Prevalence of oral lesions and measurement of salivary pH in the different trimesters of pregnancy

Abstract

INTRODUCTIONMany epidemiological studies on the prevalence of oral lesions and dental health status of pregnant women have been conducted worldwide.(1-6) However, data on the prevalence of oral lesions in the different trimesters of pregnancy is scarce. Investigations that have been done in the different trimesters are mainly restricted to dental health status and not many factors have been studied. Therefore, this study was undertaken to assess the prevalence of oral lesions during the different trimesters of pregnancy and their correlation with salivary pH change, and comparing the results against those in nonpregnant women. We also attempted to assess the changes to oral hygiene, caries, gingival and periodontal health statuses, and salivary pH in the different trimesters of pregnancy. METHODSThe study group comprised a total of 120 pregnant women (40 in the first trimester, 40 in the second, and 40 in the third) between 18 and 35 years old who attended the outpatient clinic of the Obstetrics and Gynaecology department of MM Medical Hospital, India. The control group comprised 40 nonpregnant women in a corresponding age group. The following are the exclusion criteria used in the present study: (a) contributory medical history of pathological conditions and history of drug therapy that may cause oral mucosal lesions and changes in salivary pH; and (b) smoking/ tobacco chewing habit. Data pertaining to education level and general awareness of oral hygiene were collected. The participants were from nearby villages, and most of them had dropped out of school with only a primary education. The following indices were used to assess participants' gingival and periodontal health statuses, and determine the number of teeth that were decayed, missing or filled: (a) gingival index (GI); (7) (b) simplified oral hygiene index (OHI-S); (8) (c) community periodontal index (CPI); (9) and (d) decayed-missing-filled teeth index.(10) Participants were clinically examined for the following parameters: oral hygiene, gingival health, periodontal health, dental caries, and the presence of any gingival or oral mucosal lesions (or any other oral lesions). Saliva samples were collected for the measurement of salivary pH using a digital pH meter (LT-23; Labtronics, Panchkula, Haryana, India). Saliva samples were collected from each participant at least one hour after breakfast, which would yield unstimulated saliva. For the collection of these samples, all participants were requested to be as quiet as possible. They were instructed to allow the saliva to flow into the mouth as normally as possible and expectorate into the large test tubes provided. In all, 8-10 mL of sample was collected for each participant. The pH of each sample was determined within the first half an hour after collection.The data obtained was systematically tabulated and subjected to statistical analysis. Statistical correlations among all the parameters within the first, second and third trimester groups and the control group were determined using Pearson's coeffi...

Systemic alterations and their oral manifestations in pregnant women

“…During pregnancy, dietary changes are common, such as regular consumption of snacks, sugary drinks, and citrus foods, to satisfy desires or prevent nausea. Such habits may lead to a drop in salivary pH, thus favoring an increase in the number of acidophilic microorganisms . Jain and Kaur observed an increase of Streptococcus mutans and Lactobacillus levels, especially in late pregnancy, comparing the saliva of pregnant with non‐pregnant women …”

“…It can be deduced that most of these effects on the oral tissues during pregnancy could be avoided by practicing proper oral hygiene and clinical dental follow‐up …”

Dose-adjusted Plasma Concentrations of Sublingual Buprenorphine are Lower During than After Pregnancy

“…13 A low salivary pH can reduce absorption, as less of the drug would be unionized, and this could contribute to a smaller AUC during pregnancy. In our population, salivary pH did not differ between groups, and therefore, was not correlated with changes in AUC 0→12 , Cmax, Tmax nor dissolution time.…”

The biochemistry of saliva throughout pregnancy

“…6,12,13,15,[19][20][21][22][23][24] Among all the analysis performed, and taking together previous studies and the present study, we can confidently assume that pregnancy reduces non-stimulated saliva pH. 6,12,13,19,21 The decrease of saliva pH during pregnancy may be partially justified by the higher number of daily meals. 6,26 The acidic saliva throughout pregnancy represents a risk factor for dental caries development.…”

“…14,15,21,23,34,35 Regarding salivary flow rate, most studies, including ours, reported no changes between pregnant and nonpregnant women; 6,13,19,20 however, Naveen et al 12 showed higher rates for either stimulated or non-stimulated saliva. In addition, reports regarding salivary flow rate throughout pregnancy are controversial, 34,35 suggesting that many factors may regulate this flow during pregnancy.…”