Salivary and Dental - Oral Hygiene Parameters in 3rd Trimester of Pregnancy and Early Lactation: The Effect of Education

Leyla Koç ÖZTÜRK, Serap AKYÜZ, Aysun GARAN, Ayşen YARAT
1.316 2.020


To investigate the effect of 3rd trimester of pregnancy and lactation on dental, oral hygiene and salivary parameters according to educational status. Fourteen healthy women at their 3rd trimester and lactation periods, and 12 non-pregnant women as age-matched controls were recruited. Sulcus bleeding (SBI), plaque (PI) and caries (DMF-T) indexes were estimated and unstimulated whole saliva were taken for free calcium (Ca), inorganic phosphate (Pi), glutathione (GSH),total protein (TP) levels, carbonic anhydrase activity (CA), buffering capacity (BC), flow rate (FR) and pH determinations. Pregnant subjects were also sub-divided as high and low educated sub-groups. DMFT, SBI and PI increased significantly in lactation compared to pregnancy, pH and BC in pregnancy were significantly lower than non-pregnant condition and lactation. Ca and Ca/Pi molar ratio increased and Pi decreased significantly in pregnancy compared to non-pregnant condition. DMF-T, SBI and PI increased; FR and CA decreased significantly in low educated sub-group and SBI and Ca/Pi molar ratio decreased; pH and BC increased significantly in high educated sub-group in lactation compared to pregnancy. Within the limitation of our sub-groups sample size, daily oral hygiene care and good nutrition seem to have an effective impact on maintaining and/or improving them between pregnancy and lactation.


Salivary parameters, DMFT, SBI, PI, pregnancy, lactation, education

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Hara AT, Zero DT. The caries environment: saliva, pellicle, diet, and hard tissue ultrastructure. Dent Clin North Am 2010; 54:455-67.

Stookey GK. The effect of saliva on dental caries. J Am Dent Assoc 2008; 139:11S-17S.

Rakchanok N, Amporn D, Yoshida Y, Harun-or-Rashid MD, Sakamoto J. Dental caries and gingivitis among pregnant and non-pregnant women in Chiang Mai, Thailand. Nagoya J Med Sci 2010; 72:43-50.

Vasiliauskiene I, Milciuviene S, Bendoraitiene E, Narbutaite J, Slabsinskiene E, Andruskeviciene V. Dynamics of pregnant women’s oral health status during preventive programme. Stomatologija 2007; 9:129-36.

Herrera CL, Pantoja R, de La Maza T, Sanhueza A, Salazar LA. Microbiologic and molecular diagnostic of cariogenic bacteria in pregnant women from the Araucania Region of Chile. Rev Chilena Infectol 2007; 24:270-5.

Villagrán E, Linossier A, Donoso E. Count of salivary streptococci mutans in pregnant women of the metropolitan region of Chile: crosssectional study. Rev Méd Chil 1999; 127:165-70.

Laine MA. Effect of pregnancy on periodontal and dental health. Acta Odontol Scand 2002; 60:257-64.

Kivela 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.

Rockenbach MI, Marinho SA, Veeck EB, Lindemann L, Shinkai RS. Salivary flow rate, pH, and concentrations of calcium, phosphate, and sIgA in Brazilian pregnant and non-pregnant women. Head Face Med 2006; 2:44-8.

Kitasako Y, Burrow MF, Huq LN, Stacey MA, Reynolds EC, Tagami J. A simplified quantitative test -adapted Checkbuf test- for resting saliva buffering capacity compared with a standard test. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108:551-6.

Inoue H, Ono K, Masuda W, Morimoto Y, Tanaka T, Yokota M, Inenaga K. Gender difference in unstimulated whole saliva flow rate and salivary gland sizes. Arch Oral Biol 2006; 51:1055-60.

Ono K, Inoue H, Masuda W, Morimoto Y, Tanaka T, Yokota M et al. Relationship of chewing-stimulated whole saliva flow rate and salivary gland size. Arch Oral Biol 2007; 52:427-31.

Lukacs, JR. Fertility and agriculture accentuate sex differences in dental caries rates. Currt Anthropol 2008; 49: 901-14.

