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Background/Objectives: Pediatric periodontal inflammation arises from complex host–microbe interactions. Beyond bacterial biofilms, fungal colonization—particularly by Candida albicans—is increasingly recognized as a contributor. The aim of this study was to investigate the relationship between fungal and bacterial colonization, host inflammatory mediators, and salivary parameters in children. It also aimed to identify salivary biomarkers that could be useful for the early diagnosis of oral candidiasis and periodontal inflammation. Methods: A cross-sectional study was performed on 140 children (8–15 years): healthy controls (n = 70) and cases with oral candidiasis (n = 70). Clinical indices (Plaque Index, Gingival Index, Bleeding on Probing), salivary flow, pH, and buffering capacity were recorded. Quantitative PCR assessed C. albicans and four periodontal pathogens, while ELISA measured salivary cytokines (IL-1β, IL-6, TNF-α, IL-8). Analyses included group comparisons, correlations, regression modeling, and principal component analysis (PCA). Results: Children with candidiasis exhibited higher PI, GI, and BOP (p < 0.001), along with reduced pH and buffering capacity (p < 0.001). Salivary loads of C. albicans and all targeted pathogens were elevated (p < 0.001). Cytokine levels were markedly increased (p < 0.001). GI correlated with C. albicans (ρ = 0.71) and cytokines (ρ = 0.62–0.76). Logistic regression identified C. albicans and IL-1β as independent predictors, while salivary pH and flow were found to be protective. PCA distinguished groups, with PC1 (55.2%) driven by fungal and cytokine markers. Conclusions: Oral candidiasis in children is defined by distinct microbial and inflammatory profiles. Salivary biomarker integration offers potential for early, non-invasive diagnosis and risk stratification.

In the gastroesophageal reflux disease (GERD), a highly prevalent digestive disorder, gastric content may return to the esophagus and reach the mouth, thus leading to a small number of carious lesions and high incidence of dental erosion. Since saliva plays a major role in oral homeostasis, evaluating salivary parameters is necessary in attempting to explain such outcome. This study aimed at analyzing salivary parameters (salivary flow, pH and buffering capacity), bacterial count, caries index and dental erosion in patients with GERD. Sixty patients were studied, and of these, 30 had GERD (group 1), and 30 were controls (group 2). Gastroesophageal reflux disease diagnosis confirmation was achieved by means of endoscopy, manometry and pH metric esophageal monitoring. The above mentioned salivary parameters were evaluated in patients from groups 1 and 2. The number of erosions in patients with GERD (group 1) was larger than in controls (P<0.001). The number of carious teeth was smaller in group 1 than in group 2 (P<0.001). Salivary flow (non-stimulated and stimulated) and pH did not show differences between the 2 groups (P = 0.49; P = 0.80 and P = 0.85, respectively). Salivary buffering capacity in patients with GERD showed lower values in controls (P = 0.018). The number of bacteria (Lactobacilli and Streptococci) was smaller in patients with gastroesophageal reflux disease than in controls (P = 0.0067 and P = 0.0017, respectively). It was concluded that the large number of erosions must be a result of GERD patients reduced salivary buffering capacity. The reduced number of caries of patients in group 1 can be explained by the low prevalence of bacteria (Lactobacilli and Streptococci), observed in the saliva of patients with chronic reflux.

IntroductionDental caries is a chronic, infectious, and irreversible disease of the calcified tissues of teeth, which demineralises the inorganic portion and destroys the organic substance of the tooth, which often leads to cavitation. Epidemiological studies measuring the prevalence and severity of dental caries have used modified versions of Klein and colleagues’ decayed, missing, and filled (DMF) or Gruebbel’s decayed, extraction indicated, and filled (def) indexes; however, these indexes only capture cavitated lesions. Saliva plays a vital role in caries prevention; significant reduction or deterioration of salivary function can aggravate the development of dental caries. Saliva affects the incidence of dental caries in four ways: as a mechanical cleansing agent that results in less accumulation of plaque, by reducing enamel solubility using calcium, phosphate, and fluoride, by buffering and neutralising the acids produced by cariogenic organisms, or by introducing directly through diet and by antibacterial activity. The study aims to assess the prevalence of dental caries and salivary parameters such as salivary pH, flow, and buffering capacity in six to 12 years old children of a rural tehsil of Jaipur.Materials and methodsThe study was done on a population consisting of 400 school-going children in the age group of six to 12 years. Oral examination was undertaken by a single examiner, who is the study's principal investigator, to avoid inter-examiner variability. Testing of resting saliva was done for evaluation of visual inspection of the level of hydration, saliva consistency, pH measurement, saliva quantity, and buffering capacity.Statistical analysisThe data were analysed using the chi-square test, t-test, and statistical software SPSS version 17.00 (SPSS Inc., Chicago, IL). The chi-square test was used to compare and analyse qualitative data, whereas the unpaired t-test was used to analyse and compare quantitative data. Quantitative data were summarised as mean and standard deviation. A p-value of 0.001 or less was considered for standard significance.ResultsThere was no significant difference in resting salivary flow rate between children with decayed, missing, and filled teeth (DMFT) scores less than 5 and DMFT scores of 5. The mean buffering capacity of stimulated saliva was found to be significantly more among children with DMFT scores less than 5 than children with DMFT scores of 5 or more. The mean pH of resting saliva was found to be significantly higher among children with DMFT scores less than 5 than children with DMFT scores of 5 or more.ConclusionThe prevalence of caries based on age was maximum in mixed dentition and minimum in primary dentition. In contrast, the difference in severity based on age was maximum in permanent dentition. The prevalence of caries was higher in children whose parents were aware of dental health; the difference was more significant in children with primary and mixed dentition. This study showed that salivary parameters such as salivary flow rate, salivary pH, and salivary buffering capacity among school-going children correlated with the prevalence of caries.

The aim of this study was to investigate carbonic anhydrase (CA) VI Exon 2 single nucleotide polymorphism (SNP) and its possible association with salivary parameters in type 2 diabetic patients compared to healthy adults. Caries status was measured by using the DMFT (number of decayed, missing, and filled teeth) index. Unstimulated whole saliva and blood samples were taken. SNPs of CA gene exon 2 were determined by PCR and DNA sequencing. Salivary CA activity and buffering capacity were determined by the method of Verpoorte and Ericson, respectively. Furthermore, salivary pH was measured with pH paper and salivary flow rate was calculated. Salivary buffering capacity and pH were significantly lower in diabetic patients than those of healthy subjects (P<0.05). Salivary flow rate, CA activity and DMFT levels did not differ between groups (P>0.05). Four SNPs were detected; their pubmed database number are rs2274327 (C/T), rs2274328 (A/C), rs2274329 (G/C) and rs2274330. While first three of those were responsible for amino acid changes, the last one was not. The frequencies of SNPs were not significant between groups (P>0.05). Positive significant correlation was found between CA activity and the frequency of SNPs. There was no correlation between the SNPs frequencies and pH or buffering capacity. SNPs found in this study may be related to salivary CA activity in diabetics.

Introduction: The relatively frequent systemic comorbidities of geriatric patients can be linked to salivary changes, which may induce oral alteration and discomfort with the removable prosthesis. The aim of the study was to evaluate the salivary parameters in completely edentulous patients treated by removable prosthesis, in relation to their general health status.Material and method: A cross-sectional study was performed on 30 completely edentulous patients, 53% male and 47% female, aged between 53 and 84. The evaluation of the salivary parameters (oral hydration index, pH and salivary flow, viscosity and saliva buffer capacity) was performed with the Saliva Check Buffer kit (GC Corporation).Results: The salivary changes encountered were the following: low hydration level (63%), high saliva viscosity (57%), below-average pH (27%), reduced salivary flow (77%) and low saliva buffer capacity (80%). A reduced salivary flow and saliva buffer capacity was found in women. A lower buffer capacity of the saliva was found in patients with respiratory and gastro-intestinal disease.Conclusions: The alterations of the salivary flow are relatively frequent in geriatric patients, removable denture wearers, with compromised systemic status. These changes may be a risk factor for denture stomatitis and oral candidiasis, with a negative effect on the patient’s comfort and quality of life.

Introduction: Dental caries and impaired salivary function are very common but undertreated. The aim of this study was to investigate the oral health status and salivary parameters of stroke patients. Methods: A cross-sectional study was carried out on 54 stroke and 54 non-stroke patients attending rehabilitation treatment at Hospital Universiti Sains Malaysia. Decay, Missing and Filled Teeth (DMFT) index and plaque scores were used to evaluate patients’ oral health. Salivary parameters such as salivary cortisol, salivary flow rate, pH and buffering capacity were measured. Salivary cortisol was analysed using Cobas E6000 automated immunoassay. Results: Among the 54 stroke patients, the majority were Malays 72.2% and 63.0% were male, with a mean age of 48.1 (14) years. There was a significant difference of dental caries between stroke patients, at 17.6 (4.26), compared to 15.7 (5.38) for non-stroke patients (p=0.042). Only 53.7% of stroke patients had good oral hygiene, compared to, 85.2% among non-stroke patients’ (p-value= 0.001). Salivary parameters showed no significant differences (p&gt;0.05). However salivary cortisol levels were higher in stroke patients 5.2(5.1) nmol/L) than in non-stroke patients 4.0 (3.6) nmol/L). There was no significant correlation between salivary parameters and DMFT index (P&gt;0.05). Conclusion: Stroke patients had more dental caries and poor oral hygiene compared to non-stroke patients. Salivary parameters showed no significant difference between stroke and non-stroke patients.

