ORIGINAL RESEARCH

Journal of Dentomaxillofacial Science (J Dentomaxillofac Sci ) August 2016, Volume 1, Number 2: 125-128
P-ISSN.2503-0817, E-ISSN.2503-0825

Inorganic component of saliva during fasting and

after fast break
CrossMark
Yusrini Selviani, Nurul W. Mas’ud, Arsmin NI. Fitri, Atikah B. Ferry, Rini F. Lestari,
Rasmidar Samad*

Abstract

Objective: The purpose of this study is to determine the inorganic Results: Shows that concentration of inorganic components (calcium,
component of saliva during fasting and after fast break. The study is phosphate and potassium) in the saliva decreased significantly after
an observational analytic (longitudinal/follow-up study) conducted in fast break (p<0.05). Sodium decreased insignificantly after fast break
Dental Hospital, Hasanuddin University in July 2015. (p=0.190) and magnesium increased insignificantly after break
Material and Methods: The sampling method is purposive sampling fasting (p=0.615).
with the entire population of Dental Public Health section students, Conclusion: The concentration of 4 calcium, phosphate, potassium
who are 35 people with 16 research subjects who fulfill the criteria except sodium decreased significantly after fast break, whereas the
of the study. Samples were tested in the laboratory using atomic concentrations of magnesium were not significantly increased after
absorption spectrophotometer in parts per million units. The data is fast break.
analyzed by paired t-test with SPSS version 17.0.

Keywords: Saliva, Inorganic, Fasting

Cite this Article: Selviani, Y., Mas’ud, N.W., Fitri, A.N.I. 2016. Inorganic component of saliva during fasting and after fast break. Journal of
Dentomaxillofacial Science 1(2): 118-121. DOI:10.15562/jdmfs.v1i2.10

Department of Dental Public Introduction

Health, Faculty of Dentistry,
Hasanuddin University, Makassar, Saliva is an exocrine liquid secreted into oral cavity magnesium plays important role in neuromuscular
Indonesia through three pairs of saliva glands (parotic gland, activity, central nerve system, heart beat rhythm,
submandibular gland and sublingual gland), minor fibrinolysis promoter as a vasodilator agent, and
saliva gland and gingival fluid. Saliva has many immune system builder. Phosphate in the enamel
functions in the oral cavity such as cleanser of food is required as a constituent of the hydroxyapa-
debris, helping digestion and mastication of food, tite molecules, whereas in plaque and saliva it is
setting water balance, maintaining the integrity required for remineralization process and buffer
of the tooth, antibacterial activity, antifungal and saliva and Potassium are the major cations found
antiviral, neutralizing the atmosphere of oral cavity in the intracellular fluid (joint bicarbonate) which
tissue damaged by strong acid and alkaline.1 serves as the primary buffer. Ramadan is the
Saliva consists of 94–99.5% water, organic and ninth month in the islamic lunar calendar (hijra),
inorganic component. The inorganic include Na+, which has great significance for all muslims in the
K+, Ca2+, Mg2+, Cl, SO4, H2PO4, HPO4, SCN, F, H2PO4 world. In this month, every muslim must perform
and HPO4, whereas the main organic components fasting for one month. This activity changes their
is protein, enzyme, immunoglobulin, lipid, glucose, meal and drink times, which in turn will affect the
amino acid, urea, ammonia, vitamin, mucus glyco- production of saliva due to the lack of activity of
protein, albumin, some oligopeptide and polypep- mastication in the cavity. In additional the saliva
*
Correspondence to: Rasmidar
tide which are important for oral cavity.2 component also will be different. If the component
Samad Calcium, sodium, potassium, magnesium and of saliva changes, it can cause damage in cavity.
[email protected] phosphate are found in ionic forms. These inorganic Therefore, the purpose of this study is to examine
components play an important role in oral cavity. In the inorganic content of saliva during and after
Received: 09 March 2016 saliva, calcium assists in remineralization process fasting. Besides that, the study will also analyze the
Revised: 15 August 2016 of dentin and teeths’ enamel, sodium contributes in total concentration of calcium, sodium, potassium,
Accepted: 17 August 2016
sending impulse to the nerve process, supporting magnesium and phosphate during fasting and after
Available Online: 31 August 2016
muscle cell contraction and maintaining body fluid, breakfast.3–9

