RU2266113C1 - Method for treating syalosis in patients suffering diabetes mellitus - Google Patents

Abstract

FIELD: medicine, stomatology.

SUBSTANCE: it is necessary to perform rinsing with oral remedy named "Corsodil", then comes moisturizing oral mucosa with insulin solution. Additionally, one should apply "Fluorovit" preparation onto mucous membrane of patient's tongue, cheeks and hyoid area by applying spray 30-40 min before meals 3-4 times daily. Moreover, one should apply gel named "Metrogil Denta" onto gingival mucosa once daily. The above-mentioned course consists of 10 seances, this course should be carried out once or twice annually. The innovation enables to decrease clinical signs of xerostomia and the risk for the development of oral mucosal inflammatory diseases in patients suffering diabetes mellitus.

EFFECT: higher efficiency of therapy.

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Description

The invention relates to medicine, dentistry, and can be used to treat sialosis in patients with diabetes mellitus.

There is a method of treating dysfunction of the salivary glands in Sjögren’s disease, when substitution (short-acting insulin solution and calcium pantothenate solution) and secretolytic (immunosymase) therapy were used to treat sialosis, and methyluracil ointment was prescribed for the prevention and treatment of dental diseases in salivary glands gel model “Saliva” (P.I. Ivasenko, A.Yu. Lobastov, D.A. Potashov, V.G.Suntsov, V.B. Nedoseko, V.D. Wagner, O.V.Distergova, O. P. Stepanova. Issues of pathogenesis, clinic, diagnosis, treatment chronic mumps disease (syndrome), Sjögren's and dental manifestations of the Guidelines -.. Omsk 1994.- 19)...

The disadvantages of this method are as follows: the proposed funds due to the lack of production of individual components are difficult to manufacture or have a one-sided effect, and the use of secretolitics, due to absorption in the blood, in some cases, is complicated by allergic reactions, and the therapeutic effect is reduced due to their rapid inactivation. A method for the treatment of sialosis with Sjogren’s disease is low in diabetes.

The invention is aimed at solving the problem: improving the effectiveness of the method of treatment of sialosis in patients with diabetes mellitus against the background of basic therapy.

This task is achieved by a set of measures of local (dental) and basic (endocrinological) therapy, which leads not only to the correction of secretory insufficiency and normalization of the functions and trophism of tissues of the large and small salivary glands, but also to a decrease in the clinical manifestations of xerostomia in the oral cavity and provides reducing the prevalence and severity of periodontal disease, oral mucosa, and also can significantly improve the hygiene of the oral cavity. This is achieved by applying applications on the mucous membrane of drug solutions in a certain sequence.

The method is as follows.

To increase the factors of antibacterial protection of the oral cavity, reduce dysbacteriosis and plaque formation on the teeth in the form of oral baths, the mouthwash “Corsodyl” is used (the patient rinses 2 times a day for 10 ml), the course is 10 days. Corsodyl Mouthwash manufactured by SmithKleinBeach Consumer Helsker, UK, contains 0.2% aqueous solution of chlorhexidine gluconate, 7% ethanol, polyoxyhydrogenated castor oil, sorbitol, peppermint oil and is used as a hygiene product oral cavity, the drug was not used to treat sialosis. Since in sialosis caused by diabetes mellitus, there is a violation of the production of insulin-like protein by the salivary glands, short-acting insulin is used, given its anabolic and local trophic effects. Using a syringe, the mucous membrane is moistened with 5 ml of distilled water, to which 1 drop of insulin (2 units) is added before the procedure. The solution acts in the oral cavity for 2 minutes, during which the patient carefully moistens the tongues of all parts of the oral cavity with the tongue, swallows the remaining solution. At home, patients are prescribed Fluorovit spray 30-40 minutes before meals (3-4 times a day). The patient must rinse his mouth with Rinser “Corsodyl” and independently apply the spray “Fluorovit” on the tongue, mucous membrane of the cheeks and sublingual region. This increases salivation, eliminates the traumatic factor of food and improves the formation of a food lump. Fluorovit is a source of fluorine and a general strengthening agent that stimulates the production of saliva and contains biologically active substances (eftederm, succinic and citric acids, eleutherococcus extract and peppermint oil ), which beneficially affect all metabolic processes both in the oral cavity and in the body as a whole. Ftorovit was manufactured by LDF Medic LLC, Russia, Ekaterinburg (Sanitary and Epidemiological Conclusion No. 77.99.21.916. B.000114.09.03 of 09.29.2003 TU 9163-002-20870795-03). For the treatment of sialosis with diabetes, the dietary supplement "Fluorovit" is not intended. In order to prevent infectious and inflammatory complications in the oral cavity with diabetes, a small amount of Metrogil Denta gel is applied once a day to erosion, fissures, and the changed gingival mucosa, and it is recommended not to eat food for 1 hour. Gel “Metrogil Denta” is produced by Unic Pharmaceutical Laboratory, India, and is used in patients with gingivitis and periodontitis; it has not been used to treat sialosis.

