Unstimulated salivary flow, pH, proteins and oral health in patients with Juvenile Idiopathic Arthritis

Abstract

BackgroundThere have been inconsistent conclusions regarding salivary abnormalities and their effect on oral health of Juvenile Idiopathic Arthritis (JIA) patients. The purpose of the study was to evaluate the flow rate and selected biochemical parameters of unstimulated whole saliva in correlation to oral health in JIA children.MethodsThirty-four JIA patients and 34 age- and sex-matched controls not affected by JIA (C) were divided into two groups: with mixed and permanent dentition. DMFT/dmft, gingival and simplified oral hygiene indices were evaluated. Salivary flow rate, pH, lysozyme, lactoferrin, salivary protein concentrations and peroxidase activity were assessed.ResultsThe salivary flow rate was significantly lower in the total JIA group (0.41 ml/min) as compared with the C (0.51 ml/min) and in the permanent dentition of JIA children (0.43 ml/min) as compared with the C (0.61 ml/min). A significantly lower pH was observed in total (6.74), mixed (6.7) and permanent (6.76) dentition of JIA groups in comparison to the C (7.25, 7.21, 7.28 respectively). The specific activity of peroxidase was significantly higher in JIA patients (total 112.72 IU/l, mixed dentition 112.98 IU/l, permanent dentition 112.5 IU/l) than in the C group (total 70.03 IU/l, mixed dentition 71.83 IU/l, permanent dentition 68.61 IU/l). The lysozyme concentration in JIA patients (total and permanent dentition groups) was significantly higher than in the C group. There were no significant differences in lactoferrin and salivary protein concentrations. There were no statistically significant differences in oral status between JIA patients and C, respectively: DMFT = 5.71, dmft = 3.73, OHI-S = 0.95, GI = 0.25 and DMFT 5.71, dmft = 3.73, OHI-S = 0.85, GI = 0.24. The specific activity of peroxidase in the unstimulated whole saliva was inversely correlated with the GI index, whereas the salivary lysozyme concentration was inversely correlated with the dmft index in JIA patients.ConclusionIn the course of JIA occur a reduction of the resting salivary flow rate and a decrease of saliva pH. In spite of this, no differences in the clinical oral status between the JIA children population and the control group were found. The mobilisation of salivary peroxidase and lysozyme contributes to the maintenance of healthy oral tissues.

Comprehensive Assessment of Orofacial Health and Disease Related Parameters in Adolescents with Juvenile Idiopathic Arthritis—A Cross-Sectional Study

“…Other studies reporting this effect of increased caries experience showed clearly higher values than the current study [24]. On the other hand, recent studies could not find differences in the dmf-t/DMF-T [12,13,[16][17][18][19]. It is thereby conspicuous that studies with high caries experience [24] were performed before 2000, while caries prevalence in general has been reduced during past years [33].…”

“…The score for gingival inflammation showed an increase of one point in JIA-patients in this study compared to the general healthy population [33] (Table 4). Significantly higher presence of gingival inflammation [16,18,19] and dental plaque [12,17,19] have been reported but not by all available studies [12,13,16,18]. Reasons for the increased gingival and periodontal inflammation might be a generally increased inflammatory potential in rheumatic diseases [34] as well as affected oral behavior caused by general disease burden.…”

“…Moreover, these effects can be caused by the medication as well as emotional or psychosocial concerns of a chronic disease. Further influences could be challenges in oral hygiene due to an involvement of the upper limbs or the TMJ, sugar containing medication [11] and changed salivary parameters [12][13][14][15].…”

“…Previous studies about JIA patients showed inhomogeneous and controversial results regarding oral diseases [12,13,[16][17][18][19][20][21][22][23][24]. Some studies showed increased dental caries experience [24], gingival inflammation [16,18,19] and dental biofilm accumulation [12,17,19] whereas other studies could not confirm these results [12,13,[16][17][18][19]. Only a few studies have investigated signs of periodontitis in JIA patients.…”

Sialometric and Sialochemical Changes in Morbidly Obese Patients before and after Bariatric Surgery

“…The SSF demonstrates the amount of saliva released in a given period of time; the normal mean value for SSF described in the literature is 2 mL/min (1.0 to 3.0). 20 People with hyposalivation present a value of lower than 1 mL/min. Xerostomia and/or hyposalivation are (is) related to the lack of hydration or systemic conditions.…”