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Güzel KGU et al.
320 Rev Assoc Med Bras 2017; 63(4):320-323
ORIGINAL ARTICLE
Effect of fluoride on salivary immunoglobulins and sialic acid
Kadriye Görkem Ulu G üzel1*, Zuhal Kirzioğlu2, Ali Kudret A diloğlu3, Münciye Semra Özay E rtürk 4
1PhD, Assistant Professor, Department of Pediatric Dentistry, Faculty of Dentistry, Adnan Menderes University, Aydın, Turkey
2PhD, Professor, Department of Pediatric Dentistry, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey
3MD, Clinical Microbiology Specialist Professor, Department of Microbiology, Faculty of Medicine, Bülent Ecevit University, Zonguldak, Turkey
4PhD, Pediatric Dentist, Private Clinic, Antalya, Turkey
Summary
Study conducted at Süleyman Demirel
University, Scientific Research Project
Coordination Unit, Isparta, Turkey
Article received: 1/17/2016
Accepted for publication: 1/23/2016
*Correspondence:
Hasan Efendi Mah. Adnan
Menderes Üniversitesi Diş
Hekimliği Fakültesi Pedodonti
AD. 09100
Objective: The aim of our study was to evaluate the effect of fluoride on salivary
immunoglobulin and sialic acid levels in children with dental fluorosis and healthy
teeth who live in places with high fluoride concentration in drinking water.
Method: Fifty-one (51) healthy children between 6 and 12 years old with no
caries were randomly selected from primary schools enrolled in the dental-care
program operated by the Department of Pediatric Dentistry. The children were
divided into two groups: group I comprised 26 children with dental fluorosis
[Thylstrup–Fejerskov Dental Fluorosis Index (TFI) = 4] who lived in Isparta
(2.7–2.8 ppm), and group II consisted of 25 children without dental fluorosis
who were born in low-fluoride areas and had lived in Isparta for only the previous
two years. Stimulated and unstimulated saliva were collected and analyzed for
fluoride, salivary immunoglobulins and sialic acid levels.
Results: Sialic acid level was correlated negatively with age. Levels of secretory
immunoglobulin A (sIgA) and secretory immunoglobulin G (sIgG) were higher
in children with dental fluorosis compared with those in group II, although
these differences were not significant.
Conclusion: Increased sIgA and sIgG levels may arrest the progression of caries
in subjects with dental fluorosis. Given the risks of dental fluorosis, further
studies of the effects of different fluoride levels in drinking water on salivary
composition of children with mixed dentition are needed to confirm the results
of our study and to provide data for comparison.
Keywords: dental fluorosis, fluoride, sialic acid, salivary immunoglobulin.
Introduction
Salivary secretions are important for the maintenance of
oral health. In the human saliva, there are components
that control the composition of oral microflora and the
function of microorganisms. The main proteins, peptides
and enzymes in human saliva have been identified and
characterized.1-4 Macromolecules in the saliva have dif-
ferent functions and biochemical properties.
The protective role of saliva includes a buffer effect,
flow rate, immune and non-immune antimicrobial factors
and minerals that support enamel tissue, such as calcium,
phosphorus and fluoride.4 Salivary flow rate, pH, buffer-
ing capacity, calcium-phosphate homeostasis and effects
on bacterial metabolism are important findings of the
saliva-caries interaction.5
Sialic acid is an important structural component of
salivary glycoproteins, having an essential role in enhanc-
ing bacterial agglutination. Sialic acid-containing glyco-
proteins are also important structural components of the
acquired pellicle and of dental plaque. 6
Salivary secretory immunoglobulin A (sIgA) antibod-
ies play an important role in the immune response against
dental caries, which are generated by mucosa-associated
lymphoid tissue (MALT) common in the mucosal immune
system. These antibodies may reduce the initial adhering
of bacteria to saliva-coated teeth surfaces and neutralize
extracellular enzymes.7 It has been reported that caries-free
patients have significantly higher levels of naturally occur-
ring salivary sIgA compared with caries-active subjects.8
Results of previous studies have led researchers to believe