Comparison of 5 Buffering Agents on Changes in Salivary pH in Individuals Previously Exposed to a Test Fruit Juice

NCT ID: NCT03510962

Last Updated: 2018-12-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-04-25

Study Completion Date

2018-12-05

Brief Summary

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The diurnal variation in the flow of saliva and hence the composition of saliva is an established fact. Consumption of most types of acidic and sweetened foods and beverages are known to reduce the pH of saliva and some of them even reduce it to critical pH levels and result in structural damage to the hard tissues of the tooth.

The purpose of this study is to ascertain the effect of the selected commercially available test fruit-juice drink on the salivary pH and assess the buffering capacity of the saliva with or without various intervention measures following the exposure to the test fruit-juice drink at different time intervals.

Detailed Description

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There are substantial existing evidences that there is diurnal variation in the flow of saliva and hence the composition of saliva. The average of normal pH of saliva is reported to be 6.8. Consumption of most types of acidic and sweetened foods and beverages are known to reduce the pH of saliva and some of them even reduce it to critical pH levels and result in structural damage to the hard tissues of the tooth.

Such damages can be prevented by maintaining the pH of saliva within optimal range by using oral hygiene measures.

The purpose of this study is to ascertain the effect of the selected commercially available test fruit-juice drink containing sugar on the pH of saliva and assess the buffering capacity of the saliva with or without various intervention measures following the exposure to the commercially available test fruit-juice drink at different time intervals.

Aims and Objectives:

1. To measure the pH of saliva post-exposure to commercially available test fruit-juice drink after 5, 15, 30, 45 and 60 minutes.
2. To measure the pH of saliva at 15, 30 and 45 minutes after using a tap water gargle as a buffering agent in those subjects who had prior exposure to commercially available test fruit-juice drink 15 minutes ago.
3. To measure the pH of saliva at 15, 30 and 45 minutes after using a 0.2%Chlorhexidine mouth rinse as a buffering agent in those subjects who had prior exposure to commercially available test fruit-juice drink 15 minutes ago.
4. To measure the pH of saliva at 15, 30 and 45 minutes after chewing Orbit® gum as a buffering agent in those subjects who had prior exposure to commercially available test fruit-juice drink 15 minutes ago
5. To measure the pH of saliva at 15, 30 and 45 minutes after brushing with commercially available fluoridated tooth paste and soft brush as a buffering agent in those subjects who had prior exposure to test fruit-juice drink 15 minutes ago
6. To measure the pH of saliva at 15, 30 and 45 minutes after gargling with 1% solution of baking soda as a buffering agent in those subjects who had prior exposure to commercially available test fruit-juice drink 15 minutes ago
7. To compare the efficacy of buffering agents on the pH of saliva at 15, 30, 45 minutes post intervention in subjects who have had the commercially available test fruit-juice drink 15 min prior to the a specific intervention, with the pH of saliva recorded in the same subjects at the same time periods when no intervention with any buffering agent was carried out after having the commercially available test fruit-juice drink.
8. To compare the pH of saliva recorded in the subjects at 15, 30, 45 minutes time periods when they used an intervention of gargle with tap water, with that recorded when they used mouth rinse of 0.2% Chlorhexidine, with that recorded when they brushed with soft brush and fluoridated tooth paste, with that recorded when they gargled with 1% baking soda solution and with that recorded when they chewed Orbit® chewing gum (15 minutes after using the test fruit-juice drink)

Materials and Methods:

30 volunteers in the age group of 18- 30 year with healthy oral cavities will be selected. Subjects with a history of any chronic medical illness, history of allergy, intake of drugs in the last 8 weeks, history of gastritis, bulimia will be excluded. Subjects with a DMFT score of more than 2 and Loe and Sillness Index of more than 0 will be excluded. Individuals who have and are currently undergoing orthodontic treatment will not be included in the study. Individuals who smoke or chew tobacco will not be included in the study sample. An informed consent for the research will be obtained from all the subjects who have volunteered for the study. The trial will be conducted as per the guidelines in the WHO-Handbook for Good Clinical Practice and the research protocol is approved by the Institutional Ethics Committee of the college.

The test fruit-juice drink that will be selected is Tropicana® Mixed Fruit Juice®.

