International Journal of Clinical Pediatric Dentistry

Register      Login

VOLUME 17 , ISSUE 3 ( March, 2024 ) > List of Articles

ORIGINAL RESEARCH

Comparison of Salivary Flow Rate, pH, Buffering Capacity, and Secretory Immunoglobulin A Levels between Children with Early Childhood Caries and Caries-free Children

Anjali Sivakumar, Retnakumari Narayanan

Keywords : Buffering capacity, Early childhood caries, Salivary flow rate, Salivary immunoglobulin A, Salivary pH

Citation Information : Sivakumar A, Narayanan R. Comparison of Salivary Flow Rate, pH, Buffering Capacity, and Secretory Immunoglobulin A Levels between Children with Early Childhood Caries and Caries-free Children. Int J Clin Pediatr Dent 2024; 17 (3):334-340.

DOI: 10.5005/jp-journals-10005-2751

License: CC BY-NC 4.0

Published Online: 01-06-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Background and objectives: Early childhood caries (ECC) is the most common chronic disease of childhood in many developing countries, which is associated with local, systemic, psychological, and social consequences. Multiple variables are shown to be associated with an increased risk of ECC. The knowledge regarding the role of saliva in the pathophysiological process of ECC still remains controversial and unexplored. Scanty studies focused on probing the role of salivary flow rate, pH, buffering capacity, and secretory immunoglobulin A (sIgA) in unstimulated whole saliva of children with ECC and children without ECC. Aim: To assess the salivary flow rate, pH, buffering capacity, and sIgA levels in children with ECC and caries-free children and to evaluate their role in caries risk assessment. Materials and Methods: The study was carried out among 64 children aged between 24 and 71 months. Clinical examinations were carried out according to the criteria by the World Health Organization, and carious status was recorded. Subjects were categorized as group I with ECC (dmfs-Decayed, Missing or Filled Surfaces (Deciduous dentition) of ≥5), and group II included children without ECC (dmfs = 0). Unstimulated whole salivary samples were collected in a sterile vial and stored at −70°C by draining. Estimations of salivary flow rate, pH, buffering capacity, and sIgA levels were done. Digital pH meters were used for the estimation of pH and buffering capacity. A human IgA enzyme-linked immunosorbent assay (ELISA) kit was used to estimate sIgA levels. Statistical software IBM Statistical Package for the Social Sciences (SPSS) statistics 20.0 (IBM Corporation, Armonk, New York, United States of America) was used to analyze the data. Results: The mean salivary flow rate decreased in group I children with ECC (0.15 ± 0.05) when compared to group II children without ECC (0.67 ± 0.14), which was statistically significant. In caries active children, no statistically significant correlation was found between salivary flow rate and the dmfs scores [r-value (−0.247)] and p-value (0.147). The mean level of salivary pH is decreased in group I children with ECC (4.65 ± 0.4) when compared to group II children without ECC (7.28 ± 0.18). In the caries active group, the levels of salivary pH decrease as the dmfs scores increase, and this correlation is found to be statistically significant (r-value of 0.547 and p-value of 0.002). The mean level of buffering capacity is decreased for caries-active children (5.45 ± 0.49) when compared to caries-free children (8.94 ± 0.42). In caries active children, as the dmfs scores increase, the salivary buffering capacity decreases, and this correlation is found to be not statistically significant (r-value of −0.334 and p-value of 0.161). The mean levels of sIgA in group I children with ECC were higher (10.61 ± 0.90) than that in group II children without ECC (6.11 ± 1.22). In the caries-active group, the salivary sIgA levels were comparatively higher than in the caries-free children. As the dmfs scores increase, the level of the sIgA increases in caries-active children, and this correlation is noted to be highly statistically significant (r-value of 0.769 and p-value 0.008). Conclusion: Children with ECC showed decreased salivary flow rate, pH, buffering capacity, and increased sIgA levels, while children without ECC showed increased salivary flow rate, pH, buffering capacity, and decreased sIgA levels. The salivary parameters, such as salivary flow rate and buffering capacity, showed no correlation with the dmfs score, while salivary pH and sIgA levels have a positive correlation in caries-active children.