The course of treatment 1-2 times a year for 10 sessions.

Examples of specific performance.

Example 1

Patient Ch., 68 years old. Diagnosis: type 2 diabetes mellitus in the stage of compensation. From the anamnesis: diabetes was discovered in 1984, periods of decompensation occur once a year due to a violation of the diet. The patient is registered at the endocrinologist. In a general blood test, the sugar level during the day ranged from 6.1 mmol / L to 7.8 mmol / L. The patient consulted a dentist complaining of dry mouth. The examination revealed sialosis in the stage of pronounced clinical manifestations. Chronic generalized catarrhal gingivitis. Laboratory diagnostic data for mixed saliva were: pH 5.0; viscosity 3.0; sialometry 0.2 ml / min.

Treatment: 10 ml of Corsodil oral rinse was filled into a glass and the patient was asked to rinse and spit out (2 times), and then 5 ml of the prepared insulin solution (1 drop of short-acting insulin + 5 ml of distilled water) were taken into the syringe and moisturized the mucous membrane, and also asked the patient to continue to moisturize the mucosa with her tongue for 2 minutes. The patient swallowed the solution remaining in the oral cavity and, subsequently, we applied the Fluorovit spray to the tongue, mucous membranes of the cheeks, lips and the bottom of the oral cavity. Since the phenomena of catarrhal gingivitis were detected in this patient, the Metrogil Dent gel was applied in a thin layer on the gum mucosa. After each visit, we recommended the patient not to eat for an hour, and also prescribed 30–40 minutes before meals (3-4 times a day) after rinsing the mouth with mouthwash “Corsodyl”, be sure to apply on the tongue, mucous membrane of the cheeks, lips and under the tongue spray "Fluorovit." At the end of the 10-day course of treatment, the patient noted an improvement in both general well-being and the absence of symptoms of xerostomia, and after 5 sessions the patient completely had no gingivitis. After a new laboratory diagnosis of saliva, the indicators were as follows: pH 6.0; viscosity 2.1; sialometry 0.6 ml / min. The patient was treated once a year.

Example 2

Patient M., 77 years old. Diagnosis: type 1 diabetes mellitus in the stage of compensation. From the anamnesis: diabetes was discovered in 1989 due to a genetic predisposition, periods of decompensation occur 1-3 times a year due to the untimely injection of insulin preparations. The patient is registered at the endocrinologist. In a general blood test, the sugar level during the day ranges from 5.4 mmol / L to 7.0 mmol / L. The patient approached the dentist with complaints of dry mouth. During the examination, the diagnosis was made: sialosis in the stage of pronounced clinical manifestations, chronic generalized catarrhal gingivitis. Laboratory diagnostic data were: pH 4.5; viscosity 3.6; sialometry 0.3 ml / min.

