On 12 November at 15 Janne Tiigimäe-Saar will defend her doctoral thesis „Botulinum neurotoxin type A treatment for sialorrhea in central nervous system diseases“.
Associate Professor Tiia Tamme (dr. med.), Institute of Dentistry
Professor Pille Taba (dr. med.), Head of Department, Professor in Neurology
Associate Professor Merete Bakke (PhD), Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen
Drooling or sialorrhea is defined as an inability to control oral secretions, resulting in excessive saliva accumulation in the oropharynx. Sialorrhea may occur in several neurological disorders including infantile cerebral palsy, amyotrophic lateral sclerosis and Parkinson's disease. Mostly the problem is not related to overproduction of saliva but is a result of changes in co-ordinated control mechanism and reflectory process of swallowing musculature.
Botulinum neurotoxin (BNT-A) has been used for treatment of several neurological disorders (dystonias, spasticity) for decades, but recently its effectiveness in treating sialorrhoea has been reported as a novel option. BNT-A decreases salivation.Changes in saliva could affect oral health, because saliva has a cleansing and antibacterial effect.
The aim of the study was to investigate the safety and efficacy of BNT-A injections into salivary glands for the treatment of sialorrhea in patients with central nervous system diseases
We also aimed to assess changes in saliva amount that might affect the oral microflora and saliva characteristics.
The results of the study showed that saliva amount decreased statistically significantly after BNT-A treatment. Malocclusion in cerebral palsy patients affected salivary flow intenstity. Parkinson's disease patients with akinesia-rigidity had more sialirrhea compared to patients with tremor. No statistically significant changes in salivary composition and the level of S. mutans found, but the level of Lactobacilli counts raised after BNT-A injections.
Intrasalivary gland injections of BNT-A are effective in the treatment of drooling but could decrease self-cleaning ability.