The various buffering agents that will be used are:

1. 0.2% Chlorhexidine mouth wash (Rexidine®, Indoco Remidies Ltd, Mumbai, India)- 10 ml solution swish for 60 sec and spit
2. Tap water- 10ml swish for 60 sec and spit
3. Brushing with fluoridated (Colgate Total®, Colgate-Palmolive Company, Mumbai, India) tooth paste- 2min using soft brush
4. Chewing polyol containing gum (Orbit®, Wrigley Company)- chew for 5 minutes and spit
5. Freshly prepared Sodium bicarbonate (baking soda) 1% w/v solution swish for 60 sec and spit.

The observer who will be measuring the salivary pH will remain blinded about the samples and buffering agent used.

The select individuals will be instructed to not use any mouth wash as part of oral hygiene regimen on test day and not consume any food or beverage for 2 hours prior to the collection of baseline sample of saliva at 10 AM on the test day. The select group of 30 individuals will be given a sample of 100 ml of Tropicana® mixed fruit-juice after recording their baseline salivary pH (0 min). They will be asked to sip, swish and swallow the drink within 2 minutes. After the exposure, salivary samples will be collected at 5 min and 15 min intervals for assessment of pH. Fifteen minutes after the exposure (consumption of test drink), the individuals will be asked to use one of the intervention methods included in this study. The salivary samples will be collected after 15, 30 and 45 minutes interval after the intervention. (i.e. 30, 45 and 60 minutes post exposure to the test drink respectively) The same protocol will be repeated using each intervention methods included in this study after a wash out period of minimum of 3 days. The protocol will be repeated on the study sample without any intervention following the exposure to the test fruit juice as a control.

Measurement of salivary pH will be done using a portable PH-035 Digital pH meter with automatic temperature compensation, to the accuracy of 0.1 and the machine will be calibrated on the morning of every test day and after 60 uses during the test day using Aquasol® pH calibration solutions with pH 4, 7 and 10.

Conditions

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Saliva Altered Oral Hygiene pH Tooth Structure; Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors
only primary investigator will know the intervention done by the subject. The outcome investigator(assessor) will be unaware (blinded) to which intervention the subject is undertaken.

Study Groups

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Group 1: no intervention

The subject collects the unstimulated saliva in a sterile glass dish for the measurement of baseline pH of the saliva.The subject is then given 100 ml of test mixed fruit juice,Tropicana® Mixed Fruit Juice, (PepsiCo, Inc) to drink. The subject will sip, swish and swallow the drink within 2 minutes.

Unstimulated saliva samples are collected from the subject to measure the pH of saliva after 5, 15, 30, 45 and 60 minutes of consumption of the test mixed fruit juice.

Group Type ACTIVE_COMPARATOR

Group 1: no intervention

Intervention Type OTHER

Unstimulated saliva samples are collected from the subject to measure the pH of saliva after 5, 15, 30, 45 and 60 minutes of consumption of the test mixed fruit juice without any intervention.

Group 2: tap water gargle

The subject collects the unstimulated saliva in a sterile glass dish for the measurement of baseline pH of the saliva.The subject is then given 100 ml of test mixed fruit juice,Tropicana® Mixed Fruit Juice, (PepsiCo, Inc) to drink. The subject will sip, swish and swallow the drink within 2 minutes.

Unstimulated saliva samples are collected from the subject to measure and record the pH of saliva after 5 and 15 minutes of consumption of the test mixed fruit juice.

The subject will use 10 ml of tap water as mouth rinse to swish for 60 seconds and spit. Unstimulated saliva samples are collected from the subject to measure and record the pH of saliva at 15, 30 and 45 minutes after the subject completes the gargle as an intervention.

Group Type EXPERIMENTAL

Group 2: tap water gargle

Intervention Type OTHER

The subject will use 10 ml of tap water as mouth rinse to swish for 60 seconds and spit. Unstimulated saliva samples are collected from the subject to measure and record the pH of saliva at 15, 30 and 45 minutes after the subject completes the gargle as an intervention.

Group 3: 0.2% chlorhexidine

The subject collects the unstimulated saliva in a sterile glass dish for the measurement of baseline pH of the saliva. The subject is then given 100 ml of test mixed fruit juice, Tropicana® Mixed Fruit Juice, (PepsiCo, Inc) to drink. The subject will sip, swish and swallow the drink within 2 minutes.

Unstimulated saliva samples are collected from the subject to measure and record the pH of saliva after 5 and 15 minutes of consumption of the test mixed fruit juice.

