Correlation of Blood and Salivary pH Levels in Healthy, Gingivitis, and Periodontitis Patients before and after Non-Surgical Periodontal Therapy

Abstract

Periodontitis is an infectious illness which leads to the inflammation of protective tissues around the teeth and the continuous loss of alveolar bone and conjunctive tissue. Biomarker analysis in serum and saliva helps in the evaluation of disease progression and activity. It is also established that every inflammatory change along with resultant damage of tissues ends up in altered pH values in the fluids and tissues. Aim: To correlate the connection of pH levels in both blood as well as saliva in healthy, periodontitis, and gingivitis patients. Materials and Methods: The current research involved 145 subjects amidst the age of 20 and 55 years. The subjects were split into three different groups: healthy (Group A), gingivitis (Group B), and finally chronic periodontitis (Group C). The recording of clinical parameters was done by gingival index (GI), probing depth (PD), and plaque index (PI). pH of saliva and blood was analyzed with the help of digital single electrode pH meter. Subjects have gone through scaling and root planning (SRP) coupled with the instructions of oral hygiene. They were recalled post 4 weeks, and saliva and blood samples were gathered for analyzing pH. Results: Clinical parameters GI and PI were statistically important in both group C as well as group B post SRP. A crucial change has been observed in attachment levels (AL) and PD in the case of periodontitis group post SRP. The difference in the salivary pH values were significant between group B vs. C and A vs. C before the treatment because the values for group C were acidic, whereas in groups B and A the pH was alkaline. After the treatment, the values were still significant because the pH has become more alkaline compared to preoperative value in both group B and C. Saliva’s pH levels have demonstrated a statistically significant reduction in group C post SRP. Conclusion: Salivary pH levels and blood evidently became alkaline in the group C patients post SRP and there is a positive correlation between them and the clinical parameters.

Randomized clinical trial on the clinical effects of a toothpaste containing extra virgin olive oil, xylitol, and betaine in gingivitis

“…The test toothpaste increased salivary pH to a slightly alkaline pH with a mean of 7.5, being more favorable for oral eubiosis 30 . The pH value is important for preserving correct cell biochemistry and tissue homeostasis, and it is low at sites with inflammation or cell destruction 31 .…”

“…It was recently demonstrated that periodontal pathogens grow in a moderately acid environment, e.g., pH of 5.0-7 for P. intermedia, pH of 5.5-7 for F. nucleatum, and pH of 6.5-7 for P. gingivalis. Also, the salivary pH of patients with periodontitis became more alkaline after scaling and root planning 30 . A recent study described both salivary flow and pH as markers of periodontitis severity, which was correlated with low pH values (6.25 in www.nature.com/scientificreports/ grade IV periodontitis) and low salivary flow (0.28 mL/min); conversely, pH and flow values were significantly increased in patients with severe periodontitis after 3 months of periodontal treatment (hygienization) 33 .…”

Minimization of Adverse Effects Associated with Dental Alloys

“…The decrease in salivary pH is the significant factor aggravating chemical corrosion and galvanic corrosion [ 100 , 118 ]. The decrease in salivary pH is commonly observed in patients with periodontal disease [ 119 ] and in patients with multiple caries [ 120 ]. Moreover, many systemic diseases and conditions may change the electrochemical characteristics of saliva [ 112 , 121 , 122 , 123 , 124 , 125 , 126 ].…”

Antigingivitis, Desensitizing, and Antiplaque Effects of Alkaline Toothpastes: A Randomized Clinical Trial

“…Apart from other oral environmental conditions, i.e., nutrition, atmosphere, and redox potential [ 6 ], dental biofilm growth rate may be influenced by temporary alterations of oral acidity or alkalinity [ 6 , 7 ]. The mean pH of saliva is 6.7, within the normal range of 6.2–7.6 [ 8 ]. The resting oral pH may vary between 5.0 and 9.0 depending on different factors, including age [ 9 ], gender [ 9 , 10 ], season, and even time of day [ 10 ].…”

“…At neutral pH, saliva inhibits bacterial glycolysis, thus preventing the development of anaerobic conditions [ 7 ]. Values below 7.0 indicate acidity; at this pH, the oral cavity is more susceptible to dental caries, periodontal diseases, and halitosis [ 8 , 22 ]. A study by Takashi et al showed that the growth of periodontal pathogens ( P. intermedia , F. nucleatum , and P. gingivalis ) occurs mainly at a pH of 5.0–7.0 [ 23 , 24 ].…”