Salivary pH in patients with Juvenile Idiopathic Arthritis under drug treatment with methotrexate and etanercept: single or combined administration

Aim: The aim of the study was to compare the influence of the therapy with Methotrexate and Etanercept, single or combined administration, on salivary pH in patients with Juvenile Idiopathic Arthritis (JIA). Methods: 73 patients, 57 females and 16 males aged between 7 and 25 years, were included in the study 22 of them were treated with Methotrexate (A) and 9 with Etanercept (B), while 8 used a combined administration (C) and 34 were untreated (D). The salivary fluid of each patient was collected for 5 min and its H+ concentration was immediately tested with the use of a litmus paper. No foods or drinks were taken by the patients for at least 2 hours before the test. Results: All the groups showed a mean salivary pH of 6,9, with the only exception of group B (patients treated with Etanercept) which demonstrated 4 slight means decrease to pH 6,5. Conclusions: In this study the drug therapy administered to JIA patients, compared untreated patients, does not appear to adverse more researches in order to understand if the pH decrease may be related to the drugs or caused by oral inflammatory conditions (gum, periodontal, oropharyngeal gastro-intestinal inflammation). Indeed, the concentration of nitric oxide causes by oxidative stress, can be researched in order to approximatively quantify the rate of inflammation through the Griess reagent. 4N0 + 02 + 2H20 - 4n02 + 4H+. The upper shown red-ox reaction suggests to consider the presence of H+ in salivary fluids as a possible cause of Ph decrease. At a later time, testing the salivary buffer capacity may be advisable, in order to better understand the problem, propose useful suggestions for the patients’ daily life and prevent of oral and dental diseases. At last, more attention should be payed to nutrition and home oral hygiene (H0H) of these patients for the prevention of oral and dental diseases