Prevalence of oral injuries and salivary changes in patients with chronic renal failure on hemodialysis: systematic review and meta-analysis

The objective of this study was to evaluate whether individuals with chronic renal failure (CRF) undergoing hemodialysis treatment have more salivary and oral mucosa alterations when compared to healthy individuals, through a systematic review followed by meta-analysis. A systematic literature review was performed, evaluating randomized clinical trials found in the Proquest, Embase, Scopus, Cochrane Library, Web of Science, Lilacs and Pubmed databases, using MeSH terms and other keywords. Initially, 40 articles were included in the study and, after reading the complete articles, only 15 clinical trials that analyzed oral lesions and salivary changes in patients with CRF undergoing hemodialysis treatment were eligible. Most of the clinical studies included were cross-sectional and composed of a study group and a control group. The mean age of participants in the study group was 50.19 years and in the control group, 48.95 years. The most common oral alterations found in the CRF group in relation to the control group were xerostomia, uremic breath, dysgeusia, coated tongue, gingival bleeding and pale mucosa. The salivary flow of patients with CRF was 46.6% lower than the control group. The salivary pH in the study group was also more alkaline when compared to the control group. Greater amounts of urea, phosphate, C-reactive protein and total proteins were found in the saliva of individuals with CRF. Individuals with CRF undergoing hemodialysis are more prone to changes in both the quantity and quality of saliva, as well as having a greater amount of oral changes.

El pH salival como marcador biológico en pacientes diagnosticados con carcinoma epidermoide oral de Guantánamo / Salivary pH as diagnostic biomarker in patients diagnosed with oral squamous cells carcinoma in Guantanamo / pH salivar como marcador biológico em pacientes diagnosticados com carcinoma epidermóide oral de Guantánamo

RESUMEN Introducción: El cáncer bucal constituye un problema de salud de connotación mundial. Objetivo: Comparar las variaciones del pH salival entre pacientes con carcinoma epidermoide recién diagnosticados, después del tratamiento oncoespecífico y sujetos aparentemente sanos de la provincia Guantánamo, Cuba, en el período noviembre 2019- enero 2022. Método: Se realizó un estudio descriptivo, comparativo, transversal, en pacientes ambulatorios de la consulta de Cirugía Maxilofacial del Hospital General Docente "Dr. Agostinho Neto". El grupo de estudio estuvo conformado por 200 pacientes divididos en 3 subgrupos: subgrupo I (50 pacientes recién diagnosticados con carcinoma epidermoide oral, con diagnóstico concomitante de caries dental y periodontitis crónica del adulto); subgrupo II (50 pacientes con la referida patología después de tratamiento oncoespecífico, tratados por las enfermedades bucales antes citadas) y subgrupo III (100 pacientes controles aparentemente sanos). Se estudiaron las variables: edad, sexo, tipo de dieta y pH salival. Resultados: La edad media fue de 59,8 años, 70 % fueron hombres. Se asoció la dieta consumida y cada subgrupo (p=0,001). El pH salival de los pacientes con carcinoma epidermoide recién diagnosticados afectados por ambas enfermedades bucales fue ácido (6,25±0,37) en comparación a los otros subgrupos. El 98,6 % de los pacientes con pH salival ácido presentaron una dieta usual a base de carbohidratos y grasas (p=0,000). Conclusiones: Se evidenció que el pH salival de los pacientes con carcinoma epidermoide recién diagnosticados fue ácido en comparación a los otros subgrupos, por lo que este parámetro puede usarse como un marcador biológico de la enfermedad.

ABSTRACT Introduction: Oral cancer is a common health problem worldwide. Objective: Compare the salivary pH range changes among patients diagnosed recently with oral squamous cells carcinoma after receiving oncospecific treatment and subjects apparently healthy, Guantanamo, Cuba, period time November 2019 -January 2022. Method: A descriptive, comparative, cross-sectional study was carried out in outpatients of the Maxillofacial Surgery Consultation room at the Hospital General Docente "Dr. Agostinho Neto". The study group consisted of 200 patients divided into 3 subgroups: subgroup I (50 newly diagnosed patients with oral squamous cell carcinoma, with concomitant diagnosis of dental caries and chronic adult periodontitis); subgroup II (50 patients with the aforementioned pathology after oncospecific treatment, treated for the aforementioned oral diseases) and subgroup III (100 apparently healthy control patients). The following variables were studied: age, sex, type of diet and salivary pH. Results: Average age was 59.8 years, 70% were men. There was an association between the diet consumed and each subgroup (p= 0.001). The salivary pH of newly diagnosed squamous cell carcinoma patients affected by both oral diseases was acidic (6.25±0.37) compared to the other subgroups. The 98.6% of patients with acid salivary pH presented a usual diet based on carbohydrates and fats (p=0.000). Conclusions: It was shown that the salivary pH of newly diagnosed patients with squamous cell carcinoma was acidic compared to the other subgroups. Therefore, this parameter can be used as a biological marker of the disease.

