Correlation of Salivary pH, Incidence of Dental Caries and Periodontal Status in Diabetes Mellitus Patients: A Cross-sectional Study

Seethalakshmi, C; Reddy, R C Jagat; Asifa, Nisha; Prabhu, Shivananda

doi:10.7860/jcdr/2016/16310.7351

Cited by 70 publications

(87 citation statements)

References 17 publications

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“…We found that CHX increased saliva lactate concentration and reduced its buffering capacity. These changes are commonly associated with greater risk of oral disease 22 . Regarding bacteria, we found a negative correlation between the phylum Actinobacteria and saliva lactate concentration.…”

Section: Discussionmentioning

confidence: 99%

Effects of Chlorhexidine mouthwash on the oral microbiome

Bescós

Ashworth

Cutler

et al. 2020

Sci Rep

187

165

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Following a single blind, cross-over and non-randomized design we investigated the effect of 7-day use of chlorhexidine (CHX) mouthwash on the salivary microbiome as well as several saliva and plasma biomarkers in 36 healthy individuals. They rinsed their mouth (for 1 min) twice a day for seven days with a placebo mouthwash and then repeated this protocol with CHX mouthwash for a further seven days. Saliva and blood samples were taken at the end of each treatment to analyse the abundance and diversity of oral bacteria, and pH, lactate, glucose, nitrate and nitrite concentrations. CHX significantly increased the abundance of Firmicutes and Proteobacteria, and reduced the content of Bacteroidetes, TM7, SR1 and Fusobacteria. This shift was associated with a significant decrease in saliva pH and buffering capacity, accompanied by an increase in saliva lactate and glucose levels. Lower saliva and plasma nitrite concentrations were found after using CHX, followed by a trend of increased systolic blood pressure. Overall, this study demonstrates that mouthwash containing CHX is associated with a major shift in the salivary microbiome, leading to more acidic conditions and lower nitrite availability in healthy individuals.Chlorhexidine (CHX) has been commonly used in dental practice as antiseptic agent since 1970, due to its long-lasting antibacterial activity with a broad-spectrum of action 1 . Since then, many clinical trials have shown effective results of CHX for the clinical management of dental plaque and gingival inflammation and bleeding 2-4 . This is supported by other studies using in vitro methods and reporting positive results of CHX in reducing the proliferation of bacterial species associated with periodontal disease, such as Enterobacteria, Porphyromonas gingivalis, Fusobacterium nucleatum, as well as different species of Actinomyces and Streptococcus, including Streptococcus mutans, which is considered the main etiological agent of dental caries 4,5 . Other studies have also reported that the use of CHX was effective in the treatment of halitosis, especially in reducing the levels of halitosis-related bacteria colonising the dorsal surface of the tongue 6 .The anti-microbial activity of CHX however, has been extensively studied using in vitro culture methods, which limit the identification and cultivation of all microorganisms in the environment 4 . To the best of our knowledge, only one recent study has investigated the effect of CHX mouthwash on mixed bacterial communities (microbiome) of the tongue using new genome sequencing techniques such as 16 S rRNA 7 . The study found differences in over 10 different species colonizing the tongue, and a lower microbial diversity after using CHX for a week, but did not analyse other parameters related to oral health such as pH, lactate production or buffering capacity 7 . Additionally, we and others have recently shown that the use of CHX in healthy subjects can attenuate the nitrate-reducing activity of oral bacteria by at least 80% 8-11 . This in turn leads to lo...

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Section: Discussionmentioning

confidence: 99%

Effects of Chlorhexidine mouthwash on the oral microbiome

Bescós

Ashworth

Cutler

et al. 2020

Sci Rep

187

165

View full text Add to dashboard Cite

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“…Salivary pH has been studied and proven to reach lower values in diabetic patients compared to healthy individuals . Several factors contribute to this decrease: the low concentration of bicarbonate, the greater accumulation of dental plaque and saliva with high cariogenic load and an increased concentration of salivary glucose, possibly related to microvascular complications (damage to the basal membrane of salivary glands leads to an endothelial dysfunction and the glucose molecule is easily released to the existing saliva) …”

Section: Discussionmentioning

confidence: 99%

Dental caries,diabetes mellitus, metabolic control and diabetes duration: A systematic review and meta‐analysis

Coelho

Amaro

Caramelo

et al. 2020

J Esthet Restor Dent

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Objective: To analyze articles aimed at evaluating the association between diabetes, metabolic control, diabetes duration, and dental caries.Overview: A systematic search in PubMed, Cochrane Library, Embase, and Web of Science was conducted to retrieve papers in English, Portuguese, and Spanish, up to April 2019. The research strategy was constructed considering the "PECO" strategy.Only quantitative observational studies were analyzed. The risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale. The meta-analyses were performed based on random-effects models using the statistical platform R. A total of 69 articles was included in the systematic review and 40 in the meta-analysis. Type

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“…Therefore, on one hand, the microbiological factors might be different between patients with and without DM. On the other hand, salivary factors, such as salivary pH, might be of interest because the reduced salivary pH, which has been found in patients with DM compared with those without DM, could have an influence on dental caries and periodontitis.…”

Section: Introductionmentioning

confidence: 99%