Salivary p H: A diagnostic biomarker

Introduction

The Department of Periodontology and Implantology, M.A. Randoonwala College of

Dental Sciences and Research Centre, Pune, India conducted a study to test the correlation

between the pH of saliva and periodontal disease. It is known that saliva is a dilute fluid

consisting mainly of water. Saliva also contains epithelial cells, microorganisms, blood, fluid

from gingival crevice and food particles. Saliva acts as a buffer to maintain a normal pH and to

protect the teeth from too much acidity. However, oral diseases such as tooth decay and

periodontist are associated with changes in a hosts environment. Therefore a study was designed

to test pH levels and to determine its severity to periodontal disease.

Clinicians are using different techniques today to asses and diagnose patients with

periodontal disease. Dental radiographs are used to check patients bone levels, too much bone

loss can determine oral disease. Clinicians also perio chart to detect attachment levels and

probing depth. Clinicians and investigators see saliva tests potentially being an easier method to

diagnose oral disease due to it being non-invasive, easy-to-use, inexpensive and more

comfortable for the patients. Researchers have hypothesized that a lower pH correlates with the

severity of periodontitis.

Materials and Methods

Random sampling of saliva was used and gathered by 300 patients. Each of the 300

patients were categorized into three different groups. Group A which was the control group of

100 patients with healthy gingiva. Healthy gingiva is a probing depth up to 3mm. Group B

consisted of 100 patients who had generalized gingivitis. Gingivitis is bleeding in the gingival
sulcus at 2mm probe depth. Group C which consisted of 100 patients who had chronic

periodontists. Periodontitis is loss of attachment, bone loss, and less than or equal to 5 mm

probing depths. Participants with a history of systemic disease and tobacco use were excluded

from the study to avoid a compromise of the test.

The saliva sampling required a strict protocol to refrain from inefficiencies within the

test. Participants were required to fast the night before, saliva samples were collected in the

morning. The subjects were required to rinse their mouth out with bottled water five minutes

before the test. The participants spit into a collection tube every minute for ten minutes. The

saliva samples were immediately measured to prevent any error.

Results

Healthy gingiva from the control group A concluded to have a pH of 7.06 + or - .04.

Generalized gingivitis group B concluded to have a pH of 7.24 + or - .10. Group C generalized

periodontists concluded to have a pH of 6.85 + or - .11. Surprisingly generalized gingivitis had

more alkaline pH than those of the healthy gingiva. However a patient with periodontitis has a

pH that is more acidic than healthy gingiva.

Discussion

The study found that there is a correlation between a more acidic pH and periodontitis.

However a more extensive test will need to be performed to determine a more accurate

conclusion. A pH of 7.0 is generally a healthy patient with little to minimal calculus build up. A

7.0 pH is considered to be a stable environment in the oral cavity. Saliva below the p H of 7.0 is

more prone to getting dental carriers, halitosis and periodontitis. This may be of diagnostic

value in the future, but further elaborate studies with larger sample sizes are needed to draw
definite conclusions. (Sharmila Baliga, 2013) However saliva tests can be used alongside other

tools used to diagnose and check progression of periodontal patients.

Works Cited
Sharmila Baliga, S. M. (2013). Salivary pH: a diagnostic biomarker. Indian Society
Periodontology, 461-465.