RESUMO Introdução: O câncer bucal é um problema de saúde global. Objetivo: Comparar as variações do pH salivar entre pacientes com carcinoma espinocelular recém-diagnosticado, após tratamento oncoespecífico, e indivíduos aparentemente saudáveis da província de Guantánamo, Cuba, no período de novembro de 2019 a janeiro de 2022. Método: Estudo descritivo, comparativo, cruzado seccional, em pacientes ambulatoriais da consulta de Cirurgia Bucomaxilofacial do Hospital General Docente "Dr. Agostinho Neto". O grupo de estudo foi composto por 200 pacientes divididos em 3 subgrupos: subgrupo I (50 pacientes recém-diagnosticados com carcinoma espinocelular oral, com diagnóstico concomitante de cárie dentária e periodontite crônica do adulto); subgrupo II (50 pacientes com a patologia supracitada após tratamento oncoespecífico, tratados para as doenças bucais supracitadas) e subgrupo III (100 pacientes controles aparentemente saudáveis). As variáveis estudadas foram: idade, sexo, tipo de dieta e pH salivar. Resultados: A média de idade foi de 59,8 anos, 70% eram homens. A dieta consumida e cada subgrupo foram associados (p=0,001). O pH salivar de pacientes recém-diagnosticados com carcinoma espinocelular afetados por ambas as doenças bucais foi ácido (6,25±0,37) em comparação com os outros subgrupos. 98,6% dos pacientes com pH salivar ácido apresentaram dieta habitual baseada em carboidratos e gorduras (p=0,000). Conclusões: Evidenciou-se que o pH salivar dos pacientes com carcinoma espinocelular recém-diagnosticado foi ácido em relação aos demais subgrupos. Portanto, esse parâmetro pode ser utilizado como marcador biológico da doença.

La higiene bucal en pacientes con tratamiento de Ortodoncia / Oral hygiene in patients with orthodontic treatment

RESUMEN Fundamento: Los pacientes con tratamiento de ortodoncia presentan alteraciones por la acumulación de placa que provoca los aparatos, lo que requiere de mayor control de la higiene bucal. Objetivo: Profundizar en los criterios actuales sobre la higiene bucal en pacientes con tratamiento de ortodoncia para mantener su salud bucal. Desarrollo: Se realizó una búsqueda bibliográfica en las bases de datos biomédicas: PubMed, Cochrane, Scopus, Ebsco, Cumed y Lilacs. De 86 artículos científicos se seleccionaron los 39 de mayor actualización. Se constataron las particularidades de la higiene bucal durante el tratamiento con aparatos fijos de ortodoncia, la existencia del Índice de placa de ortodoncia como índice ajustado para estos pacientes, los procedimientos para el control de la placa bacteriana, la relación entre el uso de aparatos y el pH salival, así como la importancia de la educación para la salud para aumentar la motivación de los pacientes hacia la higiene bucal. Conclusiones: La higiene bucal es el factor más importante en el mantenimiento de la salud periodontal y la prevención de caries dental durante el tratamiento de ortodoncia. Se requiere de la orientación por parte de los profesionales para motivar a los pacientes mediante la promoción y prevención de salud bucal.

ABSTRACT Background: Patients with orthodontic treatment present alterations due to the plaque addition caused by the appliances, which requires greater control of oral hygiene. Objective: To delve into the current criteria on oral hygiene in patients with orthodontic treatment to maintain their oral health. Development: A bibliographic search was conducted in biomedical databases: PubMed, Cochrane, Scopus, Ebsco, Cumed and Lilacs. Out of 86 scientific articles, the 39 most updated were selected. The accuracies of oral hygiene during the treatment with fixed orthodontic appliances, the existence of the Orthodontic Plaque Index as an adjusted index for these patients, the procedures for bacterial plaque control, the relationship between the use of appliances and salivary pH, as well as the importance of health education to increase patients' motivation towards oral hygiene were ascertained. Conclusions: Oral hygiene is the most important factor to preserve periodontal health and prevent dental caries during orthodontic treatment. Guidance by professionals is required to motivate patients through oral health promotion and prevention.

El pH salival y microbiota oral: influencia en la salud bucodental de mujeres de 45 a 55 años / Salivary pH and oral microbiota: influence on women 45 to 55 years old oral health

Nuestra cavidad bucal cuenta con características particulares como ecosistema y microbiota. Este hábitat de microorganismos es uno de los más diversos de cualquier comunidad microbiana asociada a los humanos, y además cumple ciertas funciones en los procesos biológicos y digestivos del hospedante. Aunque muchos de estos microorganismos residentes aportan beneficios, en condiciones de sinergia y exacerbación, el predominio de algunos géneros puede influir en el desarrollo de enfermedades periodontales. Se realizó una investigación cuantitativa, exploratoria, descriptiva y transversal en el de Centro de Salud de Latacunga, provincia de Cotopaxi, en Ecuador, en mujeres cuya edad oscilaba entre 45 y 55 años. Se estableció una relación lineal negativa entre la edad y el pH salival, es decir, que al aumentar la edad aumentó la acidez bucal de las pacientes. De manera similar, el pH salival influyó inversamente en la disponibilidad microbiótica, pues en las cavidades bucales más ácidas el índice de detección fue más alto en 18/25 microorganismos. Las proporciones de afecciones en la salud bucodental encontradas en las pacientes como caries (96%), gingivitis (67%), halitosis (78%) y xerostomía (56%), indican la no exclusión y superposición de las mismas, pudiendo presentarse patologías combinadas en un mismo paciente, haciendo necesario explorar de qué manera los niveles de pH y la diversidad microbiótica oral encontrados se interrelacionan, y a su vez como estas nosologías podrían tener determinantes similares(AU)

