774 final Physiological Status of Some Selected Salivary An7oxidants in Dental Caries Vol 13 No 1 (2025) DOI 10.5195/d3000.2025.774 h#p://den*stry3000.pi#.edu Physiological Status of Some Selected Salivary Antioxidants in Dental Caries Sulafa Khair Al-Deen Banoosh Alayoubi1, Intesar Jasim Al-Kaysi1, Hadeel Ayad2, Esraa Azawi4 1 College of Dentistry, University of Tikrit, Iraq 2 Ministry of Health, Iraq Abstract Objec&ve: Uric acid and total protein are the two main anBoxidants in saliva, and dental caries is the oral disease that affects most of the total populaBon. This study aimed to invesBgate the associaBon between salivary anBoxidants (uric acid and total protein) and dental caries in individuals between the ages of 20 and 30. Materials and Methods: 50 subjects (18 males and 32 females) between the ages of 19 and 30 who aTended the Efraz Health Center in Samarra city were recruited. Dental caries severity was evaluated using the DMFT and DT indices in accordance with WHO guidelines from 1997. Dental caries was divided into three categories based on scores: mild (0–10), moderate (11–20), and severe (21–and more). Salivary uric acid and salivary total protein concentraBon were assessed via chemical analysis of unsBmulated saliva sample collecBon. The staBsBcal package for social science (SPSS) version 21 was used to examine all data. Results: Males had greater mean values for the DMFT and DT fracBons than females, with the differences being staBsBcally significant (p values of 0.05 and 0.001, respecBvely). Males also had higher salivary uric acid than females (P value of 0.001) and uric acid was associated with dental caries experience. Conclusion: Salivary uric acid may act as a biomarker of dental caries. We found higher dental caries among subjects who had high levels of anBoxidants. Keywords: anBoxidant, saliva, dental caries, total protein, uric acid. Cita:on: Alayoubi SKAB, et al. (2025) Physiological Status of Some Selected Salivary An:oxidants in Dental Caries. Den:stry 3000. 1:a001 doi:10.5195/d3000.2025.774 Received: November 14, 2024 Accepted: December 19, 2024 Published: April 11, 2025 Copyright: ©2025 Alayoubi SKAB, et al. This is an open access ar:cle licensed under a Crea:ve Commons ATribu:on Work 4.0 United States License. Email:sulafa.khairy@yahoo.com Introduction Dental caries is the local acid- induced deterioration of dental hard tissue that is sensitive to bacteria fermenting dietary carbohydrates. It is a complex illness where microorganisms are involved. It is the most common and persistent oral disease, especially in young children, due to the host, the substrate, and the modification of the immune system [1-3]. Dental caries carries a significant risk of morbidity [4]. Saliva, a biological liquid found in the oral cavity, plays a crucial role in maintaining oral health through several mechanisms, including salivary flow rate, buffer capacity, and defensive roles via antibacterial features and salivary antioxidant system [5]. Saliva unquestionably improves dental health; therefore, a lack of its secretion may be the onset of disease [6]. The antioxidants in our diet, along with intracellular antioxidants and those produced by enzymatic systems, can stop a variety of inflammatory, infectious, or tumoral processes [7]. Free radical levels rising has been identified as the common element in all these activities. A rise in oxidative damage and a decline in antioxidants have been linked to specific inflammatory conditions of the mouth, such as periodontal disease [8]. Antioxidants' unique function is to fight rogue free radicals, thereby lowering their destructive potential. They Physiological Status of Some Selected Salivary An7oxidants in Dental Caries Vol 13 No 1 (2025) DOI 10.5195/d3000.2025.774 h#p://den*stry3000.pi#.edu function as a singlet oxygen quencher, hydrogen donor, electron donor, peroxide decomposer, and synergist in addition to scavenging radicals [9]. It has been reported that uric acid is the main antioxidant in saliva, accounting for more than 85% of the whole antioxidant action of latent and stimulated saliva from both healthy and periodontally compromised subjects. Total protein is another example of a salivary antioxidant [10]. The primary byproduct of purine metabolism in humans is uric acid (UA), which is created from