Effect of Khat Chewing on the Salivary pH before and after Using Mouthwashes

Document Type : Original Article

Authors

1 Section of Analytical Chemistry, Faculty of Pharmacy, Aden University, Aden, Yemen

2 Department of Analytical Chemistry, Faculty of Pharmacy, Aden University, Aden, Yemen

Abstract

Abstract
Background: Saliva is a biological fluid that has multiple protective functions. These functions can be
attained only if the saliva keeps certain physo-chemical properties such as pH.
Methods: The main purpose of the current study was to compare the salivary pH among khat chewers and
non-khat chewers before and after specific intervals (15, 30, and 60 minutes) of using three commercially
available mouthwashes (MWs). Thirty pharmacy student volunteers were divided into three groups of 10 for
the three MWs. Each group was then subdivided into 5 volunteers as khat chewer and non-khat chewer. The
statistical evaluation was carried out by using paired t-test and analysis of variance (ANOVA) for in vivo
study of salivary pH.
Findings: Low salivary pH in all khat-user volunteers before and after using MWs was indicated. There was
an increase in the salivary pH after 15 minutes of rinsing with the three selected MWs for both groups of
volunteers, after that there was a gradual decrease to the initial pH. The difference between the three groups
was not significant at baseline and after 15 minutes, but there was a significant difference after 30 and 60
minutes for the non-khat-chewing and khat-chewing volunteers.
Conclusion: It can be concluded that using MWs results in altering salivary pH and continuous khat chewing
lowers the baseline pH of saliva and ability to compensate the change of salivary pH.