Our oral cavity has particular characteristics such as ecosystem and microbiota. This habitat of microorganisms is one of the most diverse of any microbial community associated with humans, and also fulfills certain functions in the biological and digestive processes of the host. Although many of these resident microorganisms provide benefits, under conditions of synergy and exacerbation, the predominance of some genera can influence the development of periodontal diseases. A quantitative, exploratory, descriptive and cross-sectional investigation was carried out in the Latacunga Health Center, Cotopaxi province, Ecuador, in women whose age ranged between 45 and 55 years. A negative linear relationship was established between age and salivary pH, that is, with increasing age the oral acidity of the patients increased. Similarly, salivary pH inversely influenced microbiotic availability, since in the more acidic oral cavities the detection rate was higher in 18/25 microorganisms. The proportions of conditions in oral health found in patients such as caries (96%), gingivitis (67%), halitosis (78%) and xerostomia (56%), indicate their non-exclusion and overlap, and pathologies may occur combined in the same patient, making it necessary to explore how the pH levels and oral microbiotic diversity found are interrelated, and in turn, how these nosologies could have similar determinants(AU)

Efectos del colutorio de bicarbonato de sodio sobre el pH salival y la microflora oral

Resumen La caries dental es una enfermedad infecciosa producida por bacterias, es una de las enfermedades crónicas con mayor prevalencia en la infancia, extendida por todo el mundo. Objetivo . Determinar el efecto del colutorio de bicarbonato de sodio (1,1%) sobre el pH salival y la microflora bucal. Materiales y métodos . Se realizó un estudio de tipo cuasi-experimental, longitudinal, prospectivo, que tuvo una muestra de 30 estudiantes de pre-clínicas de la escuela de odontología de la Universidad Nacional del Altiplano de Puno (Perú). de ambos sexos, divididos en tres grupos a quienes se indicó el uso de colutorios teniendo como principios activos: bicarbonato de sodio al 1,1%, clorhexidina al 0,12% y agua destilada respectivamente. Se recolectaron muestras de saliva pre y post enjuague, para evaluar el efecto sobre el pH salival y muestras de dorso de la lengua para evaluar la carga bacteriana oral. Para el análisis de datos se utilizó la prueba T de Student para muestras relacionadas, con el un nivel de significancia del 95%, en el programa SPSS Ver.17. Resultados . Se detecto que el efecto del buffer del bicarbonato de sodio después de su aplicación como colutorio, pasando de un pH de 6,47 a 7,97 mostrando diferencias significativas antes y después de su aplicación (p<0,05). Así también el crecimiento bacteriano después de la aplicación del bicarbonato de sodio, disminuyo en un 47,32% (p<0,05) evidenciando una efectividad antibacteriana. Conclusiones . Se encontró que el colutorio de bicarbonato de sodio tiene un efecto de manera significativa sobre estabilización del pH salival y una acción antimicrobiana sobre la microflora bucal, inhibiendo potencialmente a microorganismos cariogénicos.

Abstract Dental caries is an infectious disease produced by bacteria, it is one of the chronic diseases with the highest prevalence in childhood, spread throughout the world. Objective . To determine the effect of sodium bicarbonate mouthwash (1.1%) on salivary pH and oral microflora. Materials and methods . A prospective, longitudinal, quasi-experimental type study was carried out, which had a sample of 30 pre-clinic students from the dental school of the National University of the Altiplano de Puno (Peru), of both sexes. Divided into three groups to whom the use of mouthwashes was indicated having as active ingredients: 1.1% sodium bicarbonate, 0.12% chlorhexidine and distilled water respectively. Saliva samples were collected before and after rinsing, to evaluate the effect on salivary pH, and samples from the back of the tongue to evaluate the oral bacterial load. For data analysis, the student's t test was used for related samples, with a significance level of 95%, in the SPSS Ver.17 program. Results . It was detected that the effect of the sodium bicarbonate buffer after its application as mouthwash, going from a pH of 6.47 to 7.97 showing significant differences before and after its application (p <0.05). Likewise, bacterial growth after the application of sodium bicarbonate decreased by 47.32% (p <0.05), evidencing antibacterial effectiveness. Conclusions . It was found that sodium bicarbonate mouthwash has a significant effect on salivary pH stabilization and an antimicrobial action on oral microflora, potentially inhibiting cariogenic microorganisms.

Resumo A cárie dentária é uma doença infecciosa produzida por bactérias, é uma das doenças crônicas com maior prevalência na infância, disseminada em todo o mundo. Objetivo . Determinar o efeito do enxaguatório bucal com bicarbonato de sódio (1,1%) no pH salivar e na microflora oral. Materiais e métodos . Foi realizado um estudo prospectivo, longitudinal, quase experimental, que contou com uma amostra de 30 alunos pré-clínicos da Faculdade de Odontologia da Universidade Nacional do Altiplano de Puno (Peru), de ambos os sexos. em três grupos para os quais foi indicado o uso de enxaguatórios bucais tendo como princípios ativos: 1,1% de bicarbonato de sódio, 0,12% de clorexidina e água destilada respectivamente. Amostras de saliva foram coletadas antes e após o enxágue, para avaliar o efeito no pH salivar, e amostras do dorso da língua, para avaliar a carga bacteriana oral. Para a análise dos dados, foi utilizado o teste t de Student para amostras relacionadas, com nível de significância de 95%, no programa SPSS Ver.17. Resultados . Foi detectado que o efeito do tampão bicarbonato de sódio após sua aplicação como enxaguatório bucal, passando de um pH de 6,47 a 7,97 apresentando diferenças significativas antes e após sua aplicação (p <0,05). Da mesma forma, o crescimento bacteriano após a aplicação de bicarbonato de sódio diminuiu 47,32% (p <0,05), evidenciando eficácia antibacteriana. Conclusões. Verificou-se que o enxaguatório bucal com bicarbonato de sódio tem efeito significativo na estabilização do pH salivar e ação antimicrobiana na microflora oral, potencialmente inibindo microrganismos cariogênicos.

