‫بسم ال الرحمن الرحيم‬

Assignment in cariology

Methods of
measuring
plaque pH
 Prepared by:- Shakir Abd Alaziz Abd Allah

METHODS OF MEASURING
PLAQUE pH
Changes in human dental plaque pH can be used to obtain
estimates of acidogenic potential of ingested food. The
presence of acid in plaque is influenced by a large number of
host, microbial, and substrate factors.

Several useful methods have been developed for monitoring

changes in plaque pH:

1- Plaque sampling:
Plaque is allowed to accumalate with the subject
abstaining from oral hygiene. After one or more days, the
plaque is sampled from accessible sites and a large number
of teeth by sequential scraping with an appropriate
instrument. The pooled plaque sample is then dispersed in
diluent and the pH is read with a microelectrode, sampling
the teeth after intervals after food ingestion can yield data
from which Steven curve can be created

Strengths of the method:-

- Does note require sophisticated equipment

- Can be efficiently used a large number of subjects

Weaknesses of the method:-

- Destroys the permeability characteristic of the plaque

- Plaque samples may be contaminated with food

- Only intermittent readings are obtained

- Does not distinguish between dietary and glycolytic acids

- Saliva availability will have a marked effect with oral
clearance difficult to assess

- Data represent an average value from many sites

- Sampling must be critically timed unless bacterial

metabolism is blocked after plaque removal

- Sample available only from accessible surfaces

- Sample represents pH at the enamel - plaque and plaque -

saliva interfaces

+ It is apparent that this methodology is straight forward

and a minable to rapid screening and detailed studies with a
large numbers of subjects

+ This technique to be useful for selecting patients who

show acidogenic responses to fermentable carbohydrates,
and it provides very consistent between laboratories data

2-Touch or micro-touch
Both glass and antimony microelectrodes have been
constructed and evaluated as tools for intraoral plaque pH
measurement. Direct readings can be obtained by placing
the electrodes on the surfaces of the teeth. By allowing
plaque to build up for specific periods of time and then
monitoring pH changes after ingestion of substrate, it is
possible to produce Steven curves. Work with antimony
touch electrodes has provided considerable insight into the
pH of plaque in the different parts of the dentition, the effect
of meals and the effect of saliva.

Glass electrodes available for this work have a diameter

from approximately 1.2 to 1.5mm.

Antimony electrodes can be constructed with relatively

small sensing ends and, when used with care can provide
accurate data. Attempts have been made to use very fine
antimony or palladium - palladium oxide electrodes to
approach interproximal sites in the dentition

Strengths of the method:-

- Does not require sophisticated equipment.

- Can be used efficiently on a large number of subjects.

- Numerous individual accessible sites may be monitored

- Can monitor pH in some carious lesions

Weaknesses of the method:-

- Measuring pH only to plaque - saliva interface

- Measuring pH only to accessible sites

- Alters permeability characteristic of plaque

- Only intermittent readings are obtained

- Dose not distinguish between dietary and glycolytic acids

- Oral clearance difficult to assess since buffering and

washing by saliva are altered

- Plaque may dehydrate due to mouth being held open

- some types of electrodes might be susceptible to protein

poisoning

- Some electrodes are fragile and lack stability

3-TELEMETRIC METHOD
It is evolved for two primary reasons. It is well
documented that greater than 90 percent of the decay which
occur in children, adolescents, and young adults reflects
attacks at sites in the dentition where food can be retained
for prolonged intervals. The pits and fissures on the occlusal
surfaces of posterior teeth and the proximal surfaces
abutting teeth present sites which may be studied by
hydrogen ion sensors implanted in the dentition. After
plaque is allowed to accumulate on the sensor surface either
wires or a radiotransmitter can be used to relay readings
from the mouth. The second important rationale for utilizing
telemetry is that pH readings are continuously made from
inner side of the plaque under conditions whereby the
plaque is not disrupted and the oral environment does not
need to be disturbed dramatically.

Strengths of the method:-

- Permeability characteristics of plaque maintained

- Can be used to distinguish between dietary and glycolytic

acids

- Continuous monitoring of pH

- Allows accurate assessment of sequestering of acids

- Glass electrodes and/or ion sensitive field effect transistors

may be used

- Measures pH at caries-prone sites in the dentition

- Measuring pH at sensing surface-plaque interface

- Large amount of technical information available on

applicable biotelemetry techniques

- Radio may be used to obtain long term continuous readings

- Wires may be used as connectors for protein studies

- Allows studies on (old) plaque, i.e., weeks to months

Weaknesses of the method:-

- Technically more demanding than other methods

- Microbial content of plaque on sensing surface might no be

normal

- Limited number of sites may be monitored when glass

electrodes are used

- Patient selection limited by need for appropriate space in

the dentition