The subject will use 10 ml of 0.2% Chlorhexidine mouth rinse (Rexidine®, Indoco Remidies Ltd, Mumbai, India) to swish for 60 seconds and spit. Unstimulated saliva samples are collected from the subject to measure and record the pH of saliva at 15, 30 and 45 minutes after the subject completes the gargle as an intervention.

Group Type EXPERIMENTAL

Group 3: 0.2% Chlorhexidine

Intervention Type DRUG

The subject will use 10 ml of 0.2% Chlorhexidine mouth rinse (Rexidine®, Indoco Remidies Ltd, Mumbai, India) to swish for 60 seconds and spit. Unstimulated saliva samples are collected from the subject to measure and record the pH of saliva at 15, 30 and 45 minutes after the subject completes the gargle as an intervention.

Group 4: fluoridated tooth paste

The subject collects the unstimulated saliva in a sterile glass dish for the measurement of baseline pH of the saliva. The subject is then given 100 ml of test mixed fruit juice, Tropicana® Mixed Fruit Juice, (PepsiCo, Inc) to drink. The subject will sip, swish and swallow the drink within 2 minutes.

Unstimulated saliva samples are collected from the subject to measure and record the pH of saliva after 5 and 15 minutes of consumption of the test mixed fruit juice.

The subject will Brush with fluoridated toothpaste (Colgate Total®, Colgate-Palmolive Company, Mumbai, India) for 2 minutes using soft brush.

Unstimulated saliva samples are collected from the subject to measure and record the pH of saliva at 15, 30 and 45 minutes after the subject completes the brushing as an intervention.

Group Type EXPERIMENTAL

Group 4: Fluoridated tooth paste

Intervention Type OTHER

The subject will Brush with fluoridated toothpaste-(Colgate Total®, Colgate-Palmolive Company, Mumbai, India) for 2 minutes using soft brush.

Unstimulated saliva samples are collected from the subject to measure and record the pH of saliva at 15, 30 and 45 minutes after the subject completes using tooth paste as an intervention.

Group 5: Polyol containing gum

The subject collects the unstimulated saliva in a sterile glass dish for the measurement of baseline pH of the saliva. The subject is then given 100 ml of test mixed fruit juice, Tropicana® Mixed Fruit Juice, (PepsiCo, Inc) to drink. The subject will sip, swish and swallow the drink within 2 minutes.

Unstimulated saliva samples are collected from the subject to measure and record the pH of saliva after 5 and 15 minutes of consumption of the test mixed fruit juice.

The subject will chew polyol containing gum (Orbit®, Wrigley Company) for 5 minutes and spit.

Unstimulated saliva samples are collected from the subject to measure and record the pH of saliva at 15, 30 and 45 minutes after the subject completes the chewing gum as an intervention.

Group Type EXPERIMENTAL

Group 5: Polyol containing gum

Intervention Type OTHER

The subject will chew polyol containing gum (Orbit®, WrigleyCompany) for 5 minutes and spit.

Unstimulated saliva samples are collected from the subject to measure and record the pH of saliva at 15, 30 and 45 minutes after the subject completes chewing as an intervention.

Group 6: 1% sodium bicarbonate solution

The subject collects the unstimulated saliva in a sterile glass dish for the measurement of baseline pH of the saliva. The subject is then given 100 ml of test mixed fruit juice, Tropicana® Mixed Fruit Juice, (PepsiCo, Inc) to drink. The subject will sip, swish and swallow the drink within 2 minutes.

Unstimulated saliva samples are collected from the subject to measure and record the pH of saliva after 5 and 15 minutes of consumption of the test mixed fruit juice.

The subject will use 10 ml freshly prepared 1% sodium bicarbonate w/v solution to swish for 60 seconds and spit.

Unstimulated saliva samples are collected from the subject to measure and record the pH of saliva at 15, 30 and 45 minutes after the subject completes the gargle as an intervention.

Group Type EXPERIMENTAL

Group 6: 1% sodium bicarbonate solution

Intervention Type OTHER

The subject will use 10 ml freshly prepared 1% sodium bicarbonate w/v solution to swish for 60 seconds and spit.

Unstimulated saliva samples are collected from the subject to measure and record the pH of saliva at 15, 30 and 45 minutes after the subject completes the gargle as an intervention.

