Salivary flow rate response to stimulation with 2% citric acid in patients with xerostomia

Authors

  • Juan Aitken Saavedra Universidad de Chile; Federal University of Pelotas
  • Rodrigo Ponce Muñoz Universidad de Chile
  • Gonzalo Rojas Alcayaga Universidad de Chile
  • Sandra Chaves Tarquinio Federal University of Pelotas
  • Karine Duarte da-Silva Federal University of Pelotas
  • Ricardo Fernandez Ramires Universidad de Chile
  • Irene Morales Bozo Universidad de Chile https://orcid.org/0000-0002-7290-0580

DOI:

https://doi.org/10.5935/2525-5711.20180005

Keywords:

Xerostomia, Tongue, Citric Acid

Abstract

Objective: Xerostomia is the subjective sensation of dry mouth and it can be an indicator of hyposalivation what would have clinical consequences like increased risk of the development of oral diseases. For this reason, the stimulation of salivary flow with organic acids, such as citric acid, must be considered as a treatment strategy for xerostomic patients with hyposalivation. This study aimed to determine the salivary responses of patients with xerostomia to stimulation on the tongue with 2% citric acid. Material and Methods: This study recruited 62 patients with xerostomia. The differences in salivary flow rate (SFR), pH, and buffer capacity values were determined before and after 1, 2, 3, 5, 7, 9, 11, 13, or 15 min of stimulation on the tongue with 2% citric acid. Results: Among the recruited patients, 92% were women and 53% had hyposalivation. The average age of the recruited patients was 55 years. The mean basal SFR value was 0.282 ml/min (DS 0.305). SFR (p=0.001) increased and pH (p=0.000) and buffering capacity (p=0.000) decreased at 1 min poststimulation relative their basal values. The values of the three parameters stabilized at 2 min poststimulation and remained constant until the end of the measurement period. Conclusion: Citric acid could be used to stimulate salivary flow in xerostomic patients with hyposalivation maintaining salivary pH values and buffering capacity within an acceptable range. However, to be considered a possible therapy for this kind of patients, it is still necessary to perform more studies.

Author Biographies

Juan Aitken Saavedra, Universidad de Chile; Federal University of Pelotas

Universidad de Chile, Department of Oral Pathology and Medicine; Federal University of Pelotas, Post Graduate Program in Dentistry, School of dentistry; Federal University of Pelotas, Center of Diagnosis of Diseases of the Mouth

Rodrigo Ponce Muñoz, Universidad de Chile

Universidad de Chile, Department of Oral Pathology and Medicine

Gonzalo Rojas Alcayaga, Universidad de Chile

Universidad de Chile, Department of Oral Pathology and Medicine

Sandra Chaves Tarquinio, Federal University of Pelotas

Federal University of Pelotas, Pelotas-RS, Brazil, Post Graduate Program in Dentistry, School of dentistry; Federal University of Pelotas, Center of Diagnosis of Diseases of the Mouth

Karine Duarte da-Silva, Federal University of Pelotas

Federal University of Pelotas, Post Graduate Program in Dentistry, School of dentistry; Federal University of Pelotas, Center of Diagnosis of Diseases of the Mouth

Ricardo Fernandez Ramires, Universidad de Chile

Universidad de Chile, Department of Oral Pathology and Medicine

Irene Morales Bozo, Universidad de Chile

Universidad de Chile, Institute for Research in Dental Sciences

References

Bardow A, Nyvad B, Nauntofte B. Relationships between medication intake, complaints of dry mouth, salivary flow rate and composition, and the rate of tooth demineralization in situ. Arch Oral Biol. 2001;46:413-23.

Llena-Puy C. The role of saliva in mantaining oral health and as an aid to diagnosis. Med Oral Patol Oral Cir Bucal. 2006;11:E449-55.

Atkinson JC, Baum BJ. Salivary enhancement: current status and future therapies. J Dent Educ. 2001;65:1096-101.

Kivelä J, Laine M, Parkkila S, Rajaniemi H. Salivary carbonic anhydrase VI and its relation to salivary flow rate and buffer capacity in pregnant and non-pregnant women. Arch Oral Biol. 2003;48:547-51.

Porter SR, Scully C. Adverse drug reactions in the mouth. Clin Dermatol. 200;18:525-32.

Niklander S, Veas L, Barrera C, Fuentes F, Chiappini G, Marshall M. Risk factors, hyposalivation and impact of xerostomia on oral health-related quality of life. Braz Oral Res. 2017;31:e14.

