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                     American International Journal of Multidisciplinary Scientific Research 
Vol. 6, No. 2; 2020 

                                       ISSN 2638-1249   E-ISSN 2638-1273 
Published by CRIBFB, USA 

 

     1 
 

 

Evaluation of Salivary pH Changes with Probiotic, Baking Soda and Mineral 
Water Rinse Among Individuals with Low Caries Experience 

 
 

Lubna Farooq 
Baqai Dental College, Karachi, Pakistan 

E-mail: jlubna85@gmail.com 
 

Muhammad Rashid Ahmed 
Baqai Medical College, Karachi, Pakistan 
E-mail: dr_rashidahmed@hotmail.com 

 
Muhammad Aitmaududdolah Khan 

Baqai Medical College, Karachi, Pakistan 
E-mail: aitmaud@hotmail.com 

 
Anum Mahmood 

Baqai Dental College, Karachi, Pakistan 
E-mail: dranum@baqai.edu.pk 

 
Zara Khan 

Dr. Irfan's Institute of Clinical Orthodontics, Pakistan 
E-mail: zarakhan18@live.com 

 
Samreen Khurram 

Baqai Dental College, Karachi, Pakistan 
E-mail: sssamreen@hotmail.com 

 
Mahnoor Farzand 

Baqai Dental College, Karachi, Pakistan 
E-mail: mahnoorfarzand01@gmail.com 

 
 

 
Received: May 01, 2020            Accepted: June 1, 2020                       Online Published: June 11, 2020 
 
doi: 10.46281/aijmsr.v6i2.594          URL:https://doi.org/10.46281/aijmsr.v6i2.594 
 
 
Abstract 
Background: Dental caries is a multifactorial disease; it causes decay in tooth and leads to unbearable pain and expensive dental 
procedures. One of potential risk factor that favor the caries process is acidic pH that a person faces usually after consumption of 
any food or drinks. Various mouth rinses are evaluated to normalize the salivary pH to break the chain of caries pathophysiology.  
Objective: To evaluate the role of probiotic, baking soda and mineral water rinses on pH of Saliva. 
Materials and methods: It were a cross sectional study conducted in institute of Karachi from -10 January to 25 June 2020. Out 
of 150 participants 60 qualified the inclusion criteria and were explained about the procedure of the study after their agreement 
they were divided into three groups each group comprised of 20 participants. Group 1 was given probiotic mouth rinse; Group 2 
was given baking soda mouth rinse and in Group 3 mineral water rinses were given. They were told to rinse the oral cavity before 
and after the food consumption and pre and post salivary changes were recorded. 

mailto:jlubna85@gmail.com
mailto:dr_rashidahmed@hotmail.com
mailto:aitmaud@hotmail.com
https://www.facebook.com/IIOCO/
mailto:sssamreen@hotmail.com
mailto:mahnoorfarzand01@gmail.com
https://doi.org/10.46281/aijmsr.v6i2.594


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Results: Significant (p-value = 0.001) change in salivary pH was observed with baking soda and mineral water rinses however 
probiotic mouth rinse did not show significant (p-value = 0.22) change. 
Conclusion: Rinsing with Baking soda and mineral water mouth rinses increased the salivary pH to normal. 
 
Keywords: Dental Caries, Probiotic, Oral Hygiene, Mineral Water, Salivary pH.  
 
1. Introduction  
Dental caries is a multifactorial and the most prevalent chronic disease in Asian region. For dental caries oral hygiene, diet and 
streptococcus mutans plays an important role for initiation and progression of disease (1)(2).  Saliva plays an important role in 
preservation of oral health.  Salivary components are important in keeping balanced pH, buffering capacity .and proteins that play 
an important role in maintenance of oral health (3) With the disturbance of salivary pH the the remineralization of tooth surface 
occurs because of the degree of supersaturation. It has been reported that the demineralization of enamel occurs when environment 
of oral cavity falls below <5.5 pH (4). To understand this phenomenon strong organic acids such as lactic acid along with other 
acids helps in promoting acidic environment that causes destruction of the tooth enamel causing dental caries(5). One study 
reported that plaque, that is exposed by sucrose can decline the pH resulting in acidic environment in oral cavity. Proper hygiene 
in oral cavity and alkaline pH promotes proline-rich proteins, mucins, provide protection to the tooth surface also attract calcium 
ions and promote remineralization (6)(7). 