Interventions

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Group 1: no intervention

Unstimulated saliva samples are collected from the subject to measure the pH of saliva after 5, 15, 30, 45 and 60 minutes of consumption of the test mixed fruit juice without any intervention.

Intervention Type OTHER

Group 2: tap water gargle

The subject will use 10 ml of tap water as mouth rinse to swish for 60 seconds and spit. Unstimulated saliva samples are collected from the subject to measure and record the pH of saliva at 15, 30 and 45 minutes after the subject completes the gargle as an intervention.

Intervention Type OTHER

Group 3: 0.2% Chlorhexidine

The subject will use 10 ml of 0.2% Chlorhexidine mouth rinse (Rexidine®, Indoco Remidies Ltd, Mumbai, India) to swish for 60 seconds and spit. Unstimulated saliva samples are collected from the subject to measure and record the pH of saliva at 15, 30 and 45 minutes after the subject completes the gargle as an intervention.

Intervention Type DRUG

Group 4: Fluoridated tooth paste

The subject will Brush with fluoridated toothpaste-(Colgate Total®, Colgate-Palmolive Company, Mumbai, India) for 2 minutes using soft brush.

Unstimulated saliva samples are collected from the subject to measure and record the pH of saliva at 15, 30 and 45 minutes after the subject completes using tooth paste as an intervention.

Intervention Type OTHER

Group 5: Polyol containing gum

The subject will chew polyol containing gum (Orbit®, WrigleyCompany) for 5 minutes and spit.

Unstimulated saliva samples are collected from the subject to measure and record the pH of saliva at 15, 30 and 45 minutes after the subject completes chewing as an intervention.

Intervention Type OTHER

Group 6: 1% sodium bicarbonate solution

The subject will use 10 ml freshly prepared 1% sodium bicarbonate w/v solution to swish for 60 seconds and spit.

Unstimulated saliva samples are collected from the subject to measure and record the pH of saliva at 15, 30 and 45 minutes after the subject completes the gargle as an intervention.

Intervention Type OTHER

Other Intervention Names

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Rexidine® Colgate Total® Orbit®

Eligibility Criteria

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Inclusion Criteria

* subjects in the age group of 18 to 30 years.
* subjects with a DMFT index score of less than 2.
* subjects with Loe and Silness index score of 0.
* subjects willing to volunteer for the study.
* subjects who are available for the whole study period of 4 months

Exclusion Criteria

* subjects with history of gastritis and bulimia.
* subjects with chronic medical illness.
* subjects with history of allergy.
* subjects with history of drug intake for last 8 weeks.
* subjects who smoke or chew tobacco.
Minimum Eligible Age

18 Years

Maximum Eligible Age

30 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Dr Meru S

OTHER

Sponsor Role lead

Responsible Party

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Dr Meru S

Prof & Head, Dept of Oral Medicine & Radiology

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Meru S, MDS

Role: PRINCIPAL_INVESTIGATOR

Uttaranchal Dental & Medical Research Institute

Locations

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Department of Oral Medicine & Radiology, Uttaranchal Dental & Medical Research Institute

Dehradun, Uttarakhand, India

Site Status

Countries

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India

References

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Larsen MJ, Nyvad B. Enamel erosion by some soft drinks and orange juices relative to their pH, buffering effect and contents of calcium phosphate. Caries Res. 1999;33(1):81-7. doi: 10.1159/000016499.

Reference Type BACKGROUND
PMID: 9831784 (View on PubMed)

Agha-Hosseini F, Mirzaii-Dizgah I, Moghaddam PP, Akrad ZT. Stimulated whole salivary flow rate and composition in menopausal women with oral dryness feeling. Oral Dis. 2007 May;13(3):320-3. doi: 10.1111/j.1601-0825.2006.01288.x.

Reference Type BACKGROUND
PMID: 17448216 (View on PubMed)

Hans R, Thomas S, Garla B, Dagli RJ, Hans MK. Effect of Various Sugary Beverages on Salivary pH, Flow Rate, and Oral Clearance Rate amongst Adults. Scientifica (Cairo). 2016;2016:5027283. doi: 10.1155/2016/5027283. Epub 2016 Mar 8.

