Relationship between enamel resistance and physical properties of saliva in drug-addicted patients

Abstract

Aim. To investigate the relationship between the physical properties of saliva and enamel resistance and caries intensity in drug-addicted patients. Materials and methods. The study involved 70 patients, who were divided into three groups: the main group (1) – 28 drug addicts diagnosed with caries, the comparison group (2) – 22 patients with caries of dental hard tissues without a history of drug addiction, and the control group (3) – 20 persons without carious lesions of dental hard tissues. We examined the rate of salivation, which was calculated by the formula: Rs = V / T, pH of oral fluid using litmus test strips (Kelilong Instruments, China), structural and functional stability of tooth enamel by the express method TER-test (V. R. Okushko, L. I. Kosareva, 1983), clinically assessed the rate of mineralization according to the Clinical Assessment of the Rate of Enamel Remineralization-test (T. L. Redinova, V. K. Leontiev and G. D. Ovrutsky, 1982), dental caries intensity using the DMF index; the International Caries Detection and Assessment System (ICDAS) was used to assess of the dental hard tissues. Results. In drug-addicted patients with caries of dental hard tissues, the slowest rate of salivation and significant changes in the oral fluid pH toward acidic were observed, namely 5.5 ± 0.09 units compared with patients of other groups. In drug addicts, the average TER-test score was 9.1 ± 0.4 points and was significantly higher than that in non-drug-addicted patients with dental caries (5.4 ± 0.2 points) and people without dental caries (1.9 ± 0.2 points). The Clinical Assessment of the Rate of Enamel Remineralization-test indicators of drug-addicted patients (6.1 ± 0.3 days) were also significantly higher than those of non-addicted and control group patients. The DMF index in drug-addicted patients was 16.4 ± 0.2 points showing a very high intensity of caries with a large proportion of deep carious lesions in the dental hard tissues. Conclusions. In drug addicts, the study results have indicated a 23 % pH shift of the oral fluid toward acidic, and a 22 % decrease in the rate of saliva secretion has also been recorded compared to the healthy individuals. These results were associated with a 79 % decrease in the tooth enamel durability and a 66 % decrease in the remineralizing capacity of the oral fluid in drug addicts as compared to the healthy individuals. The DMF index of group 1 patients differed from that of group 2 patients by 50 % and from group 3 individuals – by 98 %. Drug-addicted patients had 78 % more carious lesions in the dentin compared to non-drug-addicted patients with dental caries.