Correlation between salivary biomarkers and plaque-induced gingivitis exacerbated by pregnancy

  • Othoniel Aragon-Martinez Department of Pharmacology, School of Medicine, Autonomous University of San Luis Potosi, San Luis Potosi, Mexico.
  • Karen Loredo-Escobar Periodontics Postgraduate Program, Dentistry School, Autonomous University of San Luis Potosi, San Luis Potosi, Mexico.
  • Juan Cepeda-Bravo Periodontics Postgraduate Program, Dentistry School, Autonomous University of San Luis Potosi, San Luis Potosi, Mexico.| Periodontics Clinic, Dentistry School, Autonomous University of San Luis Potosi, San Luis Potosi, Mexico.
  • Flavio Martinez-Morales Department of Pharmacology, School of Medicine, Autonomous University of San Luis Potosi, San Luis Potosi, Mexico.
  • Maria Gonzalez-Rivera Department of Pharmacology, School of Medicine, Autonomous University of San Luis Potosi, San Luis Potosi, Mexico.
  • Saray Aranda Romo Department of Pharmacology, School of Medicine, Autonomous University of San Luis Potosi, San Luis Potosi, Mexico.


Objective: To evaluate the correlation between salivary biomarkers (the salivary antioxidant ability, salivary level of polyphenols, and other antioxidants) with plaque-induced gingivitis exacerbated by pregnancy in pregnant and nonpregnant women. Material and methods: For this observational study, medical records, dental examinations, and analyses of saliva samples were carried out in pregnant and nonpregnant women. A p-value of p<0.05 was considered significant. Results: The pregnant women (N = 17) exhibited a lower antioxidant capacity (p-value = 0.0041), higher levels of polyphenols, gingival index, bleeding on probing, and subjects consuming mineral-enriched products (p values from p<0.0001 to 0.0466), and unchanged levels of phosphotungstic acid reactive substances, proteins, oral hygienic habits, plaque index and probing depth (p-values from 0.0683 to 0.8358), in comparison with the nonpregnant women (n = 19). Also, a positive correlation between the gingival index and salivary polyphenol content was observed (r-value = 0.4087, p-value = 0.0202). Conclusion: The salivary polyphenols correlate with plaque-induced gingivitis exacerbated by pregnancy, suggesting a deficiency of salivary antioxidant protection.


