Salivary Flow Rate, pH, Buffering Capacity, Total Protein, Oxidative Stress and Antioxidant Capacity in Children with and without Dental Caries

Objectives: To measure and compare the levels of salivary flow rate, pH, buffering capacity, total protein, malondialdehyde (MDA) and total antioxidant capacity (TAC) between caries active and caries free children and to study the correlation between the DMFS/dfs score and above salivary parameters in caries active children. Study design: 50 caries active (DMFS/dfs ≥ 5) and 50 caries free (DMFS/dfs = 0) children aged between 6 to 12 years were included in the study. From all the children, unstimulated, mid-morning saliva samples were collected and salivary flow rate was calculated. Salivary pH, buffering capacity, total protein, MDA and TAC were measured. Results: The mean levels of salivary flow rate, pH, buffering capacity were significantly decreased (p < 0.05) and total protein, MDA and TAC were significantly increased (p < 0.05) in caries active children when compared to caries free controls. There was a proportionate decrease (p < 0.05) in salivary flow rate, pH and buffering capacity and proportionate increase (p > 0.05) in salivary total protein, MDA and TAC as DMFS/dfs score increased in caries active children. Conclusions: Significant alteration in the levels of salivary flow rate, pH, total proteins, MDA and TAC and their correlation with DMFS/dfs score in caries active children suggest, the levels of these physico-chemical properties of saliva can act as strong indicators of caries status in children.

Flow rate, pH, Buffering capacity, Malondialdehyde, Total antioxidant capacity, Caries active, DMFS/dfs score

1. Uberos J, Alarcón JA, Peñalver MA, Molina-Carballo A, Ruiz M, González E, et al. Influence of the antioxidant content of saliva on dental caries in an at-risk community. Br Dent J 205: 01-04, 2008.

2. Hegde AM, Rai K, Padmanabhan V. Total Antioxidant Capacity of Saliva and its Relation with Early Childhood Caries and Rampant Caries. J Clin Pediatr Dent 33(3): 231–234, 2009.

3. Fenoll-Palomares C, Muñoz-Montagud JV, Sanchiz V, Herreros B, Hernández V, Mínguez M et al. Unstimulated salivary flow rate, pH and buffer capacity of saliva in healthy volunteers. Rev Esp Enferm Dig 96(11): 773-783, 2004.

4. Lenander-Lumikari M, Loimaranta V. Saliva and Dental Caries. Adv Dent Res 14: 40-47, 2000.

5. Preethi BP, Dodawad R, Pyati A. Evaluation of Flow Rate, pH, Buffering Capacity, Calcium, Total Proteins and Total Antioxidant Capacity Levels of Saliva in Caries Free and Caries Active Children: An In Vivo Study. Ind J Clin Biochem 25(4): 425–428, 2010.

6. Kesarwala AH, Krishna MC, Mitchell JB. Oxidative stress in oral diseases. Oral Dis 22: 09–18, 2016.

7. Sarode G, Shelar A, Sarode S, Bagul N. Association between Dental Caries and Lipid Peroxidation in Saliva. Int J Oral Maxillofac Pathol 3(2): 02-04, 2012.

8. Armstrong D, Stratton RD. Oxidative Stress and Antioxidant Protection: The Science of Free Radical Biology and Disease. John Wiley &Sons, Inc, Hoboken, NJ, USA; 2016.

9. Battino M, Ferreiro MS, Gallardo I, Newman HN and Bullon P. The antioxidant capacity of saliva. J Clin Periodontol 29(3): 189–194, 2002.

10. World Health Organization. Oral Health Surveys: Basic Methods. 4th ed. World Health Organization, Geneva; 1997.

11. Navazesh M, Kumar SKS. Measuring salivary flow Challenges and opportunities. JADA 139(5): 35S-40S, 2008.

12. Wilson K and Walker J. Practical Biochemistry. Principles and tech-niques. 5th ed. Cambridge University Press, Cambridge; 2005.

13. Ericsson Y. Clinical investigation of the salivary buffering action. Acta Odontol Scand 17: 131-165, 1959.

14. Johnson AM, Rohlfs EM, Silverman LM. Protein. In: Burtis CA, Ashwood ER, Bruns DE, editors. Tietz fundamentals of clinical chem-istry. 6th ed. Elsevier, New Delhi; 325-351, 2008.