Differences of Salivary Ph, Feature, And Volume Of Children At Three Kindergartens With Different Socioeconomic Standard / Diferenças do Ph Salivar, Característica e Volume, de Crianças Em Três Jardins De Infância Com Diferentes Padrões Socioeconômicos

Introduction: Saliva is the most important biological factor to protect against dental caries. When saliva flow is reduced, oral health problems such as dental caries and oral infections can develop. It was suggested that the effect of low salivary pH is more in plaque close to the area of susceptible tooth surface. The presence of saliva in pre-school age children is a significant indicator in oral health assessment oral health. There has been an association between salivary cortisol and socioeconomic variable. Descriptions above have encouraged us to examine the salivary pH, feature, and volume of pre-school-aged community. Thus, this study was aimed to describe the differences in salivary pH, feature, and volume of the children in the three pre-school with different location and socioeconomics aspect. Methods: Descriptive survey, with a population of pre-school students in 3 different kindergartens with different socioeconomic environment. Inclusion criteria were the pre-school-aged community and got permission from parents. Exclusion criteria were a pre-school-aged community under medication treatment causes hyposalivation or hypersalivation and children who did not want to be involved in the study, with total sampling as the sampling technique, resulted in as much a 101 respondents as the study sample. The saliva was collected with unstimulated technique. Data analysis was performed using relative frequency distribution. Results: The salivary pH was slightly higher in male children than female by 0.1. The average pH value was 7.25. The salivary feature was mostly frothy bubbly, followed by thin and watery, and the sticky bubbly feature was found the least. The salivary volume of the pre-school-aged community was mostly in the very less category, followed by the less category, with no normal category was found. the p-values of salivary pH and salivary features were below 0.05 There are no significant differences between the salivary pH and salivary feature of children from the three studied kindergartens. However, there is a significant difference in the salivary volume found in children from kindergartens located in high socioeconomic standard and middle socioeconomic standard areas, which have a higher salivary volume than the children from kindergartens situated in areas with lower socioeconomic standard. Conclusion: since the reduced salivary volume was associated to children with lower socioeconomic standard, this association can justify the higher risk for caries described in the literature (AU)

Introdução: A saliva é o fator biológico mais importante na proteção contra a cárie dentária. Quando o fluxo salivar é reduzido, podem ocorrer problemas na saúde bucal, como cáries e infecções orais. Foi sugerido que o efeito do baixo pH salivar é aumentado na placa, próxima à área de superfície dentária suscetível. A presença de saliva em crianças em idade pré-escolar é um indicador significativo na avaliação da saúde bucal. Houve associação entre cortisol salivar e variáveis socioeconômicas. As descrições acima nos encorajaram a examinar o pH salivar, características e volume da comunidade em idade pré-escolar. Assim, este estudo teve como objetivo descrever as diferenças de pH, característica e volume salivar das crianças de três pré-escolas com localização e aspectos socioeconômicos distintos. Material e Métodos: Pesquisa descritiva, com população de estudantes da pré-escola de três diferentes jardins de infância com diferentes ambientes socioeconômicos. Os critérios de inclusão foram comunidade em idade pré-escolar e permissão dos pais. Os critérios de exclusão foram comunidade em idade pré-escolar sob tratamento medicamentoso que causa hipossalivação ou hipersalivação e também crianças que não quiseram se envolver no estudo, com amostragem total resultando em 101 entrevistados como a amostra do estudo. A saliva foi coletada com a técnica não estimulada. A análise dos dados foi realizada usando distribuição de frequência relativa. Resultados: O pH salivar foi ligeiramente superior nas crianças do sexo masculino do que no feminino em 0,1. O valor médio do pH foi de 7,25. O aspecto salivar era principalmente espumoso com bolhas, seguido de aspecto tênue e aguado, e o aspecto pegajoso e espumante foi o menos encontrado. O volume salivar dos estudantes em idade pré-escolar encontrava-se majoritariamente na categoria inferior a todas, seguida da categoria menos, não sendo encontrada nenhuma categoria normal, onde os valores de p do pH salivar e características salivares estavam abaixo de 0,05. Não há diferenças significativas entre o pH salivar e a característica salivar das crianças dos três diferentes jardins de infância estudados. No entanto, existe uma diferença significativa no volume salivar encontrado em crianças de creches localizadas em áreas de médio e alto padrão socioeconômico, que apresentaram maior volume salivar do que as crianças de creches situadas em áreas de menor padrão socioeconômico. Conclusão: O volume salivar reduzido esteve associado a crianças com menor padrão socioeconômico, logo essa associação pode justificar o maior risco de cárie descrito na literatura. (AU)

Periodontal disease and salivary pH: Case control study

Background: Saliva is complex fluid maintaining microbiological flora and oral hygiene. It has varying composition and has diagnostic and prognostic value. The present case-control study was aimed at finding the association between salivary pH and periodontal disease. Materials and methods: Three groups consisting of persons with healthy gingiva, persons with generalized chronic gingivitis and those with generalized chronic periodontitis were studied. Results: It was seen that the saliva of patients suffering from chronic generalized gingivitis was alkaline in nature while that of patients with chronic generalized periodontitis was acidic when compared with health individuals. The difference between the groups was significant (p=0.00). Conclusion: Salivary pH can have prognostic value for periodontal disease.

