Gülser KILINÇ, Begüm ERGAN, Gökçen ÖMEROĞLU ŞİMŞEK, Oğuz KILINÇ

Effects of Oral pH Changes on Smoking Desire

Background: Nicotine addiction is associated with nicotine absorptionfrom the buccal mucosa, and it is stated that the main factor thatdetermines nicotine absorption is saliva pH. In the literature, the effectsof changes in saliva pH values after eating and drinking on smokingdesire in smokers were not questioned. Aim: To show the effect of saliva pH changes on smoking desire. Thesecondary aim was to show the impact of coffee and water drinking onsaliva pH and smoking on oral-dental health (oral hygiene and gingivalbleeding). Study Design: Case–control study. Methods: A questionnaire was administered that included “Socio demographic Data Form” and smoking history and Fagerström Testfor Nicotine Dependence (FTND). Oral and dental examinations wereperformed with mirror sonds and using oral hygiene standard Silnessand Leöe plaque index and DMFT Index (Index of Decayed Missingor Filled Teeth). Untreated saliva samples were taken, and baselinesaliva flow rate and pH values were measured. To assess pH changes,saliva pH was remeasured after sugar-free instant coffee and waterconsumption. Smoking desire was evaluated with the Visual AnalogScale (VAS). Results: In this study, 24 (55.8%) females and 19 (44.2%) males wereamong the 43 smoking and 39 nonsmoking cases. Smoking was signifi cantly associated with poor oral hygiene (in smokers 4.71 (±1.40), innon-smokers 2.30 (±1.59); P < .01). DMFT index was higher in smok ers than in non-smokers (in smokers 6.45 (±3.69), in non-smokers 3.87(±2.67); P < .01). Gingival bleeding was more prevalent in smokers(0.68 (±0.76)) than non-smokers (1.20 (±0.90); P = .009). Salivary flowrates were lower in smokers (in smokers 2.56 (±1.34), in non-smokers3.00 (±1.22), P = .06). In both groups, pH values increased after coffeeconsumption and decreased after water; in smokers basal: 6.67 (±0.41),pH coffee: 6.93 (±0.36), pH water: 6.85 (±0.33); in non-smokers pHbasal: 6.84 (±0.37), pH coffee: 7.02 (±0.37), pH water: 6.97 (±0.31),P < .01. The VAS values of smokers at basal 4.73 (±3.21); P < 0.01,after coffee consumption 4.91 (±3.08); P < .01, and after water 3.15(±2.72); P < .01. Conclusion: The saliva pH increased after coffee consumptionand decreased after drinking water. Besides, VAS values decreasedsignificantly after drinking water. The results suggest that a simplebehavior such as drinking water may be used in conjunction withbehavioral and cognitive therapies to pursue smoking cessation.

