Effect of habitual arecanut chewing on resting whole mouth salivary flow rate and pH

Abstract

BACKGROUND: Resting whole mouth salivary flow rate (SFR) and pH play a significant role in pathogenesis of various oral diseases and conditions. AIM: To observe the effect of habitual use of arecanut and various arecanut containing products (AN) on SFR and pH. DESIGN: Cross sectional. SETTING: Outpatient Department of Dental College. PARTICIPANTS: AN chewers and non-chewers attending Dental college. MEASUREMENTS: SFR and pH. VARIABLES: Type, frequency, duration and exposure time of AN, Smoking and Alcohol habit. MATERIALS AND METHODS: Subjects study was divided into chewers (n=110) and non-chewers (n=50). The SFR (expressed in mL/10min) and pH measured. RESULTS: The difference between the mean SFR for chewers and non-chewers was not statistically significant. The difference between mean pH of chewers and non-chewers was statistically significant. (P=0.02). Difference in pH was statistically significant among the different types of AN chewers (P=0.024). With chewing raw AN, an increase in frequency and exposure time increased SFR and pH respectively. In processed AN chewers, increase in duration and frequency of consumption increased SFR and decreased pH respectively. For chewers with betel quid with tobacco, increase in duration was significantly associated with decrease in salivary pH. CONCLUSION: SFR and pH are altered in AN chewers, rendering the oral mucosa vulnerable to the toxic effects of AN.

The correlation between pH and flow rate of salivary smokers related to nicotine levels labelled on cigarettes

“…13 In addition, the changes in salivary pH and salivary flow rate are influenced by the duration of smoking and the level of nicotine labeled on the cigarette. 14 The smoking intensity is derived from the average number of cigarettes smoked daily multiplied with smoking duration in a year. 1 The concentration of nicotine in the salivary gland of smokers is different due to both the number of cigarettes smoked per day as well as the level of nicotine contained the cigarettes.…”

Association of Xerostomia and Assessment of Salivary Flow Using Modified Schirmer’s Test Among Tobacco Chewers, Smokers and Healthy Individuals.

“…6 Secretion of saliva is a reflex function emanating from salivary centers that is dependent on afferent stimulation and involves complex integration from higher centers. 5 Resting whole saliva is the mixture of secretions, which enter the mouth in the absence of exogenous stimuli. Several studies of resting whole saliva flow rates (SFR) in healthy individuals have found the value for whole saliva to be about 0.3 to 0.5 mL/minute.…”

“…Further normal variations have been shown to be age and gender independent. 5 Xerostomia is defined as the subjective perception of dry mouth. 6 The perception of dry mouth is sometimes, but not necessarily accompanied by a reduction in salivary flow.…”

“…4 Approximately 600 million people use arecanut (AN) worldwide in some form and is the fourth most commonly used psychoactive substance. 5 Oral squamous cell carcinoma (SCC) is the most common malignancy of the head and neck, with a worldwide incidence of over 300,000 new cases annually. 2 The prevalence of oral SCC in cigarette smokers is 4-7 times higher than in non-smokers, and when alcohol or chewing tobacco habits are also present, the disease prevalence increases by 19 and 123 fold, respectively.…”

Recent Concepts of Etiopathogenesis and Management of Oral Submucous Fibrosis: A Review of Literature

“…Rooban T el al analyzed that with chewing raw areca nut, there is increase in frequency and exposure time of increased salivary flow rate and pH respectively whereas in processed areca nut chewers, increase in duration and frequency of consumption increased salivary flow rate and decreased pH respectively. [37] Awang MN et al and Jeng JH et al concluded in their studies that betel nut alkaloids and polyphenols are important carcinogens, while tobacco and slaked lime act as co-carcinogens. [38][39] Sunali Khanna and Freny Karjodkar emphasized on the circulating immune complexes, serum copper, iron and selenium act as a predictors for the occurrence and progression of precancer and cancer lesions and they concluded from their study that serum copper is raised from precancer to cancer transformation, serum iron and selenium levels is decreased in cancer.…”