 http://jdmfs.org
 ORIGINAL RESEARCH

Material and Methods Results

The study is observational analytic with longi- From the table 1. The data shows that the concen-
tudinal design (follow up study). The study was tration of potassium in the saliva declined after
conducted at Dental Hospital, Faculty of Dentistry, fast break. In the normal state, total potassium in
Hasanuddin University, Makassar, Indonesia in July saliva is 360–480 ppm. The data shows a decrease in
2015. The population of this study was 35 students potassium concentration after fast break below the
from Department of Dental Public Health Faculty normal limit of 467.44 ppm, whereas during fasting
of Dentistry Hasanuddin University and total the potassium concentration is above the normal
saliva samples are 16 clinical students who fit with limit of 942.31 ppm. This is because during fasting
the criteria of research subjects. salivary flow decreased because of mastication of
Inclusion criteria for this study are the Muslim food or it is unstimulated. In this study, salivary
clinic students who are performing fasting. flow during fasting decreased while the potassium
Exclusion criteria in this study is the subject who is ion concentration is higher, this means that the
undergoing orthodontic treatment, taking antibiot- salivary flow correlated negatively with potassium.
ics, using a prosthesis, has a systemic disease and the Table 1 also shows the concentration of calcium,
habit of smoking. The inorganic content is measured phosphate and potassium in saliva decreased
by Atomic Absorption Spectrophotometer (AAS) significantly after fast break (p=0.002 for calcium,
in Parts Per Million (ppm) units derived from for phosphate p=0.000 and p=0.000 for potas-
saliva collected in the tube during fasting and sium). The mean of total calcium concentration
after breakfast. (ppm) during fasting was at 106.75 with a standard
Samples were collected at 11:00 pm during deviation of 24.47 and the mean of total calcium
fasting in the morning. To obtain saliva, subjects concentration (ppm) after fast break was at 78.75
in a resting state bowed his head and samples were with a standard deviation of 22.00. The mean of
collected into sterile plastic bottles up to half or concentration of phosphate at 68.50 with a
about 5 ml. Then, the bottles were attached with standard deviation of 18.35, while after fast break
an identification label and stored in refrigerator to was at
prevent chemical alteration in samples. The samples 23.12 with a standard deviation of 6.62. The mean
were sent to BPTP Maros Laboratory to measure concentration of potassium during fasting was at
their inorganic component by AAS. The samples 942.31 with a standard deviation of 284.32 and after
were collected at 20:30 pm, which is 90 minutes fast break was at 467.44 with a standard deviation
after fast break. To obtain saliva, subjects in a resting of 138.14.
state bowed their head and samples were collected The mean of total magnesium concentration
into sterile plastic bottles up to half or about 5 ml. (ppm) during fasting was at 2.18 with a standard
Then, the bottles were attached with an identifi- deviation of 1.231 and after fast break was at 2.35
cation label and stored in refrigerator to prevent with a standard deviation of 1.34. This shows
chemical alteration in samples. The samples were magnesium concentration has nonsignificantly
sent to BPTP Maros Laboratory to measure their increased after fast break (p=0.615).
inorganic component by AAS. Table 1 shows the mean of sodium concentra-
Data were processed using SPSS version 17.0 tion (ppm) during fasting was at 192.62 with a
and analyzed using paired t-test with significant p standard deviation of 139.34 and after fast break
value of <0.05. The data was presented in table. was at 160.25 with a standard deviation of 64.05.
This represents an insignificant reduction in the
concentration of sodium ions in saliva after fast
Table 1 Inorganic component of saliva during fasting and after fast break (p=0.190).
break
After fast Discussion
Mineral During fasting break
(ppm) Normal In this research, samples were collected at 11:00 pm
N state Mean ± SD Mean ± SD p- value
during fasting due to the process of circadian
Calcium 16 100.2 106.75 ± 24.47 78.75 ± 22.00 0.002* rhythm that worked at that time. In line with
Phosphate 16 190 68.50 ± 18.35 23.12 ± 6.62 0.000* Karami-Nougurani et al.10 stated that in order to
Calium 16 360–480 942.31 ± 284.32 467.44 ± 138.1 0.000*
avoid the possibility of confounding effects from
circadian rhythms in salivary flow, the research
Magnesium 16 4.86–14.58 2.18 ± 1.23 2.35 ± 1.34 0.615*
have to carry out at 9:00–11:00 am. The circadian
Sodium 16 46–1150 192.62 ± 39.34 160.25 ± 64.05 0.190* rhythm is a rhythm of the body that is “up” and
Significance p<0.05 “down” regularly in the span of about 24 hours. This
is also supported by Wu et al.11 who argued that
the
Journal of Dentomaxillofacial Science (J Dentomaxillofac Sci ) August 2016; 1(2): 118-121 | doi: 10.15562/jdmfs.v1i2.10 126
ORIGINAL RESEARCH