Koç Öztürk L, Furuncuoğlu H, Atala MH, Uluköylü O, Akyüz S, Yarat A. Association between dental-oral health in young adults and salivary glutathione, lipid peroxidation and sialic acid levels and carbonic anhydrase activity. Braz J Med Biol Res 2008; 41:956-9.

Sewón LA, Karjalainen SM, Söderling E, Lapinleimu H, Simell O. Associations between salivary calcium and oral health. Clin Periodont 1998; 25:915-9.

Farsi N, Al Amoudi N, Farsi J, Bokhary S, Sonbul H. Periodontal health and its relationship with salivary factors among different age groups in a Saudi population. Oral Health Prev Dent 2008; 6:147-54.

Varma S, Banerjee A, Bartlett D. An in vivo investigation of associations between saliva properties, caries prevalence and potential lesion activity in an adult UK population. J Dent 2008; 36:294-9.

WHO World Health Organization: Oral health surveys: Basic methods, ed 3, Geneva, WHO, 1987.

Rose LF, Mealey BL, Genco RJ, Cohen W. Periodontics; medicine, surgery and implants. In: Ronderos M, Michalowicz BS, Editors, Epidemiology of periodontal diseases and risk factors. 1st ed. Illinois: Elsevier Mosby; 2004. p.32-68.

Lowry OH, Rosebrough NJ, Farr AL, Randall RJ. Protein measurement with the Folin phenol reagent. J Biol Chem 1951; 193:265-75.

Ericsson Y. Clinical Investigations of the salivary buffering action. Acta Odontol Scand 1959; 17:131-65.

Peres RC, Camargo G, Mofatto LS, Cortellazzi KL, Santos MC, Nobredos-Santos M et al. Association of polymorphisms in the carbonic anhydrase 6 gene with salivary buffer capacity, dental plaque pH, and caries index in children aged 7-9 years. Pharmacogenomics J 2010; 10:114-9.

Almståhl A, Wikström M, Fagerberg-Mohlin B. Microflora in oral ecosystems in subjects with radiation-induced hyposalivation. Oral Dis 2008;14:541-9.

Beutler E. Glutathione in red blood cell metabolism. In: Beutler E, editors, A manual of biochemical methods. 2nd ed. New York: Grune and Stratton; 1975. p 112-114.

Verpoorte JA, Mehta S, Edsall JT. Esterase activities of human carbonic anhydrases B and C. J Biol Chem 1967; 242:4221-9.

Radnai M, Gorzó I, Nagy E, Urbán E, Eller J, Novák T et al. Caries and periodontal state of pregnant women. Part I. Caries status. Fogorv Sz 2005; 98:53-7.

Figuero E, Carrillo-de-Albornoz A, Herrera D, Bascones-Martı´nez A. Gingival changes during pregnancy: I. Influence of hormonal variations on clinical and immunological parameters. J Clin Periodontol 2010; 37:220-9.

Carrillo-de-Albornoz A, Figuero E, Herrera D, Bascones-Martı´nez A. Gingival changes during pregnancy: II. Influence of hormonal variations on the subgingival biofilm. J Clin Periodontol 2010; 37:230

Laurence MA, Alessandri R, Spörri S, Lang NP, Persson GR. Does pregnancy have an impact on the subgingival microbiota? J Periodontol 2009; 80:72-81.

Silness J, Loe H. Periodontal disease in pregnancy. II correlation between oral hygiene and periodontal condition. Acta Odontol Scand 1964; 22:121-35.

Gürsoy M, Pajukanta R, Sorsa T, Kononen E. Clinical changes in periodontium during pregnancy and post-partum. J Clin Periodontol 2008; 35:576-83.

Frencken JE, Phantumvanit P, Pilot T, Songpaisan Y, van Amerongen E. Manual for the atraumatic restorative treatment approach to control dental caries. 3 rd ed. Gröningen (the Netherlands): WHO Collaborating Centre for Oral Health Services Research, University of Gröningen; 19 Griffin SO, Regnier E, Griffin PM, Huntley V. Effectiveness of fluoride in preventing caries in adults. J Dent Res 2007; 86:410-5.

Jago JD, Chapman PJ, Aitken JF, McEniery TM. Dental status of pregnant women attending a Brisbane maternity hospital. Community Dent Oral Epidemiol 1984;12:398-401.

