The SaliPen’s Role in ACESO, An Oral Healthcare Digital Platform
January 2, 2025 | Aging / Dry Mouth / Oral Health / SaliPen® / Saliva / Salivary Glands / Xerostomia
Researchers and developers from the IT Center for Science and Technology (CITST) in Romania have created a project called the ACESO platform, a digital initiative designed to enable older and elderly adults to take a proactive part in their oral healthcare, alongside their physicians.
The project went through several meticulous stages of research, development, testing, and optimization to achieve a platform that uses data analytics from smart toothbrushes and the SaliPen, a cutting-edge oral electrostimulation device for dry mouth treatment. TheSaliPen seamlessly integrates into advanced electronics and software, offering easy connectivity to communication systems. Its innovative design and functionality led to its selection as a key component of the ACESO platform, which uses the data it collects to help patients and caregivers improve oral healthcare.
The ACESO platform was designed to perform several functions:
- Monitor physical health parameters such as blood pressure, glucose levels, activity, and sleep via monitoring sensors.
- Actively involve users in their oral health routines via reminders for regular monitoring, medication, and other self-care practices.
- Improve oral care through a personalized brushing experience based on user brushing behavior.
- Help caregivers optimize interventions and coach patients via remote digital assessment tools.
ACESO’s target market is composed of three groups:
- Primary users: People aged 60+ who want to improve their physical and oral health care.
- Secondary users: Dentists and hygienists, who want to improve patient care and reach out to more patients who live in remote areas.
- Tertiary users: Insurance companies, which were considered for the business aspects of the project.
Project Phases
Developers took the ACESO platform through four different phases of research, development, and creation.
Phase I
Researchers looked at various oral care and health monitoring platforms related to the proposed ACESO platform. They researched different smart methods of oral healthcare monitoring, such as inertial sensors placed around the user’s wrist, to be used in conjunction with a manual toothbrush, and a smartwatch to record the brushing movements.
The ACESO platform architecture has several security tools and features, including:
- The platform is completely separated from the user’s home network and can be secured without limitations from the existing user’s WiFi network.
- The platform can operate autonomously at the user’s premises without the need to transfer sensitive data outside the house for its operation.
- Communication between caregiver devices and the ACESO platform is direct, in a Peer-to-Peer (P2P) manner. Minimal external services are used to allow external clients to discover the platform over the internet due to dynamic IP allocation by the Internet provider.
Researchers at CITST recruited 20 elderly users to test the ACESO pilot platform. Initially, the researchers tested the users’ salivary function so they would have a basis for comparison after they used the ACESO platform.
Phase II
In Phase II of the project, researchers developed the user interface and the ACESO smart toothbrush, a manual brush transformed into a smart brush that acquires data from the movements made during brushing. They then analyzed the performance of the developed smart toothbrush, which included optimization of:
- Battery consumption connected to the microcontroller attached to the hand brush.
- Data transmission between the ACESO tablet and the developed smart brush.
- The implementation of the message transmission when longer than 23 characters.
Researchers then tested the components of the ACESO platform with the same group of 20 people over 60 years old, as well as 10 dental professionals. They found that the physical health monitoring devices (blood pressure monitor, glucometer, thermometer) were the easiest and most comfortable to use, particularly the smart brush developed for ACESO.
Researchers also tested the SaliPen device, designed to stimulate salivary flow via oral electrostimulation, and found that it was well tolerated by patients. Salivary flow measurements increased during intraoral operation of the device and patients reported an initial dry mouth sensation but very high salivary flow immediately after use, which persisted for a long period of time. The researchers were also pleased with the SaliPen as it integrated easily into the ACESO platform.
Phase III
In this stage, developers took steps to complete and optimize the integrated ACESO platform. They extended the user interface by adding the necessary buttons to access the new functionalities integrated into the platform, including integration of the smart brush, the SaliPen, and the calendar. They further extended the user interface by adding graphs allowing the visualization of parameters related to the daily monitoring activity,
In terms of smart brush integration, the first version of the brush used a manual brush incorporated in a handle. However, the user could not change the toothbrush because it was glued into the handle. Developers designed a new version of the handle that can be used with an interchangeable head from electric toothbrushes.
Regarding turning the SaliPen “smart,” developers created a 3D designed cup with an electronic circuit to monitor the presence/absence of the device in the cup. They also developed an Android app to collect and transmit data related to SaliPen usage.
Research on the operation of the platform under laboratory conditions revealed the need to improve the platform’s performance in the following areas:
- Packaging and transmitting data from the smart brush.
- Adapting the shape of the cup for the SaliPen device to eliminate errors in detecting the use of the device.
- Extending the range of caps available for the smart brush and adapting the handle so it doesn’t slip out of users’ hands when wet.
- Modifying the brush cup so that it does not retain water drained after using the brush for washing.
Following lab testing, the ACESO platform was presented and tested by 15 users. Users were asked to answer 16 questions in the form of a questionnaire comprising 14 closed questions and 2 questions. The majority of respondents said they wouldn’t make significant changes to the ACESO platform.
Phase IV
Based on user feedback, developers addressed the following issues to optimize the ACESO platform:
- Modification of the shape of the brush handle to achieve an ergonomic appearance.
- Modification of the brush cup by using magnets instead of the magnetic strip in order to avoid its demagnetisation and the impossibility of using the cup.
- Modification of the brush cup to be easily loaded.
- Completion of the user interface implementation.
- Implementation of the caregiver interface.
Results
The ACESO platform pilot studies in Romania started in February 2023 and ended in July 2023. Participants included 10 primary users and five secondary users (two dentists, one dental assistant, one orthodontist, and one general practitioner). 11 senior participants between the ages of 64 and 85 completed the pre-questionnaires, with a good gender balance of 6 males and 5 females. The participants benefited from the continuous support of CITST throughout the pilot.
Most participants reported that daily use and the ability to consult the manual made the ACESO platform easy to use, and they felt confident using the system.
FAQS
What is the ACESO platform?
The ACESO platform is a project launched by the IT Center for Science and Technology in Romania. It’s a digital initiative designed to enable elderly adults to take a proactive part in their oral healthcare, alongside their physicians.
How does the SaliPen fit into the ACESO platform?
The SaliPen is a cutting-edge device that seamlessly integrates into advanced electronics and software, offering easy connectivity to communication systems. Its innovative design and functionality led to its selection as a key component of the ACESO platform, which aims to monitor activities related to oral health.
Is the SaliPen painful to use?
No. The SaliPen delivers small electrical pulses directly into the oral cavity with the goal of stimulating the salivary glands to produce more saliva naturally. The pulses are not painful and the device can be used by individuals at home. The SaliPen is an FDA-approved dry mouth treatment.
Where can I purchase the SaliPen?