CONTEXT: The effect of sour taste and food temperature variations in dysphagic patients has not been entirely clarified. OBJECTIVE: To determine the effect of sour and cold food in the pharyngeal transit times of patients with stroke. METHODS: Patients participating in this study were 30 right-handed adults, 16 of which were male and 14 were female, aged 41 to 88 (average age 62.3 years) with ictus varying from 1 to 30 days (median of 6 days). To analyze the pharyngeal transit time a videofluoroscopy swallow test was performed. Each patient was observed during swallow of a 5 mL paste bolus given by spoon, totaling four different stimuli (natural, cold, sour and cold sour), one at a time, room temperature (22ºC) and cold (8ºC) were used. Later, the tests were analyzed using specific software to measure bolus transit time during the pharyngeal phase. RESULTS: The results showed that the pharyngeal transit time was significantly shorter during swallow of cold sour bolus when compared with other stimuli. Conclusion - Sour taste stimuli associated to cold temperature cause significant change in swallowing patterns, by shortening the pharyngeal transit time, which may lead to positive effects in patients with oropharyngeal dysphagia.

RESUMO Objetivo: O objetivo deste estudo foi analisar o comportamento alimentar de crianças e adolescentes com transtorno do espectro autista. Métodos: Participaram deste estudo 21 crianças e adolescentes com TEA, na faixa etária de 2 a 14 anos de idade, de ambos os sexos. Foi aplicado um questionário sobre o comportamento alimentar com os 21 pais e/ou responsáveis das crianças. Esse instrumento é composto por 53 questões, distribuídas nas seguintes categorias: Motricidade na mastigação; Seletividade alimentar; Aspectos comportamentais; Sintomas gastrointestinais; Sensibilidade sensorial e Habilidades nas refeições. Resultados: A análise dos dados obtidos revela que as crianças com TEA apresentaram maiores alterações no comportamento alimentar nas categorias Seletividade alimentar (34,4%), Aspectos comportamentais (27,1%) e Motricidade na mastigação (21,9%). E houve correlação entre a categoria Motricidade na mastigação com todas as outras categorias. Houve também correlação entre seletividade alimentar com aspectos comportamentais e aspectos comportamentais com sensibilidade sensorial e habilidades nas refeições. Conclusão: Portanto, é possível observar que, no comportamento alimentar de crianças e adolescentes com TEA, há uma tendência a seletividade alimentar, comportamentos habituais durante as refeições e dificuldades motoras no que se refere à mastigação e à ingestão dos alimentos.

Background: Oropharyngeal dysphagia is common in individuals after stroke. Taste and temperature are used in dysphagia rehabilitation. The influence of stimuli, such as taste and temperature, on swallowing biomechanics has been investigated in both healthy individuals and in individuals with neurological disease. However, some questions still remain unanswered, such as how the sequence of offered stimuli influences the pharyngeal response. The goal of the present study was to determine the influence of the sequence of stimuli, sour taste and cold temperature, on pharyngeal transit time during deglutition in individuals after stroke. Methods: The study included 60 individuals with unilateral ischemic stroke, 29 males and 31 females, aged 41–88 years (mean age: 66.2 years) examined 0–50 days after ictus (median: 6 days), with mild to moderate oropharyngeal dysphagia. Exclusion criteria were hemorrhagic stroke patients, patients with decreased level of consciousness, and clinically unstable patients, as confirmed by medical evaluation. The individuals were divided into two groups of 30 individuals each. Group 1 received a nonrandomized sequence of stimuli (i.e. natural, cold, sour, and sour-cold) and group 2 received a randomized sequence of stimuli. A videofluoroscopic swallowing study was performed to analyze the pharyngeal transit time. Four different stimuli (natural, cold, sour, and sour-cold) were offered. The images were digitalized and specific software was used to measure the pharyngeal transit time. Since the values did not present regular distribution and uniform variances, nonparametric tests were performed. Results: Individuals in group 1 presented a significantly shorter pharyngeal transit time with the sour-cold stimulus than with the other stimuli. Individuals in group 2 did not show a significant difference in pharyngeal transit time between stimuli. Conclusions: The results showed that the sequence of offered stimuli influences the pharyngeal transit time in a different way in individuals after stroke and suggest that, when the sour-cold stimulus is offered in a randomized sequence, it can influence the response to the other stimuli in stroke patients. Hence, the sour-cold stimulus could be used as a therapeutic aid in dysphagic stroke patients.

Alveolar bone repair is a complex and extremely important process, so that functions such as the mastication, occlusion and osseointegration of implants can be properly reestablished. Therefore, in order to optimize this process, many procedures have been used, such as grafting with biomaterials and the application of platelet-rich fibrin (PRF). Another method that has been studied is the use of photobiomodulation (PBM) with the use of low-level laser therapy (LLLT), which, through the absorption of photons by the tissue, triggers photochemical mechanisms in the cells so that they start to act in the search for homeostasis of the affected region. Therefore, the objective of this review was to analyze the use of LLLT as a possible auxiliary tool in the alveolar bone repair process. A search was carried out in scientific databases (PubMed/MEDLINE, Web of Science, Scopus and Cochrane) regarding the following descriptors: “low-level laser therapy AND alveolar bone repair” and “photobiomodulation AND alveolar bone repair”. Eighteen studies were selected for detailed analysis, after excluding duplicates and articles that did not meet predetermined inclusion or non-inclusion criteria. According to the studies, it has been seen that LLLT promotes the acceleration of alveolar repair due to the stimulation of ATP production, activation of transcription and growth factors, attenuation of the inflammatory process and induction of angiogenesis. These factors depend on the laser application protocol, and the Gallium Aluminum Arsenide—GaAlAs laser, with a wavelength of 830 nm, was the most used and, when applications of different energy densities were compared, the highest dosages showed themselves to be more efficient. Thus, it was possible to conclude that PBM with LLLT has beneficial effects on the alveolar bone repair process due to its ability to reduce pain, the inflammatory process, induce vascular sprouting and, consequently, accelerate the formation of a new bone matrix, favoring the maintenance or increase in height and/or thickness of the alveolar bone ridge.

This study compared the oral hygiene and oral microbiota in children and young people with neurological impairment and oropharyngeal dysphagia with and without gastrostomy. Forty children and young people participated in this study: 19 females and 21 males, aged 2 to 22 years (mean age 8.6 years). Participants were divided into two groups: group I (GI = 20) with gastrostomy and group II (GII = 20) without gastrostomy (with oral feeding). Oral hygiene was assessed using the Simplified Oral Hygiene Index (SOHI). Analysis of two bacteria, Streptococcus mutans and Streptococcus sobrinus, was performed by collecting saliva using an oral swab, then mRNA expression was evaluated using the polymerase chain reaction (PCR) technique. The oral hygiene index had a general median of 2.2, and the two groups were statistically different (Group I: median 2.9 and Group II: median 2.0) (p = 0.01751). Bacterial analysis indicated 13 individuals with S. mutans and none with S. sobrinus. Of the 13 individuals with S. mutans, 6 were from Group I and 7 from Group II. Those with gastrostomy had worse oral hygiene, and both groups harbored the bacterium S. mutans.