15. Al-Rawi NH. Oxidative stress, antioxidant status and lipid profile in the saliva of type 2 diabetics. Diabetes Vasc Dis Re 8(1): 22-28, 2011.

16. Koracevic D, Koracevic G, Djordjevic V, Andrejevic S, Cosic V. Method for the measurement of antioxidant activity in human fluids. J Clin Pathol 54: 356-361, 2001.

17. Prabhakar AR, Dodwad R, Raju OS. Evaluation of flow rate, pH, buff-ering capacity, calcium, total protein and total antioxidant levels of caries free and caries active children – an in vivo study. Int J Clin Pediatr Dent 2(1): 9-12, 2009.

18. Animireddy D, Bekkem VTR, Vallala P, Kotha SB, Ankireddy S, Mohammad N. Evaluation of pH, buffering capacity, viscosity and flow rate levels of saliva in cariesfree, minimal caries and nursing caries chil-dren: An in vivo study. Contemp Clin Dent 5(3): 324-328, 2014.

19. Miller WD. A study of certain questions relating to the pathology of the teeth. Dental Cosmos 46: 981-1001, 1904.

20. Wikifoundry [Internet]. [Place unknown]: Wikifoundry; Mar 18 2010, 10:29 PM. Available from: http://cariology.wikifoundry.com/page/Inhibition+of+dental+Caries.

21. Tulunoglu O, Demirtas S and Tulunoglu I. Total antioxidant levels of saliva in children related to caries, age, and gender. Int J Paediatr Dent 16(3): 186–191, 2006.

22. Farsi N. Dental caries in relation to salivary factors in Saudi population groups. J Contemp Dent Pract 3(9): 16-23, 2008.

23. Flink H. Unstimulated human whole saliva flow rate in relation to hypos-alivation and dental caries. Karolinska University Press, Sweden; 24, 2005.

24. Thaweboon S, Thaweboon B, Nakornchai S, Jitmaitree S. Salivary secre-tary IgA, pH, flow rates, mutans streptococci and Candida in children with rampant caries. Southeast Asian J Trop Med Public Health 39: 893899, 2008.

25. Swerdlove CK. Relation between the incidence of dental caries and the pH of normal resting saliva. J Dent Res 21: 7381, 1942.

26. Sakeenabi B, Hiremath SS. Dental caries experience and salivary strep-tococcus mutans, lactobacilli scores, salivary flow rate, and salivary buff-ering capacity among 6-year-old Indian school children. J Int Soc Prevent Communit Dent 1: 45-51, 2011.

27. Humphrey SP, Williamson RT. A review of saliva: Normal composition, flow, and function. J Prosthet Dent 85: 162-169, 2001.

28. Kleber CJ, Putt MS, Muhler JC. Enamel dissolution by various food acid-ulants in a sorbitol candy. J Dent Res 57(3): 447-451, 1978.

29. de Farias DG, Bezerra AC. Salivary antibodies, amylase and protein from children with early childhood caries. Clin Oral Investig. 7(3): 154-157, 2003.

30. Bhalla S, Tandon S, Satyamoorthy K. Salivary proteins and early child-hood caries: A gel electrophoretic analysis. Contemp Clin Dent 1(1):

17- 22, 2010.

31. Vibhakar PA, Patankar SR, Yadav MR. Salivary total protein levels and their correlation to dental caries. Int J Oral Maxillofac Pathol 4(3):13-16, 2013.

32. Tothova L, Kamodyova N, Cervenka T and Celec P. Salivary markers of oxidative stress in oral diseases. Front Cell Infect Microbiol 5: 1-23, 2015.

33. Rai B, Kharb S, Jain R, Anand SC. Salivary LPO product malonaldehyde in various dental diseases. World J Med Sci 1: 100-101, 2006.

34. Kesarwala AH, Krishna MC, JB Mitchell JB. Oxidative stress in oral diseases. Oral Dis 22: 9–18, 2016.

35. Babior BM. Phagocytes and oxidative stress. Am J Med 109(1): 33-44, 2000.

36. Smajic R, Kobaslija S, Dzuvo HA, Huseinbegovic A. Role of the saliva total antioxidant capacity in the caries development in children (Antioxi-dant capacity). Stomatological Review 2: 87-92, 2012.