xanthine by the enzyme xanthine oxidase. Superoxide anion and other reactive oxygen products are formed during purine metabolism when molecular oxygen serves as the electron acceptor [11]. Uric acid may serve as a sign of oxidative stress and may also act as an antioxidant with potential therapeutic benefits. Additionally, pro-oxidants, like other reducing agents, can play a part, especially at higher levels [12]. lysozyme, lactoferrin, lactoperoxidase, immunoglobulins, agglutinin, and mucins are among the numerous proteins found in saliva that help to preserve the oral tissues [13]. Additionally, a number of peptides having antibacterial activity have been discovered. These include histatins, defensins, and LL-37, the sole cathelicidin produced by humans. There appears to be a significant overlap in functionality because each of these proteins and peptides exhibits a wide range of antibacterial action. This could explain the finding that oral disease susceptibility appears to be unrelated to the concentration of any one component [14]. Although the specific cause of this 'redundancy' is unclear, other features might be involved. The aim of this study was to find a relationship between antioxidants of saliva (uric acid and total protein) and dental caries. Material and Methods Subjects and dental examination Fifty randomly chosen participants, who were treated at the Efraz Health Center in Samarra and ranged in age from 19 to 30 years, were examined between January and February 2020. Utilizing dental explorer and mouth mirrors, a clinical examination was performed. The index used for assessment of dental status was: DMFT by W.H.O. methodology for caries status and treatment need (1997) [15] to calculate decayed (D), missing (M), and filled (F) teeth. Saliva collection Following the guidelines stated by Tenovuo and Lagerlöf [16], samples were collected. Each individual was instructed to rinse their mouth with distilled water in the morning after at least two hours of fasting. After 5 minutes, salivary samples began to be collected by spitting into plastic tubes until (Five ml) of unstimulating saliva was obtained. The sample was collected, centrifuged for 10 minutes at 3000 rpm, and the supernatant portion was aspirated and stored at (- 20°C) for upcoming biochemical studies. Biochemical analysis: Salivary samples were stored for biochemical analysis. Total protein and uric acid levels in the saliva were measured calorimetrically using a spectrophotometer (Cecil CE 1011, UK). A ready kit (BIOLABO, France) was used to assess the salivary total protein and the salivary uric acid level, by exact following the manufactured instructions. Data analysis was conducted using Excel 2010. Results Table 1 shows the number and percentage of dental caries by Physiological Status of Some Selected Salivary An7oxidants in Dental Caries Vol 13 No 1 (2025) DOI 10.5195/d3000.2025.774 h#p://den*stry3000.pi#.edu both genders for all three groups [17]. Table 1. Caries severity percentage according to gender. Severity of caries experience (DMFT index) Males Females Total N % No. % No. % mild (0-10) 11 61.1 28 87.5 39 78 moderate (11-20) 7 38.9 4 12.5 11 22 severe (21- and more) 0 0 0 0 0 0 Total 18 32 50 Table 2 shows the mean and standard deviation of total protein in saliva and uric acid in males and females. Males had higher salivary uric acid than females (p < 0.001). Table 2. Comparison between salivary antioxidant constituents in both genders. Gender N Salivary Antioxidant Constituents Total protein Uric acid Mean ± SD Mean ± SD Male 18 1.50 ±0.15 2.71 ±1.3 Female 32 1.47 ±0.1 1.37 ±0.87 Total 50 1.47 ±0.12 1.85 ±1.25 p-value 0.34 0.0008 Table 3 shows the means and standard deviation of DMFT and DT indices in both genders. Males had higher caries experience than females (p < 0.007). Also, males had more decayed teeth than females (p < 0.04). Table 3. Comparison between caries experience in different genders. Gender N Caries- Experience DMFT Mean ± SD DT Mean ± SD Male 18 8.55 ±4.89 4.44 ±3.67 Female 32 4.96 ±3.9 2.68 ±2.56 Total 50 6.26 ±4.61 3.32 ±3.12 p-value 0.007 0.04 Table 4 shows the mean and standard deviation of salivary total protein and salivary uric acid in the different groups based on DMFT. Table 4. Comparison between salivary antioxidant constituents in different caries