Treatment: 10 ml of Corsodil oral rinse was collected in a glass and the patient was asked to rinse and spit 2 times, then 5 ml of the prepared insulin solution (1 drop of short-acting insulin + 5 ml of distilled water) were taken into a syringe and moistened all sections of the mucosa shells, the patient was asked to continue moisturizing the mucous membrane with his tongue for 2 minutes. The patient swallowed the solution remaining in the oral cavity and, subsequently, we applied it evenly to the mucous membranes of the lips, cheeks, the bottom of the oral cavity and the “Fluorovit” tongue. A thin layer of Metrogil Dent gel was applied to the mucous membrane of the marginal gum and it was recommended not to eat for 1 hour. At home, the patient was prescribed to apply “Fluorovit” spray to the mucosa 30-40 minutes before meals (3-4 times a day), after rinsing the mouth with rinse aid “Corsodyl”. After 1 course of treatment per year, which included 10 procedures, the patient subjectively noted an improvement in salivation. At the end of treatment, the phenomena of chronic generalized gingivitis were completely absent. Sialometry 0.8 ml / min, saliva viscosity 2.0, pH 7.0.

Example 3

Patient V., 55 years old. Diagnosis: type 2 diabetes mellitus in the stage of decompensation. From the anamnesis: diabetes was discovered in 1988. The periods of decompensation occur 1-2 times a year due to a violation of the diet and the untimely intake of insulin preparations. The patient is registered at the endocrinologist. In a general blood test, sugar levels ranged from 7.4 mmol / L to 9.5 mmol / L. The patient addressed the dentist with complaints of ulceration and soreness of the mucous membrane of the lower lip, tooth mobility and bleeding gums, as well as dry mouth. During the examination, the diagnosis was made: sialosis in the stage of pronounced clinical manifestations, periodontal disease of 2-3 severity, chronic recurrent aphthous stomatitis of the mucous membrane of the lower lip, chronic generalized catarrhal gingivitis. Laboratory diagnostic data were: pH 4.0; viscosity of mixed saliva 3.4; sialometry 0.2 ml / min.

Treatment: 10 ml of Corsodyl oral rinse was filled into a glass and the patient was asked to rinse and spit (2 times), and then 5 ml of the prepared insulin solution were filled into the syringe (1 drop of short-acting insulin + 5 ml of distilled water) and moisturized the mucous membrane, and also asked the patient to continue moisturizing the mucous membrane with the tongue for 2 minutes. The patient swallowed the remainder of the solution, and, subsequently, we applied “Fluorovit” on the tongue, lips, cheeks and bottom of the oral cavity with a spray, applied a thin layer of Metrogil Dent gel on the mucous membrane of the marginal and alveolar gums, and on the aft gel under the bandage, which the patient independently removed after 30 minutes. After each visit, the patient was advised to refrain from eating for 1 hour and was prescribed on her own at home 30-40 minutes before eating, after rinsing the mouth with mouthwash “Corsodyl”, apply “Fluorovit” spray on the tongue, mucous lips, cheeks and bottom the oral cavity. At the end of the 10-day course of treatment, we observed complete healing of aphthae and the absence of pain in the mucous membrane of the lower lip, periodontal disease of 1-2 degrees, the phenomena of marginal gingivitis were not present. Subjectively, the patient noted a significant improvement in overall health, a slight decrease in tooth mobility and the absence of bleeding gums. Laboratory diagnosis data at the end of treatment were: pH 6.0; saliva viscosity 1.7; sialometry 0.6 ml / min. After 6 months, the patient was again examined by the dentist, and the course of treatment, including 10 sessions, was repeated. At the end of the second course of treatment, the data of laboratory diagnostics were: pH 6.5; saliva viscosity 1.5; sialometry 1.0 ml / min.

The positive effect of using the proposed method of treatment consists in normalizing the functions and trophism of tissues of the large and small salivary glands, which leads to the regulation of saliva properties, reduction or complete absence of symptoms of xerostomia in the oral cavity, and also prevents and reduces the risk of inflammatory diseases of the mucous membrane of the cavity the mouth. With this course of treatment, a lasting effect is achieved, which will allow a patient with diabetes to contact a dentist no more than 2 times a year.

Claims (1)

A method of treating sialosis in patients with diabetes mellitus by moisturizing the oral mucosa with an insulin solution 1 time per day, characterized in that the moistening is carried out after rinsing with the Corsodyl oral agent and is additionally applied 3-4 times a day to the mucous membrane of the tongue, cheeks and the sublingual region with the help of the spray agent “Fluorovit” 30-40 minutes before meals, and also apply the application on the gum mucosa of the gel “Metrogil Dent” 1 time per day; course - 10 sessions 1-2 times a year.