Effect of Diuretics on Salivary Flow, Composition and Oral Health Status: A Clinico‑biochemical Study

Abstract

Background: Saliva represents an increasingly useful tool of diagnosis. Several factors such as salivary flow rates (SFRs) (unstimulated and stimulated) (U and S), pH, buffering capacity and consistency can be altered due to several disease processes or medications prescribed for various diseases. Alterations of SFRs, pH, buffering capacity and various ion concentrations can influence the pathogenesis of some of the oral diseases. Aim: Evaluation of the effect of diuretics on oral health status with regard to SFRs (U and S), pH, buffering capacity, total protein content, various ion concentrations and oral mucosal lesions. Subjects and Methods: A total of 100 patients were categorized into test group and control group based on usage of diuretics. Unstimulated and stimulated saliva were collected and evaluated for flow rates. Salivary pH was measured using pH meter. Buffering capacity was measured using Aranha’s technique. Salivary Na+, K+ and Cl− concentrations were measured using electrolyte analyzer CORNLEY ACCULYTE‑3P in ion‑selective electrode method. Salivary total protein content was measured by spectrophotometric method. Dental Caries and periodontal status were measured by using decayed, missing, filled teeth index and Russell’s periodontal index respectively. Oral mucosal examination was carried out to identify the mucosal lesions. Results: The obtained results were subjected to statistical analysis using Statistical package for social sciences software (SPSS), version 16, IBM Company by Chi‑square test and unpaired t‑test. Highly significant P for alterations of SFR/U (P < 0.001), SFR/S (P < 0.001), pH (P < 0.001), Na+ concentration (P < 0.001), buffering capacity (P < 0.001) and moderate significance for Cl− concentration (P < 0.01) were found. Alterations of total protein (P = 0.14) and K+ (P = 0.65) concentrations were not statistically significant. High prevalence was found for caries (P < 0.01), periodontal status (P < 0.001) and mucosal lesions (P < 0.01). Conclusion: Our study shows that diuretic medication significantly reduces SFRs (xerostomia) and alters salivary composition which may have an impact on the incidence of dental caries, periodontal diseases and mucosal lesion formation.

Keywords: Buffering capacity, Diuretics, pH, Saliva, Salivary flow