SALIVA: A VALUABLE LIQUID

By Nikos Papadakis, Dental Surgeon

Composition: Saliva is a colourless, odourless, non-transparent liquid, constituted mostly of water but including many solid components, the biggest part of which are organic substances, and some inorganic. Among the organic substances are: proteins, carbohydrates, amino-acids, urea, uric acid, and enzyme vitamins, as well as the ABO blood agglutinins which have forensic value. Some of its inorganic elements are calcium, phosphate, sodium, potassium, iodine and fluorine.

Excretion: It is excreted by the salivary glands in the lower jaw, which produces the largest quantity of saliva, and other glands throughout the mouth cavity which produce lesser amounts. The excretion of saliva is continuous – with fluctuations – throughout the 24 hours. The total produced quantity equals about one bottle of water daily.

Function:

1) Mechanical protection of mucous membrane in the mouth while chewing, as well as immunological protection by the excretion of antibodies. Also contains enzymes with antibacterial action

2) Helps in the ingestion

3) Helps digestion

4) Helps to expulse various metabolic products

5) Enhances flavour

6) Protects teeth from decay by decreasing acidity created by carbohydrate consumption

The saliva’s value becomes obvious in cases where its production decreases for various reasons. If that happens, ulcers appear in the mouth which requires the use of saliva substitutes. Here, we must point out that though the quantity of saliva varies in people, the more saliva produced the better the protection from tooth decay. Older people with dry mouth syndrome can use saliva substitute or special gum to induce excretion.

Saliva and the Dentist: It is an undesirable element in general for the dentist, who must use suction. However, in the case of dentures or partials, it holds them up by suction action. 

Conclusion: The saliva undeniably is the best shield of protection for the teeth and the entire mouth more generally, despite its unwelcome presence for us dentists.

OSTEOPOROSIS… THE SILENT EPIDEMIC?

By Manthos Mattheakis
Orthopedic Surgeon, Trauma Specialist

That’s how we characterize the disease today, the silent epidemic. It is a frequent and silent disease because it sneaks up and installs itself mostly without pain.

What is osteoporosis? It is the disease where we have reduction of bone density and, as a result, the danger of fractures exists. More often, fractures concern the hips, the spine and the wrists. In advanced osteoporosis the fractures occur without any force to the bones (automatic fractures).

What are the causes?  The bone is a live network that metabolizes, that is, it continuously splits, it gets absorbed and takes shape again. This repair work has been undertaken by two bone cells: osteoblasts and osteoclasts. Osteoclasts remove old bone and osteoblasts produce and reposition an equal amount of new durable bone. Their relationship before the occurrence of osteoporosis is harmonious.  Menopause, advanced age, various medicines like cortisone, insufficient calcium, sedentary life and limited exercise disturb the balance relationship of the cells so the osteoblasts produce less bone than the bone removed which in turn results in weakened bones.  

A frequent disease. Osteoporosis affects six to seven percent of the population. However, that number has grown in the past few years, especially since the duration of life has increased. This disease occurs with great frequency in the western world and affects more often women. Four in 10 women will have one or more fractures due to osteoporosis in their life time. Studies have shown that one in two women have at least one fractured vertebra, while one in six women at 75 years of age is more likely to suffer a fractured hip.

How is it diagnosed? By measuring the bone density, which is called internationally D.E.X.A. This method has minimal radiation, is reliable enough and usually is done in the lumbar spine region or the hip. Measuring various biochemical indices of the metabolism of bones after the menopause in conjunction with measuring the bone mass can help calculate the degree of bone density loss.

Treatment.  The essential treatment of osteoporosis is prevention. Once it occurs, treatment, in the best cases, can stabilize or slow down the rhythm of bone loss while it very rarely makes it disappear. A correct nutrition (dairy products, foods rich in vitamin D) and exercise of 30 minutes three times a week is suggested, while stopping smoking and avoiding drugs like cortisone are key factors in its prevention.  The pharmaceutical road suggested to prevent further deterioration once the disease has settled is calcium, vitamin D, bisphosphonates and estrogens. Surgery can also be used for vertebrae fractures but with restrictive results for the patient.   

Newer finds about osteoporosis. Scientists have found that when too large a quantity of serotonin (a chemical substance that is produced in the intestine and is channelled to the blood) reaches the bones, they gradually deteriorate. Perhaps, the secret to combat osteoporosis hides in the intestine.