concentration of the various components of saliva a decrease in the concentration of hydroxyl and
is characterized by their impact on the variation of phosphate leading to demineralization.
salivary flow. The concentration of potassium in the saliva
The second sampling was carried out 90 minutes declined after fast break. Based on the normal state,
after fast break, because the circumstance of the pH total of potassium in the saliva is 360–480 ppm.7
in the oral cavity has returned to a normal state. This shows a decrease in potassium concentration
This is supported by research from Higham12 who after fast break in the normal limit of 467.44 ppm,
stated that, based on the Stephan curve graph show- while at fasting potassium concentration is above
ing that a pH of 5.5 or less indicates the occurrence the normal limit of 942.31 ppm. This is because
of demineralization, and pH levels will stay down at the time of fasting salivary flow decreases die
or in a “critical level” for approximately 20 minutes, to mastication of food or is unstimulated. In this
pH was completely back to normal or resting state study, salivary flow during fasting decreased, while
about 45–60 minutes after mealtime. potassium concentration is higher, which mean that
In this study, the concentration of calcium salivary flow correlated negatively with potassium.
decreased significantly after fast break. Based on This is according to research conducted by Sevon16
the normal concentration, total calcium in saliva who stated that salivary flow negatively correlated
is equal to 1–2.5 mMol/L or 100.2 ppm13 and after with magnesium, potassium and phosphate and
fast break, the calcium concentration is equal to positively correlated with protein and sodium.
78.75 ppm, which indicates that there is a decrease There is a positive correlation between salivary flow
in calcium concentrations below the normal limit. rates, calcium, sodium and an inverse correlation in
This is due to the stimulation of mastication, caus- salivary flow with potassium.
ing an increase in salivary flow. Indriana14 argued Magnesium concentration has increased to
that increase in salivary flow could affect minerals a nonsignificant level after fast break. Normal
in saliva. The increase in salivary flow rate causes concentration of magnesium in the saliva is equal
a decrease in salivary calcium concentration. The to 4.86–14.58 ppm,13 whereas in this study, a
calcium in saliva plays a role in maintaining the decrease in magnesium concentration below the
integrity of the teeth by regulating remineraliza- normal limit of the results obtained during fasting
tion, if the salivary calcium is low, it will be one of is 2.18 ppm and 2.35 ppm after fast break. Study by
the factors of demineralization. Skomro117 shows obtaining magnesium in healthy
Demineralization is the release of inorganic people is at 0.14 mmol/L or 3.40 ppm. Whereas,
mineral hydroxyapatite structure at a pH below 5.5 other researches on the composition of the saliva
(the critical pH). If the concentration of calcium in does not report the total of magnesium ions due to
saliva is lower than enamel, the enamel will dissolve a low concentration.
the minerals. Therefore, the amount of minerals In this study, decreased magnesium ion concen-
in the saliva and plaque is same as in enamel. The trations during fasting are due to reduced salivary
presence of calcium ion release enamel, which flow. This is in line with Johanson et al.18 who
continues to loss a little amount of enamel element reported that the fast with a short time can reduce
and if it had been up to dentin then the patient salivary flow and it is influenced by physiological
will feel pain.6 Hasanah et al.15 stated if the calcium and psychological factors when fasting. However,
in teeth is irreplaceable, then the excess calcium there are different results with Sevon16 the research
will diffuse in to the surrounding environment. found no changes in the concentration of magne-
Demineralization will stop in case the pH and sium on salivary flow. This may be due to a body
calcium in saliva increases resulting in remineral- state that varies between individuals that affect
ization process. the composition of saliva. Several other studies
The phosphate concentration decreased signifi- confirm that the composition of the saliva flow
cantly after fast break. This is because during fasting, rates varied and differ in each individual every
humans have not eaten or taken drink for 12 hours day. It is also caused by factors of age and gender,
that led to an absence of stimulation of saliva, so the which differs for each individu.17 The concentration
salivary flow decreases and affects salivary calcium of magnesium in the body is mainly influenced
and phosphate concentrations. When the pH of by the concentration of magnesium in plasma.
saliva during fasting is normal or non-acidic due to Magnesium excretion is influenced by the concen-
lack of food intake, thereby reducing the amount of tration of calcium and phosphate. The movement
bacteria in saliva that can speed up teeth’s enamel of magnesium generally follow the movement of
demineralization.14 This is according to research phosphate that is, if the phosphate decreased, then
conducted by Hasanah et al.15 who said that when the magnesium also decreases and it is inversely
the pH in the oral cavity is acidic, it will produce proportional to calcium.19

127 Journal of Dentomaxillofacial Science (J Dentomaxillofac Sci ) August 2016; 1(2): 118-121 | doi: 10.15562/jdmfs.v1i2.10
 ORIGINAL RESEARCH

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Journal of Dentomaxillofacial Science (J Dentomaxillofac Sci ) August 2016; 1(2): 118-121 | doi: 10.15562/jdmfs.v1i2.10 128