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| ID | Type | Description | Link |
|---|---|---|---|
| U1111-1212-3387 | Registry Identifier | WHO International Clinical Trials Registry Platform (ICTRP) |
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The diurnal variation in the flow of saliva and hence the composition of saliva is an established fact. Consumption of acidic and sweetened food and beverage is known to reduce the salivary pH and some of them 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 select commercially available test carbonated drink containing sugar on the salivary pH and assess the buffering capacity of the saliva with or without various intervention measures following the exposure to the test carbonated drink at different time intervals.
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 acidic and sweetened food and beverage is known to reduce the salivary pH and some of them 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 salivary pH within optimal range by using oral hygiene measures.
The purpose of this study is to ascertain the effect of the select commercially available test carbonated drink containing sugar on the salivary pH and assess the buffering capacity of the saliva with or without various intervention measures following the exposure to the test carbonated drink at different time intervals.
Aims and objectives:
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 carbonated drink that will be selected is Coco Cola®. The various buffering agents that will be used are:
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 the test carbonated drink 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 soft drinks 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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1: no intervention | Active Comparator | 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 carbonated drink, Coco cola ® 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 carbonated drink. |
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| Group 2: tap water gargle | Experimental | 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 carbonated drink, Coco cola ® 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 carbonated drink. 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 |
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| Group 3: 0.2% chlorhexidine | Experimental | 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 carbonated drink, Coco cola ® 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 carbonated drink. 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. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Group 1: no intervention | 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 carbonated drink without any intervention |
| Measure | Description | Time Frame |
|---|---|---|
| pH of Saliva at baseline | All subjects in all groups collects the unstimulated saliva in a sterile glass dish for the measurement of baseline pH of the saliva. The subject will give the saliva sample just before being exposed to the test carbonated drink by swishing 100ml of CocaCola in mouth for 2minutes and then drinking it The outcome accessor is blinded to origin of sample (from which group). | 0 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| pH of Saliva 5 minutes after exposure to test carbonated drink | All subjects will be given 100 ml of test carbonated drink, Coco Cola ® to drink. The subject will sip, swish and swallow the drink within 2 minutes. Five minutes after this, each subject will give unstimulated saliva in a sterile dish for measurement of saliva -5minutes after exposure to test carbonated drink. The outcome accessor is blinded to the origin of sample (from which group). |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Meru S, MDS | Uttaranchal Dental & Medical Research Institute | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Oral Medicine & Radiology, Uttaranchal Dental & Medical Research Institute | Dehradun | Uttarakhand | 248140 | India |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 9831784 | Background | 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. | |
| 17448216 | Background | 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. |
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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.
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| Group 4: fluoridated tooth paste | Experimental | 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 carbonated drink, Coco cola ® 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 carbonated drink. 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 tooth paste as an intervention. |
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| Group 5: Polyol containing gum | Experimental | 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 carbonated drink, Coco cola ® 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 carbonated drink. 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 the chewing gum as an intervention. |
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| Group 6: 1% sodium bicarbonate solution | Experimental | 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 carbonated drink, Coco cola ® 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 carbonated drink. 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 2: tap water gargle | 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 | 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 |
|
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| Group 4: Fluoridated tooth paste | 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. |
|
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| Group 5: Polyol containing gum | 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 gum as an intervention. |
|
|
| Group 6: 1% sodium bicarbonate solution | 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. |
|
| 5 minutes |
| pH of Saliva 15 minutes after exposure to test carbonated drink | All subjects will give unstimulated saliva in a sterile dish for measurement of saliva -15minutes after exposure to test carbonated drink. The outcome accessor is blinded to the origin of sample (from which group). | 15 minutes |
| pH of Saliva 30 minutes after exposure to test carbonated drink | All subjects from all six (5test and 1comparator) groups will perform the assigned intervention as per schedule at time 15minutes post exposure to carbonated drink and shall give unstimulated saliva in a sterile dish for measurement of saliva -30minutes after exposure to test carbonated drink or in other words 15minutes after assigned intervention. The outcome accessor is blinded to the origin of sample (from which group). | 30 minutes |
| pH of Saliva 45 minutes after exposure to test carbonated drink | All subjects from all six (5test and 1comparator) groups will perform the assigned intervention as per given schedule at time 15minutes post exposure to carbonated drink and shall give unstimulated saliva in a sterile dish for measurement of saliva -45minutes after exposure to test carbonated drink or in other words 30minutes after assigned intervention. The outcome accessor is blinded to the origin of sample (from which group). | 45 minutes |
| pH of Saliva 60 minutes after exposure to test carbonated drink | All subjects from all six (5test and 1comparator) groups will perform the assigned intervention as per given schedule at time 15minutes post exposure to carbonated drink and shall give unstimulated saliva in a sterile dish for measurement of saliva -60minutes after exposure to test carbonated drink or in other words 45minutes after assigned intervention. The outcome accessor is blinded to the origin of sample (from which group). | 60 minutes |
| Background | 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 2001;20(2):83-92 |
| 27051556 | Background | 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. |
| Background | 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. |
| 11215994 | 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. |
| Background | 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 |
| 14653937 | 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. |
| Background | 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 |
| 25715032 | 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. |
| 18335122 | 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. |
| Background | 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 |
| 25030829 | 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. |
| Background | 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 |
| 29386812 | 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. |
| ID | Term |
|---|---|
| D002710 | Chlorhexidine |
| C546060 | hydrated silica gel-based toothpaste |
| ID | Term |
|---|---|
| D001645 | Biguanides |
| D006146 | Guanidines |
| D000578 | Amidines |
| D009930 | Organic Chemicals |
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