Salivary pH and Taste Sensitivity among Geriatric and Non-Geriatric Patients in a Tertiary Hospital: A Cross Sectional Study

@#<p><strong>OBJECTIVE: </strong>To evaluate the association of salivary pH and taste sensitivity among geriatric and non-geriatric patients in an otorhinolaryngology - head and neck surgery out-patient clinic.</p><p><strong>METHODS:</strong></p><p><strong>Design:           </strong>Cross-Sectional Study</p><p><strong>Setting:           </strong>Tertiary Government Training Hospital</p><p><strong>Participants: </strong>40 otorhinolaryngology out-patients</p><p><strong> </strong></p><p><strong>RESULTS:</strong> Of the 40 patients aged 24 to 92-years-old (mean age 59.8 years), 21 were geriatric and 19 were non-geriatric. The mean salivary pH was 6.66 (range 5 to 8) and 6.63 (range 5 to 7) for geriatric and non-geriatric groups; the difference in mean salivary pH was not statistically significant (p = .87). The salivary pH in the geriatric group showed a negative correlation with age (r=0.06), while the salivary pH in the non-geriatric group had a positive correlation with age (r=0.14). Overall, increases in age among the non-geriatric group were correlated with increase in salivary pH which were not observed in the geriatric patients. In the geriatric group, among the 4 tastants, the strongest correlation between taste sensitivity and salivary pH was observed for quinine followed by sucrose and NaCl, but no correlation for citric acid. In the non-geriatric group, the strongest correlation between taste sensitivity and salivary pH was observed for NaCl, followed by quinine, citric acid and sucrose.</p><p><strong>CONCLUSION: </strong>There was no significant difference between the mean salivary pH of geriatric and non-geriatric patients, and both means were within normal. There was a negative correlation between age and salivary pH in the geriatric group, and a positive correlation in the non-geriatric group.  Salivary pH had the strongest correlation with taste sensitivity for quinine and NaCl among geriatric and non-geriatric participants, respectively, but the reasons for, and significance of this cannot be inferred from the present study.</p><p><strong>KEYWORDS:</strong> salivary pH; taste sensitivity; gustatory function; geriatric</p>

Evaluation And Comparison Of Salivary Total Antioxidant Level, Ph And Flow Rate Among Caries Active And Caries Free Children.

Oral hygiene, saliva and its constituents have crucial role in the development of dental caries. AIM: To correlate the Total Antioxidant Level (TAL), pH and Flow Rate (FR) of unstimulated saliva with caries. DESIGN:sixty children aged 6-13 years attended to the department of Pedodontics were selected. Caries Active (CA, n=30) and Caries Free (CF, n=30). METHODOLOGY: Salivary antioxidant level estimated by Phosphomolybdenum method, pH by digital pH meter and FR measured in milliliter/minute. RESULTS:Total antioxidant level was significantly high in CA(0.19) than CF children (0.08), pH (CA: 5.96, CF: 7.13) and FR (CA: 0.32 ml/min, CF: 0.42 ml/min) were less in caries active and more in free group. CONCLUSION: Higher level of total antioxidant level, lower level of pH and FR among caries active children can be used as a caries risk indicator

Effectiveness of casein phosphopeptide-amorphous calcium phosphate and xylitol chewing gums on salivary pH, buffer capacity, and Streptococcus mutans levels: An interventional study

The aim of the study is to compare the anticariogenic effectiveness of Casein phosphopeptide- Amorphous Calcium phosphate (CPP-ACP) and xylitol chewing gums based on salivary pH, buffer capacity, and Streptococcus mutans levels. Materials and Methods: A group of twenty individuals in the age group of 18–25 years were randomly divided into two Groups A and B. Test arm A received xylitol gums and test arm B received CPP-ACP gums and they were instructed to use the gums thrice daily for 2 weeks. Unstimulated salivary samples were collected before they began the use of the gums for baseline values, 24 h after beginning the usage of chewing gums and at the end of 14 days. The samples were analyzed for pH, buffer capacity, and S. mutans levels. Results: A statistically significant reduction of salivary S. mutans levels, improvement in salivary pH, and buffer capacity were displayed in both groups 24 h and 14 days after the intervention when compared with baseline. Group B showed more statistically significant improvement in pH than group A after 24 h (P = 0.028) and at the end of 2 weeks (P = 0.041). Conclusion: CPP-ACP has better ability than xylitol in improving the pH of saliva. Both CPP-ACP and xylitol gums individually have remarkable ability in bringing down S. mutans levels while simultaneously improving the pH and buffer of saliva.

