 11-year-old), from whom information about sociodemographic characteristics, duration of breastfeeding, past bottle-feeding and non-nutritive sucking habits, taste sensitivity, body mass index (BMI), and consistency of food ingested were collected. Salivary concentrations of amylase and total protein were also determined. Data were submitted to cluster analysis (hierarchical analysis, K-means, and silhouette plot), one-way ANOVA and correlation tests. Cluster analysis included 159 children, generating three reliable and meaningful clusters: Cluster 1 (labeled "good tasters"), was characterized by older children and higher taste sensitivity; Cluster 2 ("softer food consistency") by longer bottle-feeding duration and children who eat food with lower consistency, and Cluster 3 ("breastfed") by longer breastfeeding duration (silhouette coefficient = 0.61). Cluster 3 also showed the higher percentage of normal-weight children, normal delivery, maternal schooling, and lower rate of past non-nutritional sucking habit. No correlation was found between salivary amylase and total protein concentrations, taste sensitivity and BMI, although taste sensitivity showed to be higher among girls (p = 0.002; power = 88%). The study identified three clusters, highlighting the relationship between nutritional sucking habits, consistency of food ingested, and sociodemographic characteristics. Most importantly, a close relation between bottle-feeding and consumption of soft food consistency was observed.

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BACKGROUND: Acupuncture stimulates points on the body, influencing the perception of myofascial pain or altering physiologic functions. OBJECTIVE: The aim was to evaluate the effect of electroacupuncture (EAC) and acupuncture (AC) for myofascial pain of the upper trapezius and cervical range of motion, using SHAM acupuncture as control. METHOD: Sixty women presenting at least one trigger point at the upper trapezius and local or referred pain for more than six months were randomized into EAC, AC, and SHAM groups. Eight sessions were scheduled and a follow-up was conducted after 28 days. The Visual Analog Scale assessed the intensity of local and general pain. A fleximeter assessed cervical movements. Data were analyzed using paired t or Wilcoxon's tests, ANOVA or Friedman or Kruskal-Wallis tests and Pearson's correlation (α=0.05). RESULTS: There was reduction in general pain in the EAC and AC groups after eight sessions (P<0.001). A significant decrease in pain intensity occurred for the right trapezius in all groups and for the left trapezius in the EAC and AC groups. Intergroup comparisons showed improvement in general pain in the EAC and AC groups and in local pain intensity in the EAC group (P<0.05), which showed an increase in left rotation (P=0.049). The AC group showed increases in inclination (P=0.005) sustained until follow-up and rotation to the right (P=0.032). CONCLUSION: EAC and AC were effective in reducing the pain intensity compared with SHAM. EAC was better than AC for local pain relief. These treatments can assist in increasing cervical range of motion, albeit subtly.

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BACKGROUND: Acupuncture stimulates points on the body, influencing the perception of myofascial pain or altering physiologic functions. OBJECTIVE: The aim was to evaluate the effect of electroacupuncture (EAC) and acupuncture (AC) for myofascial pain of the upper trapezius and cervical range of motion, using SHAM acupuncture as control. METHOD: Sixty women presenting at least one trigger point at the upper trapezius and local or referred pain for more than six months were randomized into EAC, AC, and SHAM groups. Eight sessions were scheduled and a follow-up was conducted after 28 days. The Visual Analog Scale assessed the intensity of local and general pain. A fleximeter assessed cervical movements. Data were analyzed using paired t or Wilcoxon's tests, ANOVA or Friedman or Kruskal-Wallis tests and Pearson's correlation (α=0.05). RESULTS: There was reduction in general pain in the EAC and AC groups after eight sessions (P<0.001). A significant decrease in pain intensity occurred for the right trapezius in all groups and for the left trapezius in the EAC and AC groups. Intergroup comparisons showed improvement in general pain in the EAC and AC groups and in local pain intensity in the EAC group (P<0.05), which showed an increase in left rotation (P=0.049). The AC group showed increases in inclination (P=0.005) sustained until follow-up and rotation to the right (P=0.032). CONCLUSION : EAC and AC were effective in reducing the pain intensity compared with SHAM. EAC was better than AC for local pain relief. These treatments can assist in increasing cervical range of motion, albeit subtly. .

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BACKGROUND: Electroacupunture (EA) includes the passage of an electrical current through the acupuncture needle and is commonly used for pain relief. OBJECTIVE: To evaluate the EA treatment effects for myofascial pain in the upper trapezius muscle. METHODS: Twenty women aged ranging from 18 to 40 years (mean=24.95; SD=5.88 years), with a body mass index ranging from 19 to 25 kg/m2 (mean=22.33; SD=0.56 kg/m2), with regular menstrual cycles controlled by oral contraceptive, local or referred pain for more than six months and at least one myofascial trigger point in the upper trapezius participated in this study. The participants received a total of nine EA sessions over five weeks. The needles were inserted at the accupoints GB20, GB21, LV3, LI4, and at "ashi" points. A mixed current of 2 Hz and 100 Hz was applied alternatively every 5 seconds for 30 minutes. The outcomes were pain intensity measured by the visual analogue scale (VAS), pressure pain threshold (PPT) measured by an algometer, electromyography (EMG) and quality of life measured by the SF-36 questionnaire. Inter-occurrences between sessions were monitored. Paired t-test, Wilcoxon test, and repeated measure analysis of variance (ANOVA) having Tukey-Kramer as post-hoc tests were used. RESULTS: Significant improvement in pain intensity and in PPT occurred after treatment (P<0.0001). EMG of the right trapezius during contraction increased significantly, suggesting muscle function enhancement; the quality of life improved, related to physical components of the SF-36 (P<0.05). CONCLUSION: The EA showed to be a reliable method for myofascial pain relief. Large randomized blinded controlled trials might be carried out to confirm these results. Article registered in the Registro Brasileiro de Ensaios Clínicos under number RBR-4hb6f6.