1. Ho CC, Chou MY. Periodontal status in Taiwanese pregnant women. J Dent Sci 2016; 11:146-151.
2. Yark FU, Gokturk O, Demir O. Interaction between stress, cytokines, and salivary cortisol in pregnant and non-pregnant women with gingivitis. Clin Oral Investig 2018;10:230-235.
3. Togoo RA, Al-Almai B, Al-Hamdi F, Huaylah SH, Althobati M, Alqarni S. Knowledge of Pregnant Women about Pregnancy Gingivitis and Children Oral Health. Eur J Dent 2019; 13:261-270.
4. Chang CH, Han ML, Teng NC, et al. Cigarette Smoking Aggravates the Activity of Periodontal Disease by Disrupting Redox Homeostasis- An Observational Study. Sci Rep 2018; 8:11055.
5. Bains VK, Bains R. The antioxidant master glutathione and periodontal health. Dent Res J (Isfahan) 2015; 12:389-405.
6. Diab-Ladki R, Pellat B, Chahine R. Decrease in the total antioxidant activity of saliva in patients with periodontal diseases. Clin Oral Investig 2003; 7:103-107.
7. Gümüş P, Emingil G, Öztürk VÖ, Belibasakis GN, Bostanci N. Oxidative stress markers in saliva and periodontal disease status: modulation during pregnancy and postpartum. BMC Infect Dis 2015; 15:261.
8. Zygula A, Kosinski P, Zwierzchowska A, et al. Oxidative stress markers in saliva and plasma differ between diet-controlled and insulin-controlled gestational diabetes mellitus. Diabetes Res Clin Pract 2019; 148:72-80.
9. Shetty MS, Ramesh A, Shetty PK, Agumbe P. Salivary and Serum Antioxidants in Women with Preeclampsia with or Without Periodontal Disease. J Obstet Gynaecol India 2018; 68:33-38.
10. Zamani-Ahari U, Zamani-Ahari S, Fardi-Azar Z, Falsafi P, Ghanizadeh M. Comparison of Total Antioxidant Capacity of Saliva in Gestational diabetes mellitus and Non-diabetic Pregnant Women. J Clin Exp Dent 2017; 9:1282-1286.
11. Surdacka A, Ciężka E, Pioruńska-Stolzmann M, et al. Relation of salivary antioxidant status and cytokine levels to clinical parameters of oral health in pregnant women with diabetes. Arch Oral Biol 2011; 56:428-436.
12. Canakci V, Yildirim A, Canakci CF, Eltas A, Cicek Y, Canakci H. Total antioxidant capacity and antioxidant enzymes in serum, saliva, and gingival crevicular fluid of preeclamptic women with and without periodontal disease. J Periodontol 2007; 78:1602-1611.
13. Procházková D, Boušová I, Wilhelmová N. Antioxidant and prooxidant properties of flavonoids. Fitoterapia 2011; 82:513-523.
14. Hirschfeld J. Neutrophil Subsets in Periodontal Health and Disease: A Mini-Review. Front Immunol 2020; 10:3001.
15. Cherian DA, Peter T, Narayanan A, Madhavan SS, Achammada S, Vynat GP. Malondialdehyde as a Marker of Oxidative Stress in Periodontitis Patients. J Pharm Bioallied Sci 2019;11: S297-S300.
16. Alkan D, Guven B, Turer CC, Balli U, Can M. Folate-receptor 1 level in periodontal disease: a pilot study. BMC Oral Health 2019; 19:218.
17. James P, Worthington HV, Parnell C, et al. Chlorhexidine mouth rinse as an adjunctive treatment for gingival health. Cochrane Database Syst Rev 2017;3:CD008676.
18. Löe H. The Gingival Index, the Plaque Index, and the Retention Index Systems. J Periodontol 1967; 38:610-616.
19. Kayalvizhi G, Radha S, Prathima GS, Mohandoss S, Ramesh V, Arumugam SB. Comparative Evaluation of Plaque Removal Effectiveness of Manual and Chewable Toothbrushes in Children: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2019; 12:107-110.
20. Silva DD, Gonçalo Cda S, Sousa Mda L, Wada RS. Aggregation of plaque disclosing agent in a dentifrice. J Appl Oral Sci 2004; 12:154-158.
21. Gonzalez-Rivera ML, Martinez-Morales F, Alonso-Castro AJ, et al. Validated and rapid measurement of the ferric reducing antioxidant power in plasma samples. Chem Pap 2018; 72:2561–2574.
22. Gonzalez-Rivera ML, Martinez-Morales F, Alonso-Castro AJ, et al. Matrix effect evaluation and validation of the 2,2′-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) radical cation scavenging assay, as well as its application using a tejate, an ancient beverage in Mexico. Chem Pap 2019; 73:2767–2781.
23. Carroll JJ, Coburn H, Douglass R, Babson AL. A simplified alkaline phosphotungstate assay for uric acid in serum. Clin Chem 1971; 17:158-160.
24. Castro RJ, Herrera R, Giacaman RA. Salivary protein characteristics from the saliva of carious lesion free and high caries adults. Acta Odontol Latinoam 2016; 29:178-185.
25. Knaś M, Maciejczyk M, Sawicka K, et al. Impact of morbid obesity and bariatric surgery on antioxidant/oxidant balance of the unstimulated and stimulated human saliva. J Oral Pathol Med 2016; 45:455-464.
26. Koppelman SJ, Smits M, Tomassen M, et al. Release of Major Peanut Allergens from Their Matrix under Various pH and Simulated Saliva Conditions-Ara h2 and Ara h6 Are Readily Bio-Accessible. Nutrients 2018;10: E1281.
27. US Department of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and Research, Center for Veterinary Medicine (USDHHS, FDA, CDER and CVM). Bioanalytical method validation: guidance for industry. Maryland, 2018. URL: Accessed March 2020
28. Singh U, Solanki V, Mehrotra S, Sharma R. An Evaluation of Applicability of Salivary Uric Acid Measurement in Preeclampsia and Normal Pregnancy and Its Correlation with Serum Uric Acid. J Obstet Gynaecol India 2019; 69:62-68.
29. Sautin YY, Johnson RJ. Uric acid: the oxidant-antioxidant paradox. Nucleosides Nucleotides Nucleic Acids 2008; 27:608-619.
30. Lewicka A, Szymański Ł, Rusiecka K, et al. Supplementation of Plants with Immunomodulatory Properties during Pregnancy and Lactation-Maternal and Offspring Health Effects. Nutrients 2019; 11:1958.
31. Mogollon JA, Bujold E, Lemieux S, et al. Blood pressure and endothelial function in healthy, pregnant women after acute and daily consumption of flavanol-rich chocolate: a pilot, randomized controlled trial. Nutr J 2013; 12:41.
32. Ginsburg I, Kohen R, Shalish M, Varon D, Shai E, Koren E. The oxidant-scavenging abilities in the oral cavity may be regulated by a collaboration among antioxidants in saliva, microorganisms, blood cells, and polyphenols: a chemiluminescence-based study. PLoS One 2013;8:e63062.
33. Monowar T, Rahman MS, Bhore SJ, Raju G, Sathasivam KV. Secondary Metabolites Profiling of Acinetobacter baumannii Associated with Chili (Capsicum annuum L.) Leaves and Concentration Dependent Antioxidant and Prooxidant Properties. Biomed Res Int 2019; 2019:6951927.
34. Costa EM, Azevedo JA, Martins RF, et al. Salivary Iron (Fe) Ion Levels, Serum Markers of Anemia and Caries Activity in Pregnant Women. Rev Bras Ginecol Obstet 2017; 39:94-101.
35. Lewicka I, Kocyłowski R, Grzesiak M, Gaj Z, Oszukowski P, Suliburska J. Selected trace elements concentrations in pregnancy and their possible role - literature review. Ginekol Pol 2017; 88:509-514.
36. Lin J, Dinis M, Tseng CH, et al. Effectiveness of the GumChucks flossing system compared to string floss for interdental plaque removal in children: a randomized clinical trial. Sci Rep 2020; 10:3052.
37. Sangiovanni E, Dell'Agli M. Special Issue: Anti-Inflammatory Activity of Plant Polyphenols. Biomedicines 2020; 8:64.
38. Chen B, Tuuli MG, Longtine MS, et al. Pomegranate juice and punicalagin attenuate oxidative stress and apoptosis in human placenta and in human placental trophoblasts. Am J Physiol Endocrinol Metab 2012;302:E1142-E1152.
39. Gawlik-Dziki U, Dziki D, Świeca M, Nowak R. Mechanism of action and interactions between xanthine oxidase inhibitors derived from natural sources of chlorogenic and ferulic acids. Food Chem 2017; 225:138-145.
How to Cite
ARAGON-MARTINEZ, Othoniel et al. Correlation between salivary biomarkers and plaque-induced gingivitis exacerbated by pregnancy. Journal of Oral Research, [S.l.], p. 1-2, nov. 2022. ISSN 0719-2479. Available at: <>. Date accessed: 28 nov. 2022. doi: