Effect of diuretics on salivary flow, composition and oral health status: A clinico-biochemical study

Abstract

Background:Saliva represents an increasingly useful tool of diagnosis. Several factors such as salivary flow rates (SFRs) (unstimulated and stimulated) (U and S), pH, buffering capacity and consistency can be altered due to several disease processes or medications prescribed for various diseases. Alterations of SFRs, pH, buffering capacity and various ion concentrations can influence the pathogenesis of some of the oral diseases.Aim:Evaluation of the effect of diuretics on oral health status with regard to SFRs (U and S), pH, buffering capacity, total protein content, various ion concentrations and oral mucosal lesions.Subjects and Methods:A total of 100 patients were categorized into test group and control group based on usage of diuretics. Unstimulated and stimulated saliva were collected and evaluated for flow rates. Salivary pH was measured using pH meter. Buffering capacity was measured using Aranha's technique. Salivary Na+, K+ and Cl− concentrations were measured using electrolyte analyzer CORNLEY ACCULYTE-3P in ion-selective electrode method. Salivary total protein content was measured by spectrophotometric method. Dental Caries and periodontal status were measured by using decayed, missing, filled teeth index and Russell's periodontal index respectively. Oral mucosal examination was carried out to identify the mucosal lesions.Results:The obtained results were subjected to statistical analysis using Statistical package for social sciences software (SPSS), version 16, IBM Company by Chi-square test and unpaired t-test. Highly significant P for alterations of SFR/U (P < 0.001), SFR/S (P < 0.001), pH (P < 0.001), Na+ concentration (P < 0.001), buffering capacity (P < 0.001) and moderate significance for Cl− concentration (P < 0.01) were found. Alterations of total protein (P = 0.14) and K+ (P = 0.65) concentrations were not statistically significant. High prevalence was found for caries (P < 0.01), periodontal status (P < 0.001) and mucosal lesions (P < 0.01).Conclusion:Our study shows that diuretic medication significantly reduces SFRs (xerostomia) and alters salivary composition which may have an impact on the incidence of dental caries, periodontal diseases and mucosal lesion formation.

Salivary Gland Dysfunction in Patients with Chronic Heart Failure Is Aggravated by Nitrosative Stress, as Well as Oxidation and Glycation of Proteins

“…In our study, HF patients received mainly beta blockers, diuretics, and statins. These medicines, by acting peripherally on alpha- and beta-adrenergic/cholinergic receptors and influencing electrolyte flow, can change the quantitative and qualitative composition of saliva [ 83 , 84 , 85 ]. Patients usually do not report any oral mucosa changes during the initial period of reduced salivary secretion.…”

Xerostomia among older home care clients

“…However, the classifications of drugs in the previously mentioned studies have varied a lot and a systematic classification of drugs has been missing. Nevertheless, loop diuretics can cause xerostomia through their pharmacodynamic effects on salivary secretion 41,42 . Our observation about proton pump inhibitors and xerostomia is supported by Ohara et al 4 , who suggest that there might be an association between and xerostomia agents that affect the digestive organs.…”

Fisiologia das Secreções Salivares e Gastrintestinais

“…Os anti-hipertensivos, como os diuréticos, beta-bloqueadores, agonistas α 2 e bloqueadores dos canais de cálcio, também podem estar relacionados à xerostomia. Prasanthi, Kannan, Patil (2014) revelaram que pacientes utilizando diuréticos obtiveram uma diminuição da taxa de fluido salivar, pH, capacidade de tamponamento e concentração de Na + e Cl -. Esses dados estão relacionados ao fato dos diuréticos bloquearem o sistema de co-transporte de eletrólitos.…”