Qualitative and quantitative salivary changes and subjective oral dryness among patients with thyroid dysfunction

There is a paucity of literature regarding the effects of thyroid disorders on the oral cavity by influencing the salivary gland function. Aims: This study aims to understand the qualitative and quantitative changes that thyroid disorder can cause in the salivary function. Settings and Design: After obtaining ethical clearance, 46 consecutive newly diagnosed thyroid dysfunction patients were enrolled in this cross-sectional study, along with 45 age-and sex-matched controls. Subjects and Methods: Unstimulated and stimulated salivary flow rates, pH, and buffering capacity of the whole saliva were studied in addition to subjective oral dryness in the study participants. Statistical Analysis Used: The independent t-test was employed to compare the means between the two groups and Pearson's Chi-square test was used to assess the goodness of fit. Results: The findings showed that females are more affected with thyroid disorders and that hypothyroidism is more commonly reported than hyperthyroidism. A significant reduction in the salivary flow rates and buffering capacity was observed among the affected group compared to the controls, whereas the salivary pH did not show significant differences between genders and also between the case and control groups. A feeling of subjective oral dryness was perceived by many affected patients. Conclusions: The study was able to establish an association between thyroid dysfunction and salivary gland function. We hope that this study leads to more high-impact research in this field as salivary diagnostics is gaining more popularity with every passing day.

Experimental study on the effects of green tea on salivary flow rate and pH value / 口腔疾病防治

Objective@# The purpose of this study was to compare the effects of different concentrations of green tea on salivary flow rate and pH value. @* Methods@# 20 healthy college students aged from 18 to 25 were included in this study, at State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University. Salivary flow rate and pH value were measured between 21: 00 and 22: 00 after drinking water, low, medium, and high concentration of green tea. @*Results@#Female salivary flow rates in low and medium concentration group were significant higher than that in high concentration group and water group (F=5.20, P < 0.01). There was no significant difference in male salivary flow rates among 4 groups (F=1.810, P=0.143). Salivary pH value in 3 green tea groups were lower than that in water group (F=3.50, P=0.02), with no significant difference among them. @*Conclusion@#Low and medium concentration green tea prevent decrease of salivary flow rate in healthy women but not in males. Salivary pH lowers after drinking different concentrations of green tea.

Comparison of changes in salivary pH levels after consumption of plain milk and milk mixed with sugar

Studies of dietary effects on saliva were common in the early part of this century, but it is now understood that such studies are of little value because the effects of other physiologic variables, such as time of day, were seldom controlled in the experimental design. The main salivary factors that, from theoretical considerations, might be expected to influence the process of caries are flow rate and the concentrations of calcium, phosphate, bicarbonate, hydrogen ions, fluoride, urea, and protein (particularly amylase). As the mankind has evolved, a drastic change has been seen in the dietary fermentable carbohydrate which eventually is associated with increased prevalence of dental caries. Milk is consumed with sugar syrups or honey to add flavor which eventually increases sugar content of milk, putting the children at a higher risk of dental caries. This study was conducted to evaluate and compare the acidogenic potential of milk as compared to milk and sugar at various time intervals. A total of 230 children aged 12 to 15 years were examined, 60 children which equal number of males and females (30 each) who satisfied the inclusion criteria were randomly selected and assigned to two groups, Group I: Plain milk (250 mL) and Group II: Milk and sugar (250 mL + 1 table spoon sugar =12.50 gm). After recording the resting pH, the change in the salivary pH in the respective groups after consuming the test meal was recorded after 5 minutes, 10 minutes, after 15 minutes, after 30 minutes and 120 minutes. The results show that there was no statistical significant difference in pH between the two groups. Statistically significant difference was seen at 10, 15, 30 minutes with highest at 15 minutes (p = 0.001) between plain milk (group I), milk and sugar (group II). The milk group showed a significant decrease in pH at 10 minutes. However, pH returned to normal at 15 - 30 minutes in group II. The study concluded that milk when added with sugar as did not pose a risk of demineralization as there was no decrease of pH below the limit of critical pH of 4.5 to 5.5

Effect of Different Sugar Free Flavoured Chewing Gums on Salivary pH- a Double Blinded, Parallel Arm Randomized Clinical Trial.

Aim: To evaluate and compare the effect of four different sugar free chewing-gums on salivary pH at 0, 10, 20, 30 minutes. Study Design: Double blinded, parallel arm Randomized Clinical Trial. Place and Duration of the Study: Department of Public Health Dentistry, College Of Dental Sciences, Davangere, India. Jan-Feb 2015. Methodology: Forty healthy dental students, aged 21 -25 years, mean age- 20.3 years were randomly allocated into 4 different study groups: Licorice group, Ginger group, Cinnamon group, and Xylitol group. Unstimulated saliva was collected from the participants at baseline, following which the participants were given respective gums to chew and the subsequent salivary samples were collected at intervals of 10, 20 & 30 minutes and pH was analyzed using pH meter. Statistical analysis was done using repeated measures ANOVA and One way ANOVA followed by Tukey’s post-hoc test. Results: Intergroup comparison showed, statistically significant difference between the groups at ten minutes (P=0.025), twenty minutes (P=0.004) and thirty minutes (P=0.001). At the end of thirty minutes, Ginger group showed maximum increase in salivary pH followed by Xylitol. When intragroup analysis was done, there was statistically significant difference in Licorice (P=0.033), Cinnamon (P=0.034) and Xylitol group (P=0.041) at different time intervals. Conclusion: The above results showed that, Ginger flavoured gum followed by Xylitol gum significantly increases salivary pH, as a means of caries prevention; it can be a good way to promote dental health. Hence, it can be suggested that the ginger flavoured gums can be advised in the subjects who are more susceptible to salivary pH fall and dental caries.

