**3. Results**

## **3.1. Variation per day of the effective salivation on the continuous vibrotactile stimulation**

We examined whether or not the effective salivation occurred continuously when the vibrotactile stimulation was carried out every day. Normal subjects (26, males 15 and females 11, average age 25) used this apparatus continuously 4 or 5 days *at* the same time and place [8]. Since patients with *decreased* salivation (hyposalivation) had the psychiatric disorder in daily life, we conducted the experiment to realistically approximate the natural condition. In particular, we produced the analysis following the 89 Hz vibrotactile stimulation with 1.9 μm amplitude from the previous experiment, because this frequency produced the most effective salivation. *No gland (right and left parotid glands, and right submandibular and sublingual glands) showed a decreasing tendency with use day after day* [8].

#### **3.2. Facial skin temperature and heart rate in normal subjects**

As shown in **Figure 4A**, facial temperature under vibration apparatus was increased about 0.5°C in 2 or 3 min, and then after 15 min of *continuous stimulation,* it was up by about 0.5°C, too. *Namely, a rise in facial temperature and an increase in RR intervals (decreasing heart rate) by vibration were affected by period of stimulating time. On the other hand, by raising about 200 ms of RR intervals after 15 min an increase in heart rate was observed when the vibration was over. The reason was thought to be parasympathetic activation recoil by vibration stimulation.*

Salivary Effects of Facial Vibrotactile Stimulation in Patients with Sjogren's Syndrome and Poor Salivation http://dx.doi.org/10.5772/intechopen.72383 111

**Figure 4.** Facial skin temperature (A) and heart rate (B) in normal subjects.

#### **3.3. The relationships between affected and unaffected patients after the vibrotactile stimulation**

*In* **Figure 5A**, we showed changes to saliva production (**Figure 5A-a**) and facial temperature (**Figure 5A-b**) in the *patients who were affected* followed the vibrotactile stimulation. On the other hand, in **Figure 5B**, we showed changes to saliva production (**Figure 5B-a**) and facial temperature (**Figure 5B-b**) in *patients who were not affected* followed the vibrotactile stimulation. As shown in **Figure 5A**, the saliva production (elevated state from avg. 0.2 to 1.5 ml) was exponentially increased after about 5 years. The finding was shown as changes to increased face temperature (in a positive direction). However, as shown in **Figure 5B**, the saliva production and facial temperature remained static.

#### **3.4.** *The affected and unaffected* **patients on the vibrotactile stimulation**

*In* **Figures 5** and **6**, *affected* patients were divided into apocatastasis for a long period and for a short period. *Affected* patients with a long period were exponentially increased after about 6 (A), 5 (B) and 1.5 (D) years. Ones with a short period were exponentially increased after about 2 months (E). Facial temperature was increased *with* increased saliva production. On the other hand, in **Figure 7**, *in unaffected patients, the saliva production* and facial temperature remained static.

#### **3.5. Questionnaire data**

**3. Results**

patients.

**stimulation**

**3.1. Variation per day of the effective salivation on the continuous vibrotactile** 

*showed a decreasing tendency with use day after day* [8].

110 Salivary Glands - New Approaches in Diagnostics and Treatment

**3.2. Facial skin temperature and heart rate in normal subjects**

*was thought to be parasympathetic activation recoil by vibration stimulation.*

We examined whether or not the effective salivation occurred continuously when the vibrotactile stimulation was carried out every day. Normal subjects (26, males 15 and females 11, average age 25) used this apparatus continuously 4 or 5 days *at* the same time and place [8]. Since patients with *decreased* salivation (hyposalivation) had the psychiatric disorder in daily life, we conducted the experiment to realistically approximate the natural condition. In particular, we produced the analysis following the 89 Hz vibrotactile stimulation with 1.9 μm amplitude from the previous experiment, because this frequency produced the most effective salivation. *No gland (right and left parotid glands, and right submandibular and sublingual glands)* 

**Figure 3.** Information of subjects. Patients in 8 and 9 showed only poor salivation. Others are Sjögren's syndrome

As shown in **Figure 4A**, facial temperature under vibration apparatus was increased about 0.5°C in 2 or 3 min, and then after 15 min of *continuous stimulation,* it was up by about 0.5°C, too. *Namely, a rise in facial temperature and an increase in RR intervals (decreasing heart rate) by vibration were affected by period of stimulating time. On the other hand, by raising about 200 ms of RR intervals after 15 min an increase in heart rate was observed when the vibration was over. The reason* 

In **Figure 8**, we showed a survey and patients with satisfaction (good) or non-satisfaction (no/ yes or bad) were examined. Patients with satisfaction had many good tendencies, but ones with non-satisfaction had many no/yes and bad.

**Figure 5.** *Patients affected* by a facial vibration. A: salivation gradually increased, and temperature changed to plus tendency near 7 years. On the other hand, patients in B rapidly increased, and temperature changed to plus tendency near 6 years. Patients in C, D and E gradually increased.

**4. Discussion**

is no/yes (red circles).

of each gland.

The continuous use of various sensory stimuli has been known to induce an adaptation [3, 7]. So we examined *the effects of vibrotactile stimulation and the adaptation in normal subjects, when the patients* continuously used this apparatus every day. *The patients' first desire is not to have an increase in salivary secretion from all salivary glands. However, the increase of total secretion quantities is necessary.* So, we first investigated changes in the total secretion quantities of normal subjects with the vibrotactile stimulation using a cotton roll indwelling each duct

**Figure 8.** Summary of vibration effects. Facial vibration produces revitalization of cells of salivary glands. Furthermore, stimulation of vibration is activated at hypothalamus, and parasympathetic nerve is activated again. In particular,

double activation shows 89 Hz frequency and 1.9 μm amplitude is the most effective vibration.

**Figure 7.** Typical examples of questionnaire data. We divided into three types (bad, no/yes and good) during effects of vibration apparatus and condition in oral cavity after vibration. Effect example is good (blue circles), and no-effect one

Salivary Effects of Facial Vibrotactile Stimulation in Patients with Sjogren's Syndrome and Poor Salivation

http://dx.doi.org/10.5772/intechopen.72383

113

On parotid glands, 89 Hz vibrotactile stimuli were shown *to result in* the more effective salivation in the right and left parotid glands and submandibular and sublingual glands,

**Figure 6.** *Patients unaffected* by a facial vibration.

Salivary Effects of Facial Vibrotactile Stimulation in Patients with Sjogren's Syndrome and Poor Salivation http://dx.doi.org/10.5772/intechopen.72383 113

**Figure 7.** Typical examples of questionnaire data. We divided into three types (bad, no/yes and good) during effects of vibration apparatus and condition in oral cavity after vibration. Effect example is good (blue circles), and no-effect one is no/yes (red circles).

**Figure 8.** Summary of vibration effects. Facial vibration produces revitalization of cells of salivary glands. Furthermore, stimulation of vibration is activated at hypothalamus, and parasympathetic nerve is activated again. In particular, double activation shows 89 Hz frequency and 1.9 μm amplitude is the most effective vibration.
