• The Journal of Korean Medicine
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• v.34 no.3
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• pp.13-24
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• 2013

Objectives: The aims of this study were to investigate the availability of diagnosis of Yin-deficiency in the elderly with xerostomia and factors influencing subjective oral dryness. Methods: We surveyed 50 patients recruited by the clinical trial, 'Efficacy of Yukmijihwang-tang on Xerostomia in the Elderly: A Randomized, Double-blind, Placebo-controlled, Two-center Trial'. The subjects were assessed on their subjective oral dryness using the Dry Mouth Symptom Questionnaire (DMSQ). Their salivary functions were measured by Unstimulated Salivary Flow Rate (USFR) measurements. In addition, the subjects were evaluated on their Qi-stagnation and Yin-deficiency conditions using the Qi-stagnation questionnaire and Yin-deficiency questionnaire. Results: There were statistically significant correlations between three variables (USFR, DMSQ score and Qi-stagnation score) and Yin-deficiency score. In the multiple regression analysis, the regression model was statistically significant (F = 10.273, p < .001). The factor most strongly influencing the subjective oral dryness was USFR (${\beta}$ = -0.386). Yin-deficiency had the next strongest impact on the subjective oral dryness (${\beta}$ = 0.371). Qi-stagnation affected the subjective oral dryness weakly (${\beta}$ = 0.075). In the simple regression analysis, Yin-deficiency had a statistically significant effect on each of six subscales of DMSQ (p < .01). Among the six subscales, DMSQ-1 ('Oral dryness at night or on awakening') was the most strongly influenced by Yin-deficiency. Conclusions: The results of this study show that the diagnosis of Yin-deficiency in the elderly with xerostomia was available and Yin-deficiency was an important factor influencing the subjective oral dryness. Therefore, the consideration of Yin-deficiency is significant for diagnosis and treatment in the elderly with xerostomia.

• Radiation Oncology Journal
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• v.22 no.2
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• pp.106-114
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• 2004

Purpose : This study was done to evaluate xerostomia fellowing intensity modulated radiotherapy for patients with head and neck cancer, and to analyze the correlation between the dosimetric parameters and xerostomia parameters. Materials and Methods : From February till October 2003, 13 patients with 3 months of follow-up were evaluated for xerostomia after being treated for head and neck cancer with IMRT. Their median age was 57 years(range: 43$\~$77). Xerostomia were assessed with a 4-question xerostomia questionnaire score (XQS) and a test for salivary flow rates (unstimulated and stimulated). The patients were also given a validated LENT SOMA scale (LSC) questionnaire. The evaluations were completed before radiation therapy (pre-RT) and at 1 and, 3 months after radiation therapy (RT). We evaluated xerostomia at pre-RT, 1 and, 3 months after RT. The association between the xerostomia parameters (XQS and LSC) and salivary flow rates (unstimulated and stimulated: USFR and SSFR) was assessed at 1 and 3 months after RT. Resrlts : All 13 patients showed no significant changes in XQS, LSC and Salivary Flow rates. As a result, we couldn't find out about xerostomia development. Based on the total mean parotid dose, 3,500 cGy, we divided these patients into two groups. The 8 patients (<3,500 cGy) showed no significant changes in XQS, LSC and Salivary Flow rates However, in 5 Patients ($\geq$3,500 cOGy), there was a significant increase in USFR and, SSFR at 3 months after RT, and for the XQS and, LSC at 1 and 3 months after RT. The correlation between XQS and, LSC, and USFR and, SSFR in ail patients (13) was significant at 3 months after RT. The correlation had a tendency to the decrease for USFR and, SSFR in proportion to the increase of XQS and, LSC. Conclusion : Based on the results of this study, IMRT seem to be an effective treatment to significantly decrease the xerostomia. XQS and, LSC seem to be a effective tool for predicting the xerostomia. A total parotid gland mean dose of <3,500 cGy should be a planning goal if substantial sparing of the gland function is desired. Furthermore, patients should be enrolled in a study to define a more accurate threshold dose for the parotid gland.