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BACKGROUND: Electroacupunture (EA) includes the passage of an electrical current through the acupuncture needle and is commonly used for pain relief. OBJECTIVE: To evaluate the EA treatment effects for myofascial pain in the upper trapezius muscle. METHODS: Twenty women aged ranging from 18 to 40 years (mean=24.95; SD=5.88 years), with a body mass index ranging from 19 to 25 kg/m2 (mean=22.33; SD=0.56 kg/m2), with regular menstrual cycles controlled by oral contraceptive, local or referred pain for more than six months and at least one myofascial trigger point in the upper trapezius participated in this study. The participants received a total of nine EA sessions over five weeks. The needles were inserted at the accupoints GB20, GB21, LV3, LI4, and at “ashi” points. A mixed current of 2 Hz and 100 Hz was applied alternatively every 5 seconds for 30 minutes. The outcomes were pain intensity measured by the visual analogue scale (VAS), pressure pain threshold (PPT) measured by an algometer, electromyography (EMG) and quality of life measured by the SF-36 questionnaire. Inter-occurrences between sessions were monitored. Paired t-test, Wilcoxon test, and repeated measure analysis of variance (ANOVA) having Tukey-Kramer as post-hoc tests were used. RESULTS: Significant improvement in pain intensity and in PPT occurred after treatment (P<0.0001). EMG of the right trapezius during contraction increased significantly, suggesting muscle function enhancement; the quality of life improved, related to physical components of the SF-36 (P<0.05). CONCLUSION: The EA showed to be a reliable method for myofascial pain relief. Large randomized blinded controlled trials might be carried out to confirm these results. Article registered in the Registro Brasileiro de Ensaios Clínicos under number RBR-4hb6f6.

CONTEXTUALIZAÇÃO: A eletroacupuntura (EA) inclui a passagem de uma corrente elétrica pela agulha de acupuntura e é comumente utilizada para aliviar a dor. OBJETIVO: Avaliar o efeito da EA no tratamento da dor miofascial do músculo trapézio superior. MÉTODOS: Participaram 20 voluntárias com idade entre 18 e 40 anos (24,95±5,88 anos), índice de massa corpórea entre 19 e 25 kg/m2 (22,33±0,56 kg/m2), ciclo menstrual regulado por anticoncepcionais, dor por mais de seis meses no trapézio superior, com pelo menos um ponto gatilho miofascial. Nove sessões de EA foram agendadas, sendo duas por semana. As agulhas foram inseridas nos pontos VB20, VB21, F3, IG4 e em pontos ashi. Aplicou-se uma corrente alternada de 2 Hz e 100 Hz a cada 5 segundos durante 30 minutos. Avaliou-se a eficácia do tratamento quantificando a intensidade da dor com a Escala Visual Analógica (EVA); o limiar de dor à pressão (LDP), com algômetro digital, eletromiografia (EMG) e com o questionário de qualidade de vida SF-36. Possíveis fatores influenciadores entre as sessões foram monitorados. Aplicaram-se os testes t pareado, Wilcoxon e análise de variância com medidas repetidas (ANOVA) e, como post-hoc, o teste de Tukey-Kramer. RESULTADO: Após o tratamento, houve melhora na intensidade da dor e no LDP (P<0,0001). A EMG no trapézio direito, durante a contração, aumentou significativamente, sugerindo melhora da função muscular. A qualidade de vida melhorou considerando os componentes físicos do SF-36 (P<0,05). CONCLUSÃO: A EA mostrou-se confiável no alívio da dor miofascial. Estudos randomizados, cegos e controlados devem ser realizados para confirmar esses resultados. Artigo registrado no Registro Brasileiro de Ensaios Clínicos sob o número RBR-4hb6f6.

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The aim of this study was to assess the electromyographic (EMG) activity and thickness of the masseter and anterior temporalis muscles in children with unilateral posterior crossbite (PCB). Thirty-six children (22 boys, 14 girls, and mean age of 8.8 +/- 1.1 years) were divided into the following groups: The case group with 20 PCB patients (10 on the left side, 10 on the right side); the control group with 16 normal occlusion (NOccl) subjects. EMG activity was recorded with bipolar surface electrodes at rest and during maximal clenching. The muscle thickness was measured with real-time ultrasound. Data were compared between groups and between sides. The correlation between EMG activity and muscle thickness was also evaluated. The data were analyzed using the Shapiro-Wilks test, Pearson's correlation and Spearman as appropriate, paired and unpaired t- test, and Mann-Whitney test. The results revealed that the masseter of the crossbite side was more active than that of the non-crossbite side in PCB group during maximal clenching. The comparisons of EMG activity between PCB and NOccl groups revealed some variability in the results, depending on the crossbite side. The ultrasonographic evaluation did not show statistically significant differences between groups, nor between sides in the PCB and NOccl groups. Significant correlation between EMG activity and thickness was observed only in the left masseter in the NOccl group. In conclusion, these findings showed that asymmetric muscle activity of the masticatory muscles was not related to the thickness of these muscles in children with PCB.

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