Various economical agents have been tried out in combating dental caries. Among these, baking soda and probiotics are 
also being used. 

The World Health Organization defined probiotics as living bacteria that are beneficial for human health. These natural 
microflorae are beneficial and essential for gut wall also maintain or healthy oral environment. Various clinical trials have 
demonstrated that certain gastrointestinal bacteria, have the ability to control the growth of oral microorganisms, including 
streptococcus mutans (8). Probiotic use provides an effective strategy to combat oral disease, including the development of dental 
caries and periodontal infections (9). Baking soda, easily available. Economical and safe house hold item being minimal abrasively, 
and having potent bactericidal property. Different microbiological studies proven its bactericidal activity towards oral pathogens 
(10)(11) Baking soda has been shown to be effective in reducing the acidity of oral cavity and reduction in caries lesion by help 
of remineralization. Therefore, its effect on oral remineralization is noteworthy (12) it is suggested by different authors baking 
soda also helpful in reducing stains and having whitening property (13)(14). 

The aim if this article is to describe and prove the beneficial role of homemade mouth rinse either by probiotic or by 
baking soda and to evaluate the salivary pH of both mouth rinses that could be beneficial in long term for remineralization of oral 
lesions  
 
2. Materials and Methods 
The cross-sectional study was done in the institute of Karachi, Pakistan. After taking ethical clearance from Ethical committee 
150 dental students were enrolled in the study, before starting the study, informed consent obtained was taken and procedure were 
explained to each participant. Patients having any acute or chronic disease of oral cavity as well as the use of any antibiotics two 
months that could affect the salivary function or pH, were excluded from the study. The patients having history of any habits like 
smoking or chewing tobacco were also excluded. 

By the help of mouth mirror and explorer examined all the subjects. 
The evaluation of decayed, missing and filled teeth (DMFT) were based on the WHO criteria.  

dental students of the institution aged RANGE  21–25 years and with DMFT < 3 were included in the study. Of the 150 
voluntary participants, 60 dental students (32 females and 28 males) with a mean age of 23.2 ± 0.71 years were eligible to 
participate in the study after applying the inclusion and exclusion criteria.  

The participants who fulfilled the inclusion criteria were selected and randomly divided into three groups, with 20 
participants in each group. 

▪ Group A: Probiotic group 
▪ Group B: baking soda group 
▪ Group C: rinse with mineral water group  

 
2.1 Preparation of Probiotic Mouth Rinse 
Probiotic mouth rinse was prepared using commercially available probiotic product. 1 g powder contains Lactobacillus acidophilus, 
Lactobacillus rhamnous, Bifidobacterium longum. The sachet contents were dissolved in 10 ml of distilled water which was used 
as a mouth rinse (15). 
 
 



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2.2 Preparation of Baking Soda Mouth Rinse  
Rinse solution was prepared by mixing approximately 1g of baking soda in 10ml of distilled water (16). 
 
2.3 Salivary pH Measurements 
2ml volume were collected using Navazesh spitting method. After rinse, saliva then spited in a disposable plastic container. Saliva 
was collected in the morning between 9;00 am and 9.30 am to prevent any bias in sample. Participants were also informed not to 
eat or drink anything which can alter the pH of saliva (except water) 1 h before sample collection. GC pH strips were used to 
check the salivary pH. After dipping for 30 sec the change of colour strip was compared with the code chart given by the 
manufacturer. 

Group A received probiotic mouth rinse and Group B received bakind soda mouth rinse and group C received 
chlorhexidine mouth rinse which is used as a control group. 

Participants were instructed to swish the 10 ml of mouth rinse for 1 min and salivary pH was recorded at pre and post 
values measured using GC pH strips. 
 
