Malnutrition, Child Clinical Trial
Official title:
Use of Low-level Laser Therapy on Children Aged One to Five Years With Energy-protein Malnutrition
Malnutrition is a clinical-social disease caused by multiple prenatal, intrauterine and
postnatal factors as well as social, political and cultural determinants (distal causes).
Despite the global and national reductions in the number of cases, malnutrition continues to
be a public health problem, with greater prevalence in pockets of poverty found in the
northern and northeastern regions of Brazil.
Episodes of malnutrition in early childhood, with consequent calcium, phosphate and vitamin
A, C and D deficiencies, can increase one's susceptibility to dental caries through three
probable mechanisms: defects in tooth formation (odontogenesis), delayed tooth eruption and
alterations in the salivary glands.
It is likely that the significant increase in susceptibility to caries in malnourished
individuals stems from alterations in the salivary secretion rate, since a reduction in
salivary flow (salivary gland atrophy) increases the susceptibility to both dental caries and
dental erosion. As saliva is the main defense factor of the oral cavity, a reduction/change
in its physical properties (secretion rate and buffering capacity) can cause immunological
disorders that affect an individual's defense capacity.
Studies have demonstrated that salivary immunoglobulin A (IgA) also plays an important role
in the immunity of the oral mucosa. Indeed, patients with IgA deficiency can experience
recurring upper airway (tonsillitis, ear infection and sinusitis), lower airway (pneumonia)
and gastrointestinal (diarrhea and parasitosis) infections.
The investigation of mechanisms that can reduce the impact of malnutrition on the defenses of
the organism is of the utmost important and interest to public health. Among such mechanisms,
low-level laser therapy has demonstrated effectiveness in the treatment of diverse conditions
and disease through the promotion of the biomodulation of the cell metabolism and due to its
analgesic and anti-inflammatory properties with no mutagenic or photothermal effects.
Laser stimulation of the major salivary glands to produce more saliva occurs through the
increase in local circulation due to vasodilatation, the induction of the proliferation of
glandular cells and cell respiration/ATP (adenosine triphosphate) synthesis as well as the
release of growth factors and cytokines to stimulate protein exocytosis. With regard to an
increase in salivary IgA, low-level laser intensifies the activation of B lymphocytes, which
differentiate into plasma cells, thereby contributing to the increase in immunoglobulin
levels.
The study of salivary aspects in malnourished children and possible treatments that can be
used to improve salivary quality and quantity in these children has significant social
relevance, as saliva is one of the main mechanisms against infection and participates in
essential functions of life, such as swallowing and the maintenance of oral health.
An experimental cross-sectional study is proposed, which will be conducted at the Center for
Educational and Nutrition Recovery in the city of Maceió, state of Alagoas, Brazil, and
University Nove de Julho (UNINOVE) in the city of Sao Paulo, Brazil. This project has been
approved by CESMAC ethics committee (CAAE 71961317.1.0000.0039).
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