• The Journal of Internal Korean Medicine
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• v.32 no.4
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• pp.473-486
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• 2011

Objectives : This study was designed to investigate the clinical characteristics and usefulness of comprehensive diagnosis of Yin-deficiency and heart rate variability in patients with burning mouth syndrome (BMS). Methods : We surveyed 30 burning mouth syndrome patients visiting the Oral Diseases Clinic of Kyung Hee University Oriental Medicine Hospital from April to September of 2011. The subjects were evaluated on self-assessed severity of burning mouth syndrome and xerostomia using visual analogue scale (VAS) score and Yin-deficiency condition (based on the 10-item Yin-deficiency questionnaire). Salivary function was measured by the unstimulated salivary flow rate (USFR), and heart rate variability (HRV) parameters were recorded by SA-2000E (Medicore Co., Ltd., Korea). Results : There were substantial significant positive correlations between burning sensation VAS scores in mouth and Yin-deficiency scores. There was significant negative correlation between xerostomia VAS score and USFR. Compared to the normal range of total power (TP) in HRV parameters, the burning mouth syndrome patients showed significant lower values of TP. Conclusions : The results of this study suggest that comprehensive diagnosis of Yin-deficiecny and HRV parameters are useful in diagnosing of burning mouth syndrome patients. Therefore, we assume that improvement of Yin-deficiency condition can be a potentially effective way to treat burning mouth syndrome.

• Journal of Oral Medicine and Pain
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• v.41 no.3
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• pp.99-109
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• 2016

Purpose: This study investigated factors influencing the xerostomia symptoms in the patients with temporomandibular disorders (TMDs). Methods: Eighty-six participants over the age of twenty were randomly enrolled from patients with TMDs. The patients were diagnosed by Diagnostic Criteria-TMD (DC-TMD). Intensity of the pain and level of stress of the patients were recorded using TMD pain visual analogue scale (VAS) and stress VAS, respectively. The Symptom Checklist-90-Revised (SCL-90R), dry mouth symptom questionnaire, unstimulated salivary flow rate (USFR) and oral moisture were measured. Results: The patients who had above the mean of the TMD pain VAS had significantly higher scores on the stress VAS, subjective dry mouth symptoms and T-score of somatization. The patients who suffered from pain more than three months had significantly higher TMD pain VAS, subjective dry mouth symptoms and T-score of somatization. There were no significant differences in xerostomic symptoms according to the diagnosis of TMDs. Moreover, TMD pain VAS and the stress VAS did not correlated to USFR and oral moisture. Conclusions: The level of individuals' TMD pain and stress significantly affect their subjective dry mouth symptoms, however, it did not affect USFR and oral moisture.

• The Journal of Korean Medicine
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• v.32 no.4
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• pp.100-110
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• 2011

Objectives: The aim of this study was to investigate the usefulness of a comprehensive diagnosis of yin-deficiency and heart rate variability in halitosis patients. Methods: We surveyed 62 halitosis patients visiting the Halitosis Clinic in the Kyung Hee University Oriental Medicine Hospital from August 2010 to April 2011. The subjects were evaluated on self-assessed severity of halitosis and xerostomia using visual analogue scale (VAS) score and yin-deficiency condition (based on the 10-item Yin-deficiency Questionnaire). Salivary function was measured by the unstimulated salivary flow rate (USFR) and heart rate variability (HRV) parameters were recorded by SA-2000E (Medicore Co. Ltd., Korea). Results: There were substantial significant positive correlations between halitosis, xerostomia VAS scores and yin-deficiency scores. There was significant negative correlation between xerostomia VAS score and USFR. Compared to the normal USFR group (USFR>0.1$m{\ell}$/min), the decreased USFR group (USFR${\leq}0.1m{\ell}$/min) showed significant lower values of Total Power (TP), Lower Frequency (LF), and High frequency (HF). Conclusions: The results of this study suggest that the comprehensive diagnosis of yin-deficiency and HRV are useful in diagnosing of halitosis patients with xerostomia. Therefore, we assume that improvement of yin-deficiency condition can be a potentially effective way to treat halitosis with xerostomia.

