Saliva increases protective potential during periodontitis

Two constituents of saliva that form part of the defense mechanism of the oral cavity increase during periodontitis, and decrease again after treatment for the condition, study findings show.

The researchers observed that output of mucin - the major component of submandibular/sublingual saliva - and amylase - an enzyme produced by the parotid gland to break down high-molecular-weight carbohydrates - increases and decreases in relation to tissue damage in periodontal disease.

"These results might reinforce the hypothesis that salivary glands respond to the disease increasing the protective potential of saliva in relation to periodontal status, and this condition would result in changes in the rate of secretion when the periodontal disease improves," says the team.

Writing in Oral Diseases, Lucila Busch (University of Buenos Aires, Argentina) and colleagues evaluated the relationship between these salivary components and 92 adult patients' periodontal status before and after treatment.

After examination and diagnosis, participants were grouped according to disease severity: clinically healthy, and mild, moderate, and severe periodontitis. Probing pocket depth (PPD) and clinical attachment level (CAL), both measured in millimeters, was assessed at six sites per affected tooth.

All individuals received thorough oral hygiene instructions, and those with any form of the disease received one session of treatment, consisting of scaling and root planing.

The researchers collected saliva samples from all participants and found a significant positive correlation between salivary mucin, amylase, or proteins, and PPD and CAL before treatment.

Multivariate analysis confirmed a positive and significant correlation between mucin, amylase, and protein concentration and CAL, while mucin and protein output were also significantly correlated with PPD.

After periodontal treatment and improvement of clinical parameters, both the concentration and output of mucin, amylase, and protein decreased in the moderate and severe periodontitis group. In particular, mucin and amylase levels dropped significantly after treatment in participants with moderate disease, from 2.60 to 1.98 mg/mL, and 123.6 to 102.6 U/mL, respectively.

"Thus, the increase in mucin and amylase salivary concentration suggests a defence mechanism of the oral cavity and its decrease, after treatment, indicates a relationship between its secretion and the periodontal status," conclude Busch et al.

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