HTML PDF Share
  1. Machiulskiene V, Campus G, Carvalho JC, et al. Terminology of dental caries and dental caries management: consensus report of a workshop organized by ORCA and Cariology Research Group of IADR. Caries Res 2020;54(1):7–14. DOI: 10.1159/000503309
  2. Academy of Pediatric Dentistry Guidelines; Council of Clinical Affairs; Latest Revision 2016. Policy on early childhood caries (ECC): classification, consequences and preventive strategies.
  3. Prabhakar A, Dodawad R, Os R. Evaluation of flow rate, pH, buffering capacity, calcium, total protein and total antioxidant levels of saliva in caries free and caries active children-an in vivo study. Int J Clin Pediatr Dent 2009;2(1):9–12. DOI: 10.5005/jp-journals-10005-1034
  4. Pyati SA, Naveen Kumar R, Kumar V, et al. Salivary flow rate, pH, buffering capacity, total protein, oxidative stress and antioxidant capacity in children with and without dental caries. J Clin Pediatr Dent 2018;42(6):445–449. DOI: 10.17796/1053-4625-42.6.7
  5. Preethi BP, Pyati A, Dodawad R. Evaluation of flow rate, pH, buffering capacity, calcium, total protein and total antioxidant levels of saliva in caries free and caries active children - an in vivo study. Biomed Res 2010;21(3):289–294.
  6. Animireddy D, Reddy Bekkem VT, Vallala P, et al. Evaluation of pH, buffering capacity, viscosity and flow rate levels of saliva in caries-free, minimal caries and nursing caries children: An in vivo study. Contemp Clin Dent 2014;5(3):324–328. DOI: 10.4103/0976-237X.137931
  7. Thaweboon S, Thaweboon B, Nakornchai S, et al. Salivary secretory IgA, pH, flow rates, mutans streptococci and Candida in children with rampant caries. Southeast Asian J Trop Med Public Health 2008;39(5):893–899.
  8. Lamberts BL, Pederson ED, Shklair IL. Salivary pH-rise activities in caries-free and caries-active naval recruits. Arch Oral Biol 1983;28(7):605–608. DOI: 10.1016/0003-9969(83)90008-0
  9. Gopinath VK, Arzreanne AR. Saliva as a diagnostic tool for assessment of dental caries. Arch Orofac Sci 2006;1(1):57–59.
  10. Malekipour MR, Messripour M, Shirani F. Buffering capacity of saliva in patients with active dental caries. Asian J Biochem 2008;3(5):280–283.
  11. Qiong Zhou Q, Bai J, Qin M. [Relationship between cariogenic microbe, salivary buffer capacity and early childhood caries]. Zhonghua Kou Qiang Yi Xue Za Zhi. 2007;42(10):581–584.
  12. Ranadheer E, Nayak UA, Reddy NV, et al. The relationship between salivary IgA levels and dental caries in children. J Indian Soc Pedod Prev Dent 2011;29(2):106–112. DOI: 10.4103/0970-4388.84681
  13. Gornowicz A, Tokajuk G, Bielawska A, et al. The assessment of sIgA, histatin-5, and lactoperoxidase levels in saliva of adolescents with dental caries. Med Sci Monit 2014;20:1095–1100. DOI: 10.12659/MSM.890468
  14. de Farias DG, Bezerra AC. Salivary antibodies, amylase and protein from children with early childhood caries. Clin Oral Investig 2003;7(3):154–157. DOI: 10.1007/s00784-003-0222-7
  15. Al Amoudi N, Al Shukairy H, Hanno A. A comparative study of the secretory IgA immunoglobulins (s.IgA) in mothers and children with SECC versus a caries free group children and their mothers. J Clin Pediatr Dent 2007;32(1):53–56. DOI: 10.17796/jcpd.32.1.l338366jw54634q5
  16. Pal S, Mitra M, Mishra J, et al. Correlation of total salivary secretory immunoglobulin A (SIgA) and mutans specific sIgA in children having different caries status. J Indian Soc Pedod Prev Dent 2013;31(4):270–274. DOI: 10.4103/0970-4388.121831
  17. Cogulu D, Sabah E, Kutukculer N, et al. Evaluation of the relationship between caries indices and salivary secretory IgA, salivary pH, buffering capacity and flow rate in children with Down's syndrome. Arch Oral Biol 2006;51(1):23–28. DOI: 10.1016/j.archoralbio.2005.06.001
  18. Doifode D, Damle S. Comparison of salivary IgA levels in caries free and caries active children. Int J Clin Dent Sci 2011;2:10–14.
  19. Bagherian A, Asadikaram G. Comparison of some salivary characteristics between children with and without early childhood caries. Indian J Dent Res 2012;23(5):628–632. DOI: 10.4103/0970-9290.107380
  20. Shifa S, Muthu MS, Amarlal D, et al. Quantitative assessment of IgA levels in the unstimulated whole saliva of caries-free and caries-active children. J Indian Soc Pedod Prev Dent 2008;26(4):158–161. DOI: 10.4103/0970-4388.44031
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.