severity. Caries Severity (DMFT) index N Salivary Antioxidant Constituents Total protein Uric acid Mean ± SD Mean ± SD Mild group 3 9 1.46 ±0.12 1.7 ±1.1 Moderate group 1 1 1.51 ±0.11 2.37 ±1.5 P-value p=0.11 p=0.1 Table 5 shows the correlation of total protein and uric acid based on caries severity. It was found that there was a positive statistically significant correlation between DMFT and salivary uric acid. Table 5. Correlation of dental caries severity and salivary antioxidant constituents. Salivary antioxidant Constituents DT DMFT r p- value r p- value Total protein 0.045 0.75 0.134 0.35 Uric acid 0.102 0.48 0.371 0.007 Physiological Status of Some Selected Salivary An7oxidants in Dental Caries Vol 13 No 1 (2025) DOI 10.5195/d3000.2025.774 h#p://den*stry3000.pi#.edu Figure 1 shows the concentration of salivary total protein in different age groups. Figure 1. Total protein in different age groups. Figure 2 shows the concentration (g/ml) of salivary uric acid in different age groups. Figure 2. Uric acid in different age groups. Discussion In the present study, males had greater levels of salivary uric acid than females. Other studies [18,19] similarly found that males had considerably higher overall prevalence of hyperuricemia than females. This may be due to sex hormones, which increase renal urate clearance in women and decrease tubular urate post- secretory reabsorption in males [20]. The current study also discovered that salivary uric acid levels rise along with an increase in prevalence of caries. A similar finding was made by another study [21], and these findings may be explained by the fact that an increase in saliva's total antioxidant capacity may alter Streptococcus' adhesion to dental plaque and promote more cariogenic activity. In contrast, another study [22] found a negative correlation between salivary uric acid and caries prevalence. This may be due to enhanced production of reactive oxygen species (ROS) in the presence of bacteria by increased activity of neutrophils and monocytes in the oral cavity during phagocytosis [23]. It was found that antioxidants enhance oral health by providing protection against reactive oxygen species that induce damage of oral tissue especially gingival hyaluronic acid and proteoglycan. In this study, the prevalence of dental caries was significantly higher in men than in women. This finding is in line with other studies [24], which attributed this finding to women's greater exposure to oral health information, stronger oral health beliefs, and greater frequency of preventive behaviors [25]. According to their site, location, and mode of action, salivary total protein may play a preventive function in dental caries or may promote the colonization of microorganisms [26]. This study found no link between salivary total protein and the occurrence of caries, which is consistent with other research's findings [27,29]. In contrast, a study by Nireeksha et al. [30] revealed that the mean salivary protein was lower in individuals with higher caries experience. This finding may be explained by the salivary proteins' protective effect against the free diffusion of acids on the tooth surface, which prevents the development of dental caries [30]. Salivary proteins also vary by age [31]. Conclusion The findings of this study support the hypothesis that salivary uric acid may function as a biomarker of dental caries status. Higher dental caries experience was 0 0.5 1 1.5 2 19 21 23 25 27 29 T.Protien T.Protien 1.61.71.55 1.811.96 4.16 1.53 3.2 3.7 1.9 1.55 0.94 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 19 21 23 25 27 29 U ric a ci d Age Physiological Status of Some Selected Salivary An7oxidants in Dental Caries Vol 13 No 1 (2025) DOI 10.5195/d3000.2025.774 h#p://den*stry3000.pi#.edu found among subjects who had high levels of antioxidants. Conflicts of interest The authors declare no competing interest. References 1- Miralles L, Silvestre FJ, Hernández-Mijares A, Baujsta D, Llambes F, Grau D. Dental caries in type 1 diabejcs: influence of systemic factors of the disease upon the development of dental caries. Med Oral Patol Oral Cir Bucal 2006; 11: E256-60. 2- Okoye LO, Ekwueme OC. Prevalence of Dental Caries in a Nigerian Rural Community: A Preliminary Local Survey. 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