Resting Salivary Flow Rate and pH Decreases in Chewable Tobacco Users.

Background: Salivary flow rate and pH may be altered by chewable tobacco, the habit which is becoming a threat for oral cancer epidemic. The objective of the study was to find out the relationship between alterations in resting salivary flow rate (RSFR) and pH, which are early signs of oral health deterioration, with different forms of chewing tobacco products. Methods: A total of 354 healthy male subjects, consuming any form of chewable tobacco, belonging to low socioeconomic areas of Karachi were selected for this cross sectional study. A questionnaire was used to collect demographic data and details of chewing habits (using since, pack/day, duration of exposure etc.). Resting saliva of every subject was collected for 5min and RSFR was expressed in ml/min. Salivary pH was determined by using pH strips (pH 0-14). Data was analyzed on SPSS version 20. Results: Of 354 subjects, 27.4% were gutka, 24.3% niswar, 24.3% paan and 24% multiple users with mean RSFR as 0.40±0.30, 0.65±0.32, 0.64±0.39 and 0.41±0.25 respectively. Mean resting salivary pH was 6.58±0.78 with the lowest pH; 6.16±0.65 in multiple users. RSFR and pH significantly decreased with increase in packs consumed/day, duration of exposure and duration of usage. Conclusion: A significant negative correlation was found between RSFR and pH with tobacco chewing.

Study on effects of citric acid induced acid load on salivary secretion / 国际检验医学杂志

Objective To investigate the effects of citric acid on the related indexes of salivary secretion under acid loading in or‐der to optimize the citric acid load method .Methods The saliva samples were collected from 10 young healthy volunteers at 1-90 s before ,at 91-120 s during and at 121-210 s after citric acid loading .The indexes were detected in saliva with mixed loading and after loading .The salivary alpha‐amylase(sAA ) activity ,pH value ,saliva flow rate ,total protein concentration in various groups were detected .The ratio values before and after the acid loading were compared among the groups .Results (1)The sAA activity , saliva pH value and total protein concentrations after acid loading were significantly increased compared before loading (P<0 .05) , moreover the ratio of after loading and before loading was greater than 1(P<0 .05);(2) however in the citric acid mixing ,the sAA activity ,saliva pH value and total protein concentration were decreased compared with before acid loading ,its ratio was less than 1 (P<0 .05) .Conclusion Citric acid affects the secretion result of acid loading saliva secretion ,it is suggested that the saliva under acid loading is separated treated and analyzed .

Hyposalivation, acidic saliva, decayed teeth and oral yeast prevalence in children with mucopolysaccharidosis / Hiposalivação, saliva acídica, dentes cariados e prevalência oral de levedura em crianças com mucopolisacaridose

OBJECTIVE: Patients with mucopolysaccharidosis present several alterations of the stomatognathic complex, however, no data is available on saliva biochemistry and yeast colonization. The aim of the study was to evaluate caries experience as well as saliva biochemistry and microbiology parameters in patients with mucopolysaccharidosis. METHOD: The sample consisted of twelve participants with mucopolysaccharidosis followed in the Metabolic Disease Unit of the Centro Hospitalar de S. João and twelve healthy participants followed at the Faculty of Dental Medicine, University of Porto. To all participants, Decayed, Missing, Filled Teeth (DMFT) index was evaluated. In addition, saliva was collected to evaluate biochemical parameters (flow rate, pH, sodium, potassium, chloride, calcium, phosphate, α-amylase and IgA) and the microbiological profile (total microorganisms, mutans streptococci and yeasts) of all participants. RESULTS: In comparison to controls, the mucoplysacharidosis patients presented a higher prevalence of decayed teeth, lower salivary flow and pH values. They also presented also lower calcium and higher phosphate ions in saliva. No differences were found between groups regarding oral microbial load for total microorganisms, mutans streptococci and yeasts as well as oral prevalence of mutans streptococci. However, MPS patients presented higher prevalence of oral Candida in comparison to controls. CONCLUSION: The higher prevalence of decayed teeth and higher oral yeast colonization in MPS patients may be related to the lower saliva calcium concentration, pH and flow.