A motion sickness plaster releasing a powerful antisialogogic agent, scopolamine, was tested in a double blind clinical trial for its effect on salivary parameters in 14 healthy young men. The agent caused a decline in salivary flow rates, which was most pronounced during unstimulated conditions. Salivary pH and buffer capacity were also reduced. Salivary levels of Streptococcus mutans and lactobacilli showed a tendency to increase during 2 days on the antisialogogic agent, but the effect on S. mutans levels was not statistically significant.

ContextType 1 diabetic children exhibit poorer oral health than general population. However, no oral health preventive protocol exists for attending to the oral health needs of such children.AimTo evaluate the effect of an oral health preventive protocol on salivary parameters and gingival health of children with type 1 diabetes mellitus over a period of 6 months.Materials and methodsFifty diabetic children, aged 6–12 years were selected and divided into two groups. Children in group I received a comprehensive oral health preventive protocol. The parameters recorded were oral hygiene practices, salivary flow rate, pH, buffer capacity, viscosity, electrolytes, and plaque and gingival indices. These were compared at baseline, 3-, and 6-month intervals.Statistical analysisStatistical analysis was done using IBM SPSS STATISTICS (version 22.0). Tests were based on the type of data.ResultsThe intervention group (group I) showed favorable improvements in the parameters assessed. A greater number of participants adopted the correct oral hygiene methods. Unstimulated salivary flow rate increased from 0.36 ± 0.21 to 0.82 ± 0.16 mL/minute in group I and from 0.32 ± 0.24 to 0.58 ± 0.16 mL/minute in group II after 6 months (p = 0.001). Salivary buffer capacity increased from 3.07 ± 2.64 to 10.40 ± 0.82 in group I while in group II, it improved from 3.20 ± 1.47 to 9.33 ± 1.44 (p = 0.02). Salivary viscosity decreased in group I from 1.97 ± 0.42 to 1.15 ± 0.06 and from 1.97 ± 0.35 to 1.23 ± 0.11 in group II after 6 months (p = 0.02). Gingival scores changed from 1.07 ± 0.35 to 0.20 ± 0.23 in group I and from 1.04 ± 0.28 to 0.85 ± 0.25 in group II (p = 0.001).ConclusionThe preventive protocol used in the present study showed a significant (p < 0.05) improvement in the parameters assessed.How to cite this articleSingh V, Gauba K, Goyal A, et al. Effect of an Oral Health Preventive Protocol on Salivary Parameters and Gingival Health of Children with Type 1 Diabetes. Int J Clin Pediatr Dent 2021;14(1):109–114.

Radiotherapy for head and neck cancer (HNC) frequently results in irreversible salivary gland damage and persistent xerostomia. This study aimed to assess the efficacy of a topical mucoadhesive disc containing xylitol in comparison to water with respect to (i) subjective symptom burden of nocturnal dry mouth and (ii) objective salivary flow parameters in post-radiotherapy HNC patients. In a randomized, single-blind, crossover-controlled clinical trial, 33 patients with radiotherapy-induced xerostomia received either adhesive discs (XyliMelts) or water across two treatment phases, separated by a washout period of 7 days. Subjective outcomes were assessed using a 100 mm visual analogue scale (VAS) and the Shahdad symptom relief questionnaire. Objective measures included unstimulated and stimulated salivary flow rates. Within-group pre-post comparisons were analyzed using paired t-tests or Wilcoxon signed-rank tests; between-group differences were assessed using independent t-tests or Mann-Whitney U tests (p < 0.05). Adhesive discs use was associated with significantly greater subjective symptom relief (76% vs. 24%; p < 0.001), improved sleep continuity (67% vs. 9%; p < 0.001), and higher willingness to continue product use (70% vs. 30%; p = 0.044). Perceived oral moisture, comfort, and flavor ratings were also higher with adhesive discs. No changes were observed in salivary flow parameters. Tolerability was high, with minimal adverse events reported. Topical, symptom-oriented interventions may provide meaningful relief for patients suffering from post-radiotherapy xerostomia, especially when regenerative treatment options are limited. Further clinical trials are warranted to confirm these findings in larger populations and to evaluate long-term efficacy and safety. Mucoadhesive xylitol discs appear to be well tolerated and are perceived as beneficial by patients experiencing xerostomia following HNC therapy.

