Changes in the Oral Cavity Mucosal Surface under the Influence of Wearing Protective Face Masks—Nitric Oxide Concentration Analysis—Preliminary Report

Round 1

Reviewer 1 Report

The comments are included in the file attached hereto.

Comments for author File: Comments.pdf

Author Response

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Author Response File: Author Response.docx

Reviewer 2 Report

Dear authors, 

This work is really interesting, dealing with a trending topic. However, in this field, it could have been done more. Some major revision are needed: 

1. title - nitric oxide should be written in the extended form

2. Abstract - line 23 - please correct: example nitric oxide (NO). 

3. Introduction - line 102 - The dryness is responsible for most of the problems with the teeth' hard tissues and oral mucosa. This phrase should be milder. e.g., the dryness could contribute 

4. Statistics and Results - Statistical analysis is poor. Please try to change the statistical method with a GLM for different time points. You wrote that measurement of NO concentration in exhaled air was done twice. But it seems that you measured it three times: before starting work, before 8 hours of having a mask, and 1.5 hours after a meal (while you eat I think you don't wear a mask - I hope). This is a bias. Moreover, the results didn't convince me: Looking at Figure 2 (very poor editing - please attach a better quality graph) the graph did not match with the p-value. When you have these tiny differences even in the standard deviation, you could have missed the sample size or the study design. 

Best regards

 

Author Response

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Author Response File: Author Response.docx

Reviewer 3 Report

Congratulations to the authors for this excellent and interesting study. The manuscript represents an important contribution in the field of infection prevention and protective devices, especially in times like these.

The examination is very important in order to raise awareness for the rational use and handling of protective masks and to face potential negative impact on healthcare workers and patients. I was very surprised how diverse the effects can be. In my view the authors processed and discussed this interesting issue in a precise way and provide valuable information.

Scientific content is valid, issue is introduced conviently, methods are sound and results are reported clearly, discussion  contains solid arguments.

Nevertheless I have some amendmends:

section Introduction is too detailed and should be shortened; the same applies for section discussion.

possible add on for further studies or add on for next study protocol:
performing microbial samples from masks after application and samples of oral flora before and after wearing the masks.

 

 

 

 

Author Response

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Author Response File: Author Response.docx

Reviewer 4 Report

The article "The changes in the oral cavity mucosa surface under the influence of wearing protective face masks – NO concentration analysis – preliminary report" aims to highlight the changes in the mucosa and NO emissions among healthy subjects wearing face masks for long periods.

-        Abstract:  Reformulation type of study (see line 23)

-        Introduction:

o   Somewhat long; I recommend reformulation of the information regarding SARS-COV-2 infection

o   Regarding the WHO recommendations, those of April 2020 are not the last. The recommendations were updated in December 2020. https://apps.who.int/iris/bitstream/handle/10665/337199/WHO-2019-nCov-IPC_Masks-2020.5-eng.pdf?sequence=1&isAllowed=y and in December 2021.

o   I do not consider the information regarding "septic shock" relevant for the current study; I think they can be removed instead you can refer to iNOS expression levels in human periodontal disease tissue than in healthy periodontal tissue

-        Unformulated hypothesis

-      Material and method

o What kind of questions are found in the questionnaire?

o Who performed the oral clinical examination? Did you also evaluate the level of oral hygiene?

o How did you determine that the patient does not have other associated pathologies unknown to them?

o Do change patients in subjects because the participants in the study are considered healthy

- Results: they are partial highlighting the changes in the concentration of NO in the breathed air. There are only a few subjective references regarding the sensation of dry mouth; maybe you can also do the analysis in relation to other variables (depending on the questions in the questionnaire)

- Discussions:

o In line 225, the C0VID-19 virus must be changed to SARS-COV-2

o There are many references to NO and general and oral pathologies. There are no arguments regarding the increase in NO emission in healthy subjects.

- Conclusions:  Somewhat generalists. Be more specific in relation to the purpose of the study and the results obtained.

 

Author Response

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Author Response File: Author Response.docx

Round 2

Reviewer 2 Report

Dear authors,

Thanks for providing the modification requested by the reviewers. 

Best regards 

Reviewer 4 Report

Hello.

After the changes made in the content of the article, I consider that it is in an acceptable form for policing. Thank you for your cooperation. Good luck in your future scientific activity.