• The Journal of Internal Korean Medicine
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• v.39 no.3
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• pp.363-371
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• 2018

Objective: The aim of this study was to investigate the clinical characteristics of patients showing fissured tongue (FT) with burning mouth syndrome (BMS). Methods: We reviewed the clinical records of 16 FT patients with BMS who visited the Oral Diseases Clinic of Kyung Hee University Korean Medicine Hospital from March 1, 2017 to February 28, 2018. The subjects were graded by FT classification and compared with each group on a numeral rating scale (NRS) of tongue pain, proportion of coated tongue, unstimulated salivary flow rate (USFR), Ryodoraku, and heart rate variability (HRV) results. Results: FT grade had no significant correlation with NRS of tongue pain and USFR. FT grade had a substantially significant positive correlation with BMI and LF/HF ratio in HRV. FT grade had a substantially significant negative correlation with proportion of coated tongue. The most frequent accompanying symptoms were xerostomia and insomnia. Conclusions: The results of this study suggest that FT has no correlation with tongue pain in BMS. Rather, FT seems to correlate with sympathetic function acceleration.

• The Journal of Internal Korean Medicine
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• v.39 no.4
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• pp.699-707
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• 2018

Objectives: This study was designed to investigate characteristics of digital infrared thermal imaging (DITI) and quantitative evaluations in patients with burning mouth syndrome (BMS). Methods: We reviewed the clinical records of 38 patients with BMS who visited the Oral Diseases Clinic of Kyung Hee University Korean Medicine Hospital from March 1st, 2018 to June 30th, 2018. The subjects were evaluated with digital infrared thermal imaging (DITI) and for heart rate variability (HRV), unstimulated salivary flow rate (USFR), and the proportion of coated tongue. Results: Most patients showed higher temperatures on the central part of the tongue (T2) than on the middle of the forehead (T1). The patients tended to have a high Low frequency/High frequency (LF/HF) ratio. Statistically significant negative correlations were noted between the age of patients and the temperature of T1 and T2. Statistically significant negative correlations were also observed between the LF/HF ratio and 'T1-T2' values. Conclusions: This study suggests that DITI and HRV are useful for the validation of patients with BMS. Correlations between the result values suggest that sympathetic function acceleration is related to temperature distribution and, ultimately, to symptoms.

• The Journal of Internal Korean Medicine
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• v.35 no.4
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• pp.532-545
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• 2014

Objectives: The purpose of this study was to evaluate the clinical effect of Korean medical treatments such as herbal medicine, acupuncture, and electroacupuncture by using the portable gas chromatograph OralChroma$^{TM}$ (Abimedical, Japan) in halitosis patients. Methods: We surveyed 30 halitosis patients who had visited the Oral Diseases Clinic in the Korean Medical Hospital of Kyunghee University from October, 2013 to November, 2014. Before starting Korean medical treatment, the subjects were evaluated on sociodemographic characteristics, severity of discomfort using visual analogue scale (VAS), unstimulated salivary flow rate (USFR), and halitosis associated life-quality test (HALT) score. To evaluate the therapeutic effect, we measured the volatile sulfur compounds (VSCs) in breath by using OralChroma$^{TM}$ before and after 3 weeks treatment. Results: The concentration of total VSCs measured by OralChroma$^{TM}$ significantly decreased (p=0.001). Furthermore, the level of hydrogen sulfide and methyl mercaptan also significantly decreased (p<0.05). However, although the level of dimethyl sulfide decreased as well, there was no significance(p>0.05). Conclusions: Korean medical treatment was effective in treating halitosis by decreasing VSCs. Further study, with well-designed randomized controlled trials with larger number of cases will be needed in the future.