Keywords


1. 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; 9(3): 72-80.
2. Mor BM, McDougall WA. Effects of milk on pH of
plaque and salivary sediment and the oral clearance
of milk. Caries Res 1977; 11(4): 223-30.
3. Imfeld T, Schmid R, Lutz F, Guggenheim B.
Cariogenicity of Milchschnitte (Ferrero GmbH) and
apple in program-fed rats. Caries Res 1991; 25(5):
352-8.
4. Edgar M, Dawes C, O'Mullane D. Saliva and oral
health. 4th ed. Bicester, UK: Stephen Hancocks
Limited; 2012. p. 4.
5. Akande OO, Alada A, Aderinokun GA, Ige AO.
Efficacy of different brands of mouth rinses on oral
bacterial load count in healthy adults. Afr J Biomed
Res 2004; 7: 125-8.
6. Kennedy JG. The botany, chemistry and
pharmacology of QAT. In: Kennedy JG, editor. The
flower of paradise: the institutionalized use of the
drug Qat in North Yemen. New York, NY: Springer;
1987. p. 176-88.
7. Manghi RA, Broers B, Khan R, Benguettat D,
Khazaal Y, Zullino DF. Khat use: lifestyle or
addiction? J Psychoactive Drugs 2009; 41(1): 1-10.
8. Kassim S, Islam S, Croucher RE. Correlates of
nicotine dependence in U.K. resident Yemeni khat
chewers: A cross-sectional study. Nicotine Tob Res
2011; 13(12): 1240-9.
9. Al-Motarreb A, Al-Habori M, Broadley KJ. Khat
chewing, cardiovascular diseases and other internal
medical problems: The current situation and
directions for future research. J Ethnopharmacol
2010; 132(3): 540-8.
10. Al-Hebshi NN, Skaug N. Khat (Catha edulis)-an
updated review. Addict Biol 2005; 10(4): 299-307.
11. Hijazi M, Jentsch H, Al-Sanabani J, Tawfik M,
Remmerbach TW. Clinical and cytological study of
the oral mucosa of smoking and non-smoking qat
chewers in Yemen. Clin Oral Investig 2016; 20(4):
771-9.
12. Al-Maweri SA, Warnakulasuriya S,4, Samran A.
Khat (Catha edulis) and its oral health effects: An
updated review. J Investig Clin Dent 2018; 9(1):
e12288.
13. Al-Sharabi AK, Shuga-Aldin H, Ghandour I,
Al-Hebshi NN. Qat chewing as an independent risk
factor for periodontitis: A cross-sectional study. Int J
Dent 2013; 2013: 317640.
14. Ali AA, Al-Sharabi AK, Aguirre JM, Nahas R. A
study of 342 oral keratotic white lesions induced by
qat chewing among 2500 Yemeni. J Oral Pathol Med
2004; 33(6): 368-72.
15. Schmidt-Westhausen AM, Al Sanabani J, Al-Sharabi
AK. Prevalence of oral white lesions due to qat
chewing among women in Yemen. Oral Dis 2014;
20(7): 675-81.
16. Al-Kholani AI. Influence of Khat Chewing on
Periodontal Tissues and Oral Hygiene Status among
Yemenis. Dent Res J (Isfahan) 2010; 7(1): 1-6.
17. Al-Maweri SA, Alaizari NA, Al-Sufyani GA. Oral
mucosal lesions and their association with tobacco
use and qat chewing among Yemeni dental patients.
J Clin Exp Dent 2014; 6(5): e460-e466.
18. Al-Maweri SS, Al-Sufyanib G. OP144: Prevalence
of oral cancer, potentially malignant lesions and oral
habits among patients visiting dental school, Sana'a
University. Oral Oncol 2013; 49(Suppl 1): S59.
19. Dhaifullah E, Al-Maweri SA, Al-Motareb F,
Halboub E, Elkhatat E, Baroudi K, et al. Periodontal
health condition and associated factors among
university students, Yemen. J Clin Diagn Res 2015;
9(12): ZC30-ZC33.
20. Lukandu OM, Koech LS, Kiarie PN. Oral lesions
induced by chronic Khat use consist essentially of
thickened hyperkeratinized epithelium. Int J Den
2015; 2015: 104812.
21. Mengel R, Eigenbrodt M, Schunemann T, Flores-deJacoby L. Periodontal status of a subject sample of
Yemen. J Clin Periodontol 1996; 23(5): 437-43.
22. Hill CM, Gibson A. The oral and dental effects of
q'at chewing. Oral Surg Oral Med Oral Pathol 1987;
63(4): 433-6.
23. Alsharabi AKK. oral and para-oral lesions caused by
Takhzeen Al-Qat. (Qat chewing) [PhD Thesis]. Al
Khurtum, Sudan: Faculty of Dentistry, University of
Khartoum; 2002.
24. Al-Alimi KR, Razak AAA, Saubb R. Salivary caries
parameters: Comparative study among Yemeni khat
chewers and nonchewers. J Dent Sci 2014; 9(4):
328-31.
25. Astatkie A, Demissie M, Berhane Y, Worku A. Oral
Effect of Khat Chewing on the Salivary pH Badulla and Yahiya
154 Addict Health, Summer 2019; Vol 11, No 3
http://ahj.kmu.ac.ir, 06 July
symptoms significantly higher among long-term khat
(Catha edulis) users in Ethiopia. Epidemiol Health
2015; 37: e2015009.
26. Masoud A, Al-Qaisy A, Al-Faqeeh A, Al-Makhadri
A, Al-Awsh D, Al-Madhagi H, et al. Decreased
antioxidants in the saliva of Khat chewers. Saudi J
Dent Res 2016; 7(1): 18-23.
27. Salimetrics LLC, SalivaBio LLC. Saliva collection
and handling advice. 3 rd ed. Carlsbad, CA:
Salimetrics; 2015.
28. Paraskevas S, Danser MM, Timmerman MF, Van
der V, van der Weijden GA. Optimal rinsing time for
intra-oral distribution (spread) of mouthwashes. J
Clin Periodontol 2005; 32(6): 665-9.
29. Heintze U, Birkhed D, Bjorn H. Secretion rate and
buffer effect of resting and stimulated whole saliva
as a function of age and sex. Swed Dent J 1983; 7(6):
227-38.
30. Lee CK, Schmitz B. Determination of pH, total acid,
and total ethanol in oral health products: oxidation of
ethanol and recommendations to mitigate its
association with dental caries. Journal of Dentistry,
Oral Medicine and Dental Education 2009; 3: 1-4.
31. Pontefract H, Hughes J, Kemp K, Yates R,
Newcombe RG, Addy M. The erosive effects of
some mouthrinses on enamel. A study in situ. J Clin
Periodontol 2001; 28(4): 319-24.
32. Pretty IA, Edgar WM, Higham SM. The erosive
potential of commercially available mouthrinses on
enamel as measured by Quantitative Light-induced
Fluorescence (QLF). J Dent 2003; 31(5): 313-9.
33. Addy M, Loyn T, Adams D. Dentine
hypersensitivity--effects of some proprietary
mouthwashes on the dentine smear layer: A SEM
study. J Dent 1991; 19(3): 148-52.
34. Soham B, Srilatha KT, Seema D. Effects of
fluoridated toothpaste and mouth rinse on salivary
pH in children- an in vivo study. J Oral Hyg Health
2015; 3: 192.
35. Van Rensburg BGJ. Oral biology. Chicago, IL:
Quintessence Pub. Co.; 1995. p. 459-90.