Bretas LP, Rocha ME, Vieira MS, Rodrigues ACP. Fluxo Salivar e Capacidade Tamponante da Saliva como Indicadores de Susceptibilidade à Doença Cárie. Pesqui Bras Odontopediatr Clin Integr. 2008;8:289-93.

da Mata AD, da Silva Marques DN, Silveira JM, Marques JR, de Melo Campos Felino ET, Guilherme NF. Effects of gustatory stimulants of salivary secretion on salivary pH and flow: a randomized controlled trial. Oral Dis. 2009;15:220-8.

Ghezzi EM, Lange LA, Ship JA. Determination of variation of stimulated salivary flow rates. J Dent Res. 2000;79:1874-8.

Femiano F, Rullo R, di Spirito F, Lanza A, Festa VM, Cirillo N. A comparison of salivary substitutes versus a natural sialogogue (citric acid) in patients complaining of dry mouth as an adverse drug reaction: a clinical, randomized controlled study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112:e15-20.

Horswill CA, Stofan JR, Horn MK, Eddy DE, Murray R. Effect of exercise and fluid consumption on salivary flow and pH. Int J Sports Med. 2006;27:500-4.

Fox PC, van der Ven PF, Sonies BC, Weiffenbach JM, Baum BJ. Xerostomia: evaluation of a symptom with increasing significance. J Am Dent Assoc. 1985;110:519-25.

Wilson CB. An updated Declaration of Helsinki will provide more protection. Nat Med. 2013;19:664.

Navazesh M, Mulligan RA, Kipnis V, Denny PA, Denny PC. Comparison of whole saliva flow rates and mucin concentrations in healthy Caucasian young and aged adults. J Dent Res. 1992;71:1275-8.

Márton K, Madléna M, Bánóczy J, Varga G, Fejérdy P, Sreebny LM, et al. Unstimulated whole saliva flow rate in relation to sicca symptoms in Hungary. Oral Dis. 2008;14:472-7.

Shiboski CH, Shiboski SC, Seror R, Criswell LA, Labetoulle M, Lietman TM, et al.; International Sjögren's Syndrome Criteria Working Group. 2016 American College of Rheumatology/European League Against Rheumatism classification criteria for primary Sjögren's syndrome: A consensus and data-driven methodology involving three international patient cohorts. Ann Rheum Dis. 2017;76:9-16.

Ericsson Y. Clinical Investigations of the Salivary Buffering Action. Acta Odontol Scand. 1959;17:131-65.

Percival RS, Challacombe SJ, Marsh PD. Flow rates of resting whole and stimulated parotid saliva in relation to age and gender. J Dent Res. 1994;73:1416-20.

Navazesh M, Christensen C, Brightman V. Clinical criteria for the diagnosis of salivary gland hypofunction. J Dent Res. 1992;71:1363-9.

Azevedo LR, Damante JH, Lara VS, Lauris JR. Age-related changes in human sublingual glands: a post mortem study. Arch Oral Biol. 2005;50:565-74.

Sonesson M, Eliasson L, Matsson L. Minor salivary gland secretion in children and adults. Arch Oral Biol. 2003;48:535-9.

Tanasiewicz M, Hildebrandt T, Obersztyn I. Xerostomia Of Various Etiologies: A Review of the Literature. Adv Clin Exp Med. 2016;25:199-206.

Fox PC, Busch KA, Baum BJ. Subjective reports of xerostomia and objective measures of salivary gland performance. J Am Dent Assoc. 1987;115:581-4.

Bergdahl M, Bergdahl J, Johansson I. Depressive symptoms in individuals with idiopathic subjective dry mouth. J Oral Pathol Med. 1997;26:448-50.

Bergdahl M, Bergdahl J. Low unstimulated salivary flow and subjective oral dryness: association with medication, anxiety, depression, and stress. J Dent Res. 2000;79:1652-8.

McIntyre JM. Erosion. Aust Prosthodont J. 1992;6:17-25.

Featherstone JD, Behrman JM, Bell JE. Effect of whole saliva components on enamel demineralization in vitro. Crit Rev Oral Biol Med. 1993;4:357-62.

Nagler R, Kitrossky M, Chevion M. Antioxidant activity of rat parotid saliva. Arch Otolaryngol Head Neck Surg. 1997;123:989-93.

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Published

2018-01-20

How to Cite

1.
Saavedra JA, Muñoz RP, Alcayaga GR, Tarquinio SC, da-Silva KD, Ramires RF, et al. Salivary flow rate response to stimulation with 2% citric acid in patients with xerostomia. J Oral Diagn [Internet]. 2018 Jan. 20 [cited 2024 Sep. 19];3:1-6. Available from: https://jordi.com.br/revista/article/view/150

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