2.4 Statistical Analysis 
Data were analyzed using SPSS version 18. Descriptive statistics, such as mean and standard 
deviation, were calculated. Paired t-test was used to compare the pH of saliva in pre and post results. The statistical significance 
was assessed at P < 0.05. 
 
3. Results 
Table 1. 20 participants in different group 
 

N= 20 participants in each 
group 

Group A Group B Group C  

 Mean SD  Mean SD  Mean SD  

Pre pH  6.4    ±  0.71 6.2   ±   0.72 6.6  ±  0.70 

Post pH  6.9    ±   0.75 7.2    ±  0.32 7.0  ±  0.41 

P value  P < 0.22 P <  0.001 P < 0.001 

 
 

 
 

Figure 1. Comparison of pre and post results of the group 
  

pre pH

post pH

Column1

5.6

5.8

6

6.2

6.4

6.6

6.8

7

7.2

group A group B group C

Comparison of pre and post results of the groups 

pre pH post pH



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4. Discussion 
Oral diseases including dental caries, periodontitis and halitosis usually occur when there is an imbalance between bacterial growth 
and host immune system (1). To maintain the balance in offer mentioned saliva plays major role in the favor of host and provide 
a homeostatic environment for oral tissues as well as for normal flora (2). The changes in saliva leads to initiation of disease 
pathophysiology that ultimately harms the patient (3). In our study three different oral rinses were used to identify the differences 
in pH of saliva before and after the use of the regimen. However, we do not find significant results with probiotic mouth rinse 
though the salivary pH was increased to neutral level but it was not statistically significant when compared with baking soda mouth 
rinse. The mentioned results are similar with the findings of Kamalaksharappa et al. In his study he also found the rise in pH after 
probiotic mouth rinse use in children, however the finding was not statistically significant (4). In another study a different protocol 
was highlighted in which the research makes the participants to apply the probiotic (in paste form) directly on teeth. The results 
in initial weeks were not significant nevertheless after 4th application of probiotic on 14th day he found a significant rise in pH of 
saliva (5). The mentioned study highlighted that the long-term application of probiotic may significantly alter the pH in favor of 
host besides short term application i.e. rinsing that one can perform in few seconds. Study by Byju et., al. reveled that continuous 
use of probiotic decreased the colonies of Streptococcus mutans but when the salivary pH was compared the result was in favor 
of our study he also noticed the non-significant rise in salivary pH (6). Koopaie et., al used normal and probiotic cakes in his study 
to identify the difference in salivary pH and Streptococcus mutans count, he reported that there was significant decrease in colonies 
of Smutans besides he also had the same finding regarding salivary pH as ours furthermore, he mentioned that the both cakes i.e. 
normal and probiotic reduced the pH of saliva for some time after eating (7).  

Regarding baking soda our study found promising results immediately after the rinsing and we observed significant (p-
value = 0.001) beneficial change in salivary pH. The parallel findings were highlighted in a meta-analysis in which it was mentioned 
that after sugar consumption the baking soda significantly reversed salivary pH to normal(8). In another study acidic drinks 
(orange juice, sugar syrups) were given to participants and after that pH changes were noted in saliva, the study demonstrated the 
findings regarding baking soda similar to our study(9). Ballal et., al highlighted the effects of using bicarbonated sugar free gums 
on salivary pH, the researcher found significant increase in pH of saliva in participants who used sugar free bicorbonated chewing 
gums when compared with the participants who used sugar free chewing gums   (10).  

The role of different mouth rinses (homemade and herbal) has been evaluated by different researchers to provide a better 
preventive regimen with good safety profile to general public, however no any homemade or herbal product is marketed yet and 
clinical trial on larger population are required to obtain the good results and to identify the potential side effects of these mouth 
rinses after long term use. 
 
5. Conclusion 
Rinsing with Baking soda and mineral water mouth rinses increased the salivary pH to normal. Probiotic mouth rinses did not 
show a significant effect on salivary pH. 
 
Conflict of interest 
None  
 
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