Reference Type BACKGROUND
PMID: 27051556 (View on PubMed)

Guay-Fen Huang Hsiao-Hua Changi Yin-Lin Wang'. Ming-Kuang Guo. Effect of oral rinse with soft drinks on human plaque pH. Chin Dent J 20(2):83-92,2001

Reference Type BACKGROUND

Ciolino LA, McCauley HA, Fraser DB, Wolnik KA. The relative buffering capacities of saliva and moist snuff: implications for nicotine absorption. J Anal Toxicol. 2001 Jan-Feb;25(1):15-25. doi: 10.1093/jat/25.1.15.

Reference Type BACKGROUND
PMID: 11215994 (View on PubMed)

Ravi Gupta, Abhishek Solanki, Swati Sharma, Parvind Gumber, Asmita Sharma, Rekha Upadhyay. A Knowledge, Attitude and Practices of Soft Drinks among Adolescent Students and their Dental Health: A Questionnaire Study. International Journal of Dental Health Concerns 1(1):8-12,2015.

Reference Type BACKGROUND

Dawes C. What is the critical pH and why does a tooth dissolve in acid? J Can Dent Assoc. 2003 Dec;69(11):722-4.

Reference Type BACKGROUND
PMID: 14653937 (View on PubMed)

Sudeep CB, Anzil KS Ali, Vivek S, Ambalavanan P, Vivek Suku Ninan, Fajar Ummer. Effects on ph value of saliva following intake of three beverages: A double blind cross-over study. International Journal of Dental and Health Sciences.1(3);18-23:2013

Reference Type BACKGROUND

Tenuta LM, Fernandez CE, Brandao AC, Cury JA. Titratable acidity of beverages influences salivary pH recovery. Braz Oral Res. 2015;29:S1806-83242015000100234. doi: 10.1590/1807-3107BOR-2015.vol29.0032. Epub 2015 Feb 11.

Reference Type BACKGROUND
PMID: 25715032 (View on PubMed)

Chitharanjan Shetty, Mitra N Hegde, Darshana Devadiga.Correlation between dental caries with salivary flow, pH and buffering capacity in adult south Idoan population: An in-vitro study.Internationl J Res Ayurveda Pharm 4(2):219-223,2013

Reference Type BACKGROUND

de Almeida Pdel V, Gregio AM, Machado MA, de Lima AA, Azevedo LR. Saliva composition and functions: a comprehensive review. J Contemp Dent Pract. 2008 Mar 1;9(3):72-80.

Reference Type BACKGROUND
PMID: 18335122 (View on PubMed)

Sudeep C B, Vipin Jain, Mathew Maliyil , Peter Simon Sequeira, Jithesh Jain. Effects on pH Value of Saliva Following Intake of Three Beverages Containing Apple Juice - A Double Blind Cross- Over Study. National Journal of Medical and Dental Research 1(4): 18-23,2013

Reference Type BACKGROUND

Choi SE, Kim HS. Sodium Bicarbonate Solution versus Chlorhexidine Mouthwash in Oral Care of Acute Leukemia Patients Undergoing Induction Chemotherapy: A Randomized Controlled Trial. Asian Nurs Res (Korean Soc Nurs Sci). 2012 Jun;6(2):60-6. doi: 10.1016/j.anr.2012.05.004. Epub 2012 May 24.

Reference Type BACKGROUND
PMID: 25030829 (View on PubMed)

Arpita Ramisetti, Ramesh Babu M, Kalpana Kotha, Gururam Tej K, Sravani Chirtha. Influence of Salivary pH and Urea Level on Calculus Formation - A Clinical Study. Carib.j.SciTech, 2; 503-508,2014

Reference Type BACKGROUND

Chandel S, Khan MA, Singh N, Agrawal A, Khare V. The effect of sodium bicarbonate oral rinse on salivary pH and oral microflora: A prospective cohort study. Natl J Maxillofac Surg. 2017 Jul-Dec;8(2):106-109. doi: 10.4103/njms.NJMS_36_17.

Reference Type BACKGROUND
PMID: 29386812 (View on PubMed)

Margaret F. Lemaster. Restore pH balance. Sunstar spotlight, special sponsored supplement. March 2012

Reference Type BACKGROUND

Bhavna Jha Kukreja, Vidya Dodwad, Herbal mouth washes- a gift of nature. International Journal of Pharma and Bio Sciences 3(2);46-52:2012

Reference Type BACKGROUND

Other Identifiers

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U1111-1212-3732

Identifier Type: REGISTRY

Identifier Source: secondary_id

UDMRI_Sal_pH_F

Identifier Type: -

Identifier Source: org_study_id

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