Machuca G, Khoshfeiz O, Lacalle JR, Machuca C, Bullon P. The influence of general health and socio-cultural variables on the periodontal condition of pregnant women. J Periodontol, 1999; 70:779-85. 3Yalcin F, Eskinazi E, Soydinc M, Basegmez C, Issever H, Isik G et al. The effect of sociocultural status on periodontal conditions in pregnancy. J Periodontol 2002; 73:178-82.

Walsh LJ. Clinical aspects of salivary biology for the dental clinician. J Min Interven Dent 2007; 9: 22-41. de Almeida PDV, Grégio AM, Machado MA, de Lima AA, Azevedo LR. Saliva composition and functions: a comprehensive review. J Contemp Dent Pract 2008; 9:72-80.

Sawair FA, Ryalat S, Shayyab M, Saku T. The unstimulated salivary flow rate in a Jordanian healthy adult population. J Clin Med Res 2009; 1:219-25.

Lingström P, Moynihan P. Nutrition, saliva, and oral health. Nutrition 2003;19:567-9.

Ademuyiwa O, Odusoga OL, Adebawo OO, Ugbaja RN. Endegenous antioxidant defences in plasma and erythrocytes of pregnant women during different trimesters of pregnancy. Acta Obstet Gynecol Scand 2007; 2:1-6.

Chater S, Abdelmelek H, Douki T, Garrel C, Favier A, Sakly M et al. Exposure to static magnetic field of pregnant rats induces hepatic GSH elevation but not oxidative DNA damage in liver and kidney. Arch Med Res 2006 37:941-6.

Raijmakers MT, Roes EM, Poston L, Steegers EA, Peters WH. The transient increase of oxidative stress during normal pregnancy is higher and persists after delivery in women with pre-eclampsia. Eur J Obstet Gynecol Reprod Biol 2008; 138:39-44.

Mottino AD, Hoffman T, Jennes L, Cao J, Vore M. Expression of multidrug resistance-associated protein 2 in small intestine from pregnant and postpartum rats. Am J Physiol Gastrointest Liver Physiol 2001; 280:G1261-73.

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.

Fenoll-Palomares C, Muñoz Montagud JV, Sanchiz V, Herreros B, Hernández V, Mínguez M et al. Unstimulated salivary flow rate, pH and buffer capacity of saliva in healthy volunteers. Rev Esp Enferm Dig 2004; 96:773-83.

Kivelä J, Parkkila S, Parkkila AK, Rajaniemi H. A low concentration of carbonic anhydrase isoenzyme VI in whole saliva is associated with caries prevalence. Caries Res 1999; 33:178-84.

Hara AT, Karlinsey RL Zero DT. Dentine remineralisation by simulated saliva formulations with different Ca and Pi contents. Caries Res 2008; 42:51Ehrlich H, Koutsoukos PG, Demadis KD, Pokrovsky OS. Principles of demineralization: modern strategies for the isolation of organic frameworks. Part II. decalcification. Micron 2009; 40:169-93.

Elizarova VM, Petrovich IU. Ionized calcium in the saliva of children with multiple caries. Stomatologiia (Mosk) 1997;76:6-8.

Robertson WG, Marshall RW. Ionized calcium in body fluids. Crit Rev Clin Lab Sci 1981; 15:85-125.

Cornejo LS, Brunotto M, Hilas E. Salivary factors associated to the prevalence and increase of dental caries in rural schoolchildren. Rev Saşde Pşblica 2008; 42:19-25.

Shaw L, Murray JJ, Burchell CK, Best JS. Calcium and phosphorus content of plaque and saliva in relation to dental caries. Caries Res 1983;17:543-8.

Salvolini E, Di Giorgio R, Curatola A, Mazzanti L, Fratto G. Biochemical modifications of human whole saliva induced by pregnancy. Br J Obstet Gynaecol 1998; 105: 656-60. 55- Guidozzi F, Maclennan M, Graham KM, Jooste CP. Salivary calcium, magnesium, phosphate, chloride, sodium and potassium in pregnancy and labour. S Afr Medl J 1992; 81:152-4. 56- Al-Nuaimy KMT, Al-Sandook TA. Salivary calcium level during lactation. Al–Rafidain Den J 2006; 6:12-4.