Objective: The pivotal role of saliva in maintaining oral environment is accomplished through regulation of its flow rate, Potential of Hydrogen (pH), and secretion of minerals, including calcium. The great number of calciums contained in Almond is beneficial for preserving oral health. The current study aimed to assess the effect of almond intake on salivary parameters and its calcium levels from individuals with and without caries. Methods: The study was an experimental design with pretest and posttest. The subjects were divided into two categories, control (wax gum pieces) and treatment (almond) group, respectively. Sample was isolated for both unstimulated and stimulated saliva. The flow rate, pH, buffer capacity and calcium levels were determined. The data analysis were performed using a Statistical Package for the Social Sciences (SPSS) software and a t-test was selected to evaluate the statistical difference. Results: Almonds significantly increased salivary flow rate, pH, buffer value and calcium ion levels (p&lt;0.05). In addition, the greater change of pH, buffer capacity, calcium ions, excluding pH value were noticed in almond stimulation compared to wax gums (p&lt;0.05). No significant difference of saliva flow, pH and buffers between caries and non-caries individuals was observed, but saliva from free decay teeth showed more calciums secretion than the decay teeth. Conclusion: Almonds promoted the raise of salivary flow rate, pH, buffer capacity and calcium ions both in the healthy and caries subjects. Keywords: Prunus dulcis, Saliva, Flow rate, Buffer capacity, Calcium

Purpose: Compare the risk for dental caries between a group of immunodeficient children and a group of healthy children, by analysis of salivary flow (SF), the hydrogenionic potential of saliva (pH), buffering capacity (BC), Streptococcus mutans count (SM) and the presence of dental caries. Methodology: Thirty children were selected for this study and divided in G1- immunodeficient children and G2-healthy children. Salivary flow (SF) was obtained by the method of stimulated saliva. The measurement of pH and TC levels were measured by pH indicator strips. To determine Streptococcus mutans (SM), 0.1 ml of each sample was transferred to a microtube with 0.9 ml sterile NaCl. Four dilutions were made and 0.1 ml aliquots of each dilution were inoculated in Mitis salivarius agar and incubated at 37 °C for 48h. The children underwent to an intraoral clinical examination to identify dental caries. The data were analyzed by the Mann- Whitney test (α=0.05). Results: G1 and G2 showed very low values of SF. Both groups showed normal pH values. With regard to BC, the majority of subjects in both groups had pH> 5.5. There was no statistically significant difference regarding the levels of SF, SM and the presence of carious lesions. Conclusion: Immunodeficiency was not a determinant factor to increase the risk of caries to the evaluated children. Caries risk in children with and without immunodeficiency - a comparative study

Effect of orthodontic fixed appliances on salivary flow and viscosity

This study aimed to evaluate the effect of human saliva in vitro and salivary flow in situ on the roughness and mineral content of bleached enamel. Dental specimens were divided into five groups (n=15): not bleached (NB); bleached (35% hydrogen peroxide) and exposed to distilled water (DW); human saliva in vitro (IV); normal salivary flow in situ (NSF); and low salivary flow (LSF) in situ. Enamel roughness (Ra, Rz) and calcium/phosphorus contents were evaluated with laser profilometry and energy-dispersive spectroscopy, respectively, at baseline (T1), after bleaching (T2), and after seven days (T3). Salivary pH and buffer capacity were evaluated with colorimetric strips and salivary calcium and phosphorus with absorbance spectrophotometry. Data were analyzed with non-parametric tests and linear regression (α=0.05). After contact with saliva, Ra and Rz of LSF=DW>IV=NSF=NB was found. For DW and LSF, the roughness of T1<T2=T3 was found. For IV, T1<T3<T2; for NSF, T1=T3<T2. Enamel calcium/phosphorus content did not change with bleaching or with saliva contact (p≥0.05). Buffer capacity and calcium concentration did not differ between LSF and NSF. Phosphorus was higher, and pH was lower in LSF. Ra and Rz were, respectively, 0.14 and 1.95 lower with NSF than LSF. The conclusions were that NSF in situ and human saliva in vitro recovered original enamel roughness. The experimental conditions did not affect enamel mineral content. Recovery of bleached enamel roughness was higher in NSF when compared to LSF, regardless of salivary pH, calcium and phosphorus concentrations, and buffer capacity.

Mastic is a resin derived from the mastic tree (Pistacia lentiscus). The scent of mastic is known to have a stimulating effect on salivary secretion. The present study aimed to measure the effect of chewing mastic on various salivary parameters. For comparison, chewing parafilm, a tasteless wax, and a commercially available chewing gum were included. This study was conducted with 35 participants. Saliva samples were collected on 3 separate days, with each participant receiving 1 of the 3 chewing stimuli on each study day. Salivary flow rate, pH, and spinnbarkeit were determined. The results showed that chewing mastic, like chewing gum, increased salivary flow and pH compared to chewing parafilm. Chewing mastic resulted in the highest increase in salivary pH. In all cases, spinnbarkeit decreased after chewing; this effect was least pronounced when chewing gum.

Dental erosion, gastro-oesophageal reflux disease and saliva: how are they related?