PDF

___

1. Kurumu Tİ. Turk Sağlık Araştırması. 2020 [cited 2020 01.07.2020]. Available from: https://data.tuik.gov.tr/Bulten/Index?p=Turkiye-Saglik-Arastirmasi-2019-33661.
2. Benowitz NL. Pharmacology of nicotine: addiction, smoking-induced disease, and therapeutics. Annu Rev Pharmacol Toxicol. 2009;49:57-71. [CrossRef]
3. D’Souza MS, Markou A. Neuronal mechanisms underlying development of nicotine dependence: implications for novel smoking-cessation treatments. Addict Sci Clin Pract. 2011;6(1):4-16.
4. Tanda G, Goldberg SR. Alteration of the behavioral effects of nicotine by chronic caffeine exposure. Pharmacol Biochem Behav. 2000;66(1):47-64. [CrossRef]
5. Parvinen T. Stimulated salivary flow rate, pH and lactobacillus and yeast concentrations in non-smokers and smokers. Scand J Dent Res. 1984;92(4):315-318. [CrossRef]
6. Bergström J, Eliasson S, Dock J. A 10-year prospective study of tobacco smoking and periodontal health. J Periodontol. 2000;71(8):1338-1347. [CrossRef]
7. Pickworth WB, Rosenberry ZR, Gold W, Koszowski B. Nicotine absorption from smokeless tobacco modified to adjust pH. J Addict Res Ther. 2014;5(3):1000184. [CrossRef]
8. Tomar SL, Henningfield JE. Review of the evidence that pH is a determinant of nicotine dosage from oral use of smokeless tobacco. Tob Control. 1997;6(3):219-225. [CrossRef]
9. 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;25(1):15-25. [CrossRef]
10. Laine M, Tenovuo J, Lehtonen OP, et al. Pregnancy-related changes in human whole saliva. Arch Oral Biol. 1988;33(12):913-917. [CrossRef]
11. Laine M, Pienihäkkinen K. Salivary buffer effect in relation to late pregnancy and postpartum. Acta Odontol Scand. 2000;58(1):8-10. [CrossRef]
12. Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO. The Fagerström test for nicotine dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict. 1991;86(9):1119-1127. [CrossRef]
13. Uysal MA, Kadakal F, Karşidağ C, et al. Fagerstrom test for nicotine dependence: reliability in a Turkish sample and factor analysis. Tuberk Toraks. 2004;52(2):115-121.
14. Aslan Dilek BN, Nesrin D, Oğuz K, et al. Tütün Bağımlılığı ile Mücadele El Kitabı. TC Sağlık Bakanlığı; 2010:82.
15. Silness J, Loe H. Periodontal disease in pregnancy II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand. 1964;22:121-135. [CrossRef] 16. World Health Organization. Oral Health Surveys: Basic Methods. Geneva: World Health Organization; 2013.
17. Heishman SJ, Singleton EG, Moolchan ET. Tobacco craving questionnaire: reliability and validity of a new multifactorial instrument. Nicotine Tob Res. 2003;5(5):645-654. [CrossRef]
18. Heishman SJ, Lee DC, Taylor RC, Singleton EG. Prolonged duration of craving, mood, and autonomic responses elicited by cues and imagery in smokers: effects of tobacco deprivation and sex. Exp Clin Psychopharmacol. 2010;18(3):245-256. [CrossRef]
19. Hildreth SB, Gehman EA, Yang H, et al. Tobacco nicotine uptake permease (NUP1) affects alkaloid metabolism. Proc Natl Acad Sci USA. 2011;108(44):18179-18184. [CrossRef]
20. Richter P, Hodge K, Stanfill S, Zhang L, Watson C. Surveillance of moist snuff: total nicotine, moisture, pH, un-ionized nicotine, and tobacco-specific nitrosamines. Nicotine Tob Res. 2008;10(11):1645-1652. [CrossRef] 21. Benowitz NL, Hukkanen J, Jacob P, 3rd. Nicotine chemistry, metabolism, kinetics and biomarkers. Handb Exp Pharmacol. 2009;192(192):29-60. [CrossRef]
22. Pullishery F, Panchmal GS, Siddique S. Salivary thiocyanate, uric acid and pH as biomarkers of periodontal disease in tobacco users and non-users – an in-vitro study. J Clin Diagn Res. 2015;9(7):ZC47-ZC50. [CrossRef]
23. Gasior M, Shoaib M, Yasar S, Jaszyna M, Goldberg SR. Acquisition of nicotine discrimination and discriminative stimulus effects of nicotine in rats chronically exposed to caffeine. J Pharmacol Exp Ther. 1999;288(3):1053-1073.
24. El Yacoubi M, Ledent C, Ménard JF, et al. The stimulant effects of caffeine on locomotor behaviour in mice are mediated through its blockade of adenosine A(2A) receptors. Br J Pharmacol. 2000;129(7):1465-1473. [CrossRef]
25. Treloar HR, Piasecki TM, McCarthy DE, Baker TB. Relations Among caffeine consumption, smoking, smoking urge, and subjective smoking reinforcement in daily life. J Caffeine Res. 2014;4(3):93-99. [CrossRef]
26. Emurian HH, Nellis MJ, Brady JV, Ray RL. Event time-series relationship between cigarette smoking and coffee drinking. Addict Behav. 1982;7(4):441-444. [CrossRef]
27. Treur JL, Taylor AE, Ware JJ, et al. Associations between smoking and caffeine consumption in two European cohorts. Addiction. 2016;111(6):1059-1068. [CrossRef]
28. Khemiss M, Ben Khelifa M, Ben Saad H. Preliminary findings on the correlation of saliva pH, buffering capacity, flow rate and consistency in relation to waterpipe tobacco smoking. Libyan J Med. 2017;12(1):1289651. [CrossRef]
29. Fenoll-Palomares C, Muñoz Montagud JV, Sanchiz V, et al. Unstimulated salivary flow rate, pH and buffer capacity of saliva in healthy volunteers. Rev Esp Enferm Dig. 2004;96(11):773-783. [CrossRef]
30. Bergström J, Eliasson S. Noxious effect of cigarette smoking on periodontal health. J Periodont Res. 1987;22(6):513-517. [CrossRef]
31. Bergström J, Eliasson S. Cigarette smoking and alveolar bone height in subjects with a high standard of oral hygiene. J Clin Periodontol. 1987;14(8):466-469. [CrossRef]
32. Müller HP, Stadermann S, Heinecke A. Bleeding on probing in smokers and nonsmokers in a steady state plaque environment. Clin Oral Investig. 2001;5(3):177-184. [CrossRef]