OBJETIVO: Pacientes portadores de mucopolissacaridose apresentam várias alterações do complexo estomatognático; no entanto, não existem dados disponíveis sobre a bioquímica da saliva e ou sobre a colonização por fungos. O objetivo deste estudo foi avaliar a prevalência de cárie dentária bem como parâmetros bioquímicos e microbiológicos em pacientes com mucopolissacaridose. MÉTODOS: A amostra foi constituída por doze participantes com mucopolissacaridose, acompanhados na Unidade de Doenças Metabólicas do Centro Hospitalar de S. João do Porto e por doze participantes saudáveis acompanhados na Faculdade de Medicina Dentária da Universidade do Porto. Para todos os participantes, o índice de dentes cariados, perdidos ou obturados foi avaliado. Além disso, foram recolhidas amostras de saliva de todos os participantes para avaliar os parâmetros bioquímicos (fluxo salivar, pH, sódio, potássio, cloreto, cálcio, fosfato, α-amilase e IgA) e microorganismos tais como Streptococcus mutans e leveduras. RESULTADOS: Em comparação aos controles, os pacientes com MPS apresentam maior prevalência de dentes cariados assim como fluxo salivar e pH reduzido. Os pacientes com MPS apresentaram também taxas menores de íons de cálcio e maiores de íons de fosfato. Não foram encontradas diferenças entre os grupos quanto à carga microbiana oral por microrganismos totais, Streptococcus mutans e leveduras, bem como quanto à prevalência oral de Streptococcus mutans. No entanto, os pacientes com MPS apresentaram maior prevalência de candidíase oral em comparação com os controlos. CONCLUSÃO: A maior prevalência de dentes cariados e a maior colonização oral por leveduras em pacientes com MPS pode estar relacionada com a baixa concentração de cálcio salivar, com o pH ácido e com a hiposalivação.

Menstrual Cycle Related Changes In Human Whole Salivary pH And Salivary Leukocyte Count.

Introduction: Steroid sex hormones influence every system of the body including the oral cavity. It influences the composition and flow rate of saliva. The aim was to estimate the changes in human whole salivary pH and salivary leukocyte count during the various phases of menstrual cycle. Materials and method: 30 female patients between 18-35 years were included in the study. They were free from any systemic illness or medication. Unstimulated saliva was collected between 10AM and 11AM during the follicular (7th day), ovulatory (12th-14th days), and luteal (21st day) phases and evaluated for changes in salivary pH and leukocyte count. Result: The salivary pH showed significant difference in value between ovulatory and luteal phase while the salivary leukocyte count showed significant difference in values during all the three phases. Conclusion: Steroid sex hormones do influence the composition of saliva and thus influence the health of periodontal tissues indirectly.

Influence of salivary pH on the sorption rate of nano-filled composite resin.

Background: Physical properties of a resin composite are as important for the longevity of composite material as the mechanical properties are for its survival in the oral environment. Objectives: The aim of this study is to evaluate the effect of artificial saliva with different pH (4.6, 5.1, 5.7, 6.3, 6.9, 7.5 & 8.1) on the sorption of dental nano-filled composites. Material and Methods: 5 disc shaped specimens were made for each group of pH with nano-filled composite resin and immersed for four weeks. Optical density was measured in Ultraviolet Vis Spectrophotometer. Statistical one-way analysis of variance (one-way ANOVA) and the two-way analysis of variance (ANOVA) were used throughout this study. Results: No significant differences were detected in specimens of any group of pH. Conclusions: Salivary pH has no effect on the nano-filled dental composite material. Future research needs to test more experimental designs that could depict the clinical behavior of the restorative material in vitro environment.

Enamel erosion caused by the effervescent acid powder in Tiritón ice cream: an in vitro study / Erosión del esmalte dental producto del polvo ácido efervescente contenido en helado Tiritón

The aim of this article was to see the erosive effect of the efferves¬cent powder acid in Tiritón ice cream (Nestlé Savory, Vevey, Switzerland) on the human tooth enamel. The erosive potential of Tiritón ice cream was determined under in vitro conditions by subjecting five tooth enamel slices from three healthy permanent first molars from healthy patients attending the dental clinic at the Universidad Nacional Andres Bello in Concepción. The samples were exposed to a mixture of saliva from a girl without incidence of dental caries and the effervescent powder in the stick holding the Tiritón ice cream for 10, 20, 30, 40 and 50 seconds. Afterwards, the effect was assessed through a scanning electron microscope (SEM) and pH measurement. All specimens showed a pH of 3.0. The SEM showed increasing levels of erosion for longer periods of exposure time. Tiritón ice cream produces a much more acidic environment than the one required for starting enamel dissolution. This will later cause a higher vulnerability to caries and dental erosion than the reported in other candy. The images obtained through SEM clearly show the erosive effect caused by the effervescent acid powder for periods of exposure time shorter than a minute.

El objetivo de este trabajo fue visualizar el efecto erosivo sobre el esmalte dental humano del polvo ácido efervescente contenido en el helado Tiri¬tón (Nestle Savory, Vevey, Suiza). El potencial erosi¬vo del helado Tiritón, se determinó en condiciones in vitro sometiendo 5 cortes de esmalte, de 3 primeros molares permanentes sanos, provenientes de pacien¬tes sanos de la clínica odontológica de la Universidad Nacional Andrés Bello, sede Concepción. Las mues-tras fueron sometidas a la mezcla de saliva de una ¬niña sin incidencia de caries y el polvo efervescente contenido en el helado Tiritón, en 10, 20, 30 40 y 50 segundos, posteriormente se visualizó el efecto a través de microscopia electrónica de barrido (MEB) y medición del pH. Todos los especímenes presentaron un pH de 3,0. A través de MEB se observaron grados crecientes de erosión en función del tiempo. El helado Tiritón genera un medio ácido mucho mayor al necesario para el inicio de la disolución del esmalte lo que posteriormente provocará vulnerabilidad a la caries y a la erosión dental, superior al reportado en otras golosinas. Las imágenes obtenidas a través de MEB permitieron visualizar con claridad el efecto erosivo que se produce, por el polvo ácido eferves¬cente en tiempos de exposición menores al minuto.