IADR Abstract Archives
The Impact of Intensive Exercise on Saliva – a Systematic Review and Meta-Analysis.
Objectives: The mechanisms that explain dental erosion in athletes remain unclear. We assessed effects of physical training on salivary parameters as a potential mechanism of dental erosion.
Methods: The systematic review was performed following the PRISMA guidelines. A systematic search was conducted in the following databases: Medline (Ovid) Scopus, Web of Science, Sportsdiscus and grey literature using MeSH terms up to January 2021. One researcher individually selected the studies according to the eligibility criteria (athletes, physical activity, salivary parameters) and performed data extraction and methodological evaluation. Secondary screening was performed by two additional researchers to assess included studies. A random effects model was adopted in the meta-analysis. Certainty of the evidence was assessed using the GRADE approach. The outcomes assessed were the salivary parameters: saliva flow rate, salivary IgA concentration, saliva total protein (STP) content, salivary α-amylase and salivary mucins in individuals after periods of intense exercise.
Results: The inter examiner agreement at full-text screening was excellent (kappa score = 0.72). Thirty-one studies were included in the systematic review of which fifteen studies were included in the meta-analyses. Eight studies were considered as low risk of bias, seventeen moderate risk and two studies were at high risk of bias. The results of the meta-analysis indicated that there was no statistically significant effect of intense physical activity on saliva flow rate (effect size: -0.01) (p=0.88), salivary IgA (effect size: -12.93) (p=0.14), STP (effect size: -596.81) (p=0.30), salivary α-amylase (effect size: 12.68) (p=0.12) and salivary mucins (effect size: 0.73) (0.44) with extremely high heterogeneity (>70%). However, the certainty of the evidence obtained by GRADE for all outcomes was very low.
Conclusions: Intense exercise was not related to alterations in the salivary parameters which were hypothesised to cause dental erosion in athletes. However, we observed high heterogeneity and substantial risk of bias
Methods: The systematic review was performed following the PRISMA guidelines. A systematic search was conducted in the following databases: Medline (Ovid) Scopus, Web of Science, Sportsdiscus and grey literature using MeSH terms up to January 2021. One researcher individually selected the studies according to the eligibility criteria (athletes, physical activity, salivary parameters) and performed data extraction and methodological evaluation. Secondary screening was performed by two additional researchers to assess included studies. A random effects model was adopted in the meta-analysis. Certainty of the evidence was assessed using the GRADE approach. The outcomes assessed were the salivary parameters: saliva flow rate, salivary IgA concentration, saliva total protein (STP) content, salivary α-amylase and salivary mucins in individuals after periods of intense exercise.
Results: The inter examiner agreement at full-text screening was excellent (kappa score = 0.72). Thirty-one studies were included in the systematic review of which fifteen studies were included in the meta-analyses. Eight studies were considered as low risk of bias, seventeen moderate risk and two studies were at high risk of bias. The results of the meta-analysis indicated that there was no statistically significant effect of intense physical activity on saliva flow rate (effect size: -0.01) (p=0.88), salivary IgA (effect size: -12.93) (p=0.14), STP (effect size: -596.81) (p=0.30), salivary α-amylase (effect size: 12.68) (p=0.12) and salivary mucins (effect size: 0.73) (0.44) with extremely high heterogeneity (>70%). However, the certainty of the evidence obtained by GRADE for all outcomes was very low.
Conclusions: Intense exercise was not related to alterations in the salivary parameters which were hypothesised to cause dental erosion in athletes. However, we observed high heterogeneity and substantial risk of bias