J Bagh Coll Dentistry Vol.

19(1), 2007 Salivary flow rate

Salivary flow rate and pH in relation to tongue surface

variations
Ameena Ryhan B.D.S., M.Sc.(1)

ABSTRACT
Background: Different tongue surface variations were seen among individuals. This study was aimed to see any
relation between salivary flow rates, pH with these variations.
Material and method: A total of 43 females were examined for their variations on tongue surfaces. A flow rate and
pH were measured for whole salivary gland sample for each student.
Results: Twenty four of cases (55.8%) showed normal tongue texture, 16 of them (37.2%) were with fissured tongue,
while only 2 students with hairy tongue and one with geographic tongue.
Conclusion: A non significant difference was found between normal and fissured tongue regarding the flow rate and
pH. While a significant differences was found between normal and fissured tongue regarding the mean age, that
fissured tongue increased with age.
Key words: Flow rat, pH, fissure tongue. (J Bagh Coll Dentistry 2007; 19(1)62-64)

INTRODUTION
Changes in general health of human beings
may be reflected by oral mucosa. In addition to
the background factors, there are local factors in
mouth causing reaction in tongue mucosa.
The effect of tobacco, heavy drinks, spices
and person habits in taking ones meals are seen
in reactions of mucosa [1] .
Variations of the tongue surface are named
according to the clinical appearance. Fissured
tongue is also called scrotal tongue or lingua
plicota, it is a familial but not always a
congenital condition. The fissures are of variable
depth and usually extended laterally from a
median groove. It is an asymptomatic condition
unless food particles and debris lodging in the
depths of the fissures cause mild glossitis.
Fissured tongue has been reported to be as high
as 21%[2].
In geographic tongue (Benign migratory
glossitis), the classic manifestation is an area of
erythema, with atrophy of filliform papillae of
the tongue, surrounded by a serpiginous, white,
hyperkeratotic border. The patients are
asymptomatic; however sensitivity to hot and
spicy foods has been reported. The etiology and
pathogenesis are poorly understood, it is noted in
adult than children [3,4].
Hairy tongue characterized by a hypertrophy
and elongation of filliform papillae, with lack of
normal desquamation, colored from yellowish
white to dark brown. Normal filliform papillae
are approximately (1 mm) in length, whereas in
case of hairy tongue the papillae have been
measured at more than (15 mm) in length. The
precipitating factors include poor oral hygiene,
use of medication (broad-spectrum antibiotic),
and therapeutic radiation of head and neck.
The incidence and prevalence of hairy tongue
increased with increasing age. The prevalence
varies widely from 8.3% in children and young
adults to 57% in persons who are addicted to
drugs and incarcerated [5] .
Saliva in the mouth has many functions, one
of the main functions is the protection of oral
mucosa, while in persons with dry mouth, the
cause of many subjective troubles and objective
changes is slowing down of salivation. Mucosal
signs of decreased salivary flow include
inflammation, dryness and inability to express
saliva from gland orifice [7] .
Salivary flow rate can be measured for whole
salivary secretion under resting or stimulated
conditions, however the range of flow rates for
each these is vary wide among healthy
individuals [7]. Therefore, a clear distinction
between normal and abnormal flow rate may not
be possible [8] .
Navazesh et al found that rates of 0.12-0.16
ml/min. seem to define the range below which
there is a higher rate of oral and hard tissue
abnormalities using that as a baseline [9].
Buffering capacity of saliva refers to its
ability to resist a change in pH when an acid is
added to it. This property is largely due to
bicarbonate content of the saliva which is in turn
dependent on salivary flow rate. Bicarbonate
concentration also regulates salivary pH,
therefore there is a relation between salivary pH,
buffering capacity and flow rate, with pH and
buffer capacity increasing as flow rate increased
[10]
.
The source of the bicarbonate is partly from
the plasma which transfer to saliva and partly
from endogenous bicarbonate produced by gland
metabolism [11] .

