Evaluation of Salivary Flow Rate, pH and Buffer in Pre, Post & Post Menopausal Women on HRT.
BACKGROUND
Climateric is considered to be a natural phase of life which by definition is the period of life starting from decline in ovarian activity until after the end of ovarian function. It is accompanied by various health consequences that include the changes in saliva too. This study was carried out to evaluate the salivary flow rate, pH, buffering capacity in pre-menopausal, post-menopausal and post-menopausal women on HRT.


OBJECTIVE
(1) To evaluate the salivary flow rate, pH of resting saliva and stimulated saliva and buffer capacity of stimulated saliva in pre-menopausal, post-menopausal and post-menopausal women on Hormone Replacement Therapy (HRT). (2) To compare the above salivary findings between pre-menopausal, post-menopausal and post-menopausal women on HRT.


METHODS
The study was carried out on 60 patients. These patients were divided into three groups of 20 patients: Group 1: Pre-menopausal women (control), Group 2: post-menopausal women (case), Group 3: post-menopausal women on HRT (case). The control group consisted of 20 women volunteers, having regular ovulatory menstrual cycles with no known systemic illness and deleterious habits and Group 2 consists of 20 post-menopausal women and Group 3 will consist of 20 post-menopausal women on HRT. After clearing the mouth by swallowing, stimulated saliva was collected after chewing paraffin for 10 mins in to a glass centrifuge tube graded in 0.1 mL increments up to 10mL.in rare cases the collection time will be reduced or extended (5-15 min), salivary flow rate will be determined as ml/min, immediately after collection, pH was determined by dipping pH test paper directly into the sample of oral fluid, salivary buffer capacity was determined by using saliva check buffer kit (GC corporation). The data obtained was statistically evaluated using chi-square test, fisher exact test ANOVA analysis.


RESULTS
In our study we found salivary flow rate significantly lower in the post-menopausal women in comparison with the menstruating women and also there was improvement in the flow rate in individuals who were on HRT, it was also observed that salivary pH of the post-menopausal group was significantly lower than that of the control group, statistically significant difference in buffer capacity values was found between the groups however buffer capacity values were higher in the post-menopausal group than the control group.


CONCLUSIONS
From the above study it is clear that post-menopausal women will present with oral discomfort, while HRT can improve the same. Hence our role as physicians and health care providers is to incorporate preventive dental health care in post-menopausal women and clearly inform patients about both the benefits and the limitations of HRT.
Assistant Professor, Department of Oral Medicine and Radiology, Dayananda Sagar College of Dental Sciences , Bangaluru, Karnataka, India .
Mahesh
M
D R
Professor, Department of Oral Medicine and Radiology, Bangalore Institute of Dental Sciences , Bangaluru, India .
Komali
K
G
Professor and H.O.D, Department of Oral Medicine and Radiology, Bangalore Institute of Dental Sciences , Bangaluru, India .
Jayanthi
J
K
Professor and H.O.D, Department of Orthodontics, SJM Dental College , Chitradurga, Karnataka, India .
Dinesh
D
D
Consultant Dental Surgeon, Yenopoya Dental College , Mangalore, Karnataka, India .
Saikavitha
S
T V
Consultant Dental Surgeon, Bapuji Dental College and Hospital , Davengere, Karnataka, India .
Preeti
P
Dinesh
Hormonal fluctuations; Postmenopause; Saliva & HRT