(1)Assisstant lecturer, College of Dentistry, University of

Baghdad

Oral Diagnosis 62
J Bagh Coll Dentistry Vol. 19(1), 2007 Salivary flow rate

MATERIALS AND METHODS

This study included 43 females' students from
the secondary school and college of dentistry in
Baghdad. The mean age of them was 16.4 years
and the age range was 1324 years. A medical
history was taken and the oral examination was 17.75
done for each female. 18

Variations of the tongue surfaces were 17.5

classified according to the clinical appearance as: 17

Fissured tongue; geographic tongue and hairy 16.5

Mean
tongue. The whole resting (unstimulated) 15.83
16
salivary samples were collected into a graduated
plastic tube for 10 minutes at morning between 15.5

9-10:30 a.m. The flow rates were calculated as 15

mL/min. and the pH was measured for each 14.5

sample by PW-9421 pH meter at room Normal tongue Fissured tongue
temperature directly after collection of the
samples.
Figure 1: Mean age (years) of normal and
RESULTS fissured tongue.
The sample distribution is seen in Table 1.
Table 1: Sample distribution The mean flow rate of whole salivary
Sample No. % secretion of samples with fissured tongue
Normal tongue 24 55.8 (1.6681.163) showed a non significant
Fissured tongue 16 37.2 difference from that of normal tongue
Geographic tongue 1 2.3 (1.9621.123), (P>0.05) (Figure 2, table 2). The
Hairy tongue 2 4.7 mean pH of the samples with fissured tongue
Total 43 100 (6.9890.338) showed a non significant
difference from that with normal tongue
Twenty-four of them (55.8%) were with (6.7870.349), (P>0.05), as shown in Table 2,
normal tongue, sixteen (37.2%) were with and Figure 3.
fissured tongue, while only two (4.7%) with Normal tongue occur in 60.71% of the
hairy tongue and one (2.3%) with geographic examined sample in the age group of (13-16)
tongue. The mean age of females with fissured years while fissured tongue occur in 28.57% in
tongue was 17.75 4.669 years, is significantly the same age group (Table 3).
higher than that of normal tongue which was Fissured tongue seen in 53.3% of the examined
15.834.061 years ( P<0.002) (Table 2,figure 1) sample of an age group 21-24 years while normal
tongue seen in 46.7% in the same age group
Table 2: Mean and SD of age, pH and flow (Table 3).
rate with their statistical analysis For the hairy and geographic tongue we cant
depend on the results because of their small
Normal Fissured
number.
tongue tongue
Sig.

p-
Variable Mean Mean t-test
value
SD SD
15.83 17.75
Age/years 3.843 0.002 S* 1.962
4.061 4.669 2
1.962 1.668 1.9
Flow rate 0.638 0.533 NS
1.123 1.163 1.8
Mean

1.668
6.787 6.989 1.7
pH 2.138 0.052 Ns
0.349 0.338 1.6
* P<0.05 significant 1.5
Normal tongue Fissured
tongue

Figure 2: The mean flow rate of normal and

fissured tongue

Oral Diagnosis 63
J Bagh Coll Dentistry Vol. 19(1), 2007 Salivary flow rate

Table 3: Sample distribution according to the age group

Normal tongue Fissured tongue Geographic tongue Hairy tongue Total
Age group
No. % No. % No. % No. % No. %
13-16 17 60.71 8 28.57 1 3.57 2 7.14 28 65.11

17-20 - - - - - - - - - -

21-24 7 40.7 8 53.3 - - - - 15 34.88

Non significant ( P > 0.05)

6.989
7
6.9
6.787
Mean

6.8
6.7
6.6
Normal tongue Fissured tongue

Figure 3: The mean pH of normal and fissured tongue

DISCUSSION
All the salivary samples were taken at
morning between 9-10:30 a.m. reduce variation
In this study, fissured tongue was seen in
females with a mean age higher than that of
normal tongue. This agrees with the finding of
Kullaa-Mikkonen et al (3) who said that
fissured tongue can be diagnosed initially in
childhood, but it is diagnosed more frequently in
adulthood and the prominence of the condition
appears to increase with increasing age.
In this study, fissured tongue was seen in
37.2% of the examined sample. The prevalence
of fissured tongue worldwide varies by
geographic location and has been reported to be
as high as 21% (3).
Flow rate and pH of fissured tongue samples
showed no significant differences from that of
normal tongue samples. This may be explained
on the base that salivary flow rate and pH have
no effect on the tongue changes and this is
enforced by the finding that fissured tongue has
no specific etiology but a polygenic or autosomal
dominant mode of inherence is suspected
because this condition increased frequency in
families with an affected proband (3).
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