Histatins, a group of proteins produced by human salivary glands, have a variety of innate immune functions including the ability to: kill oral microorganisms, neutralize toxins, inactivate protease/collagenase activities, inhibit co-aggregation of oral bacteria, and inhibit lipopolysaccharide mediated activities. Hemagglutinin B (HagB), a virulence factor of the periodontal pathogen Porphyromonas gingivalis, induces a robust cytokine and chemokine response in human myeloid dendritic cells. In this study, I hypothesize that histatin 5 can attenuate a HagB-induced chemokine response. Objectives: To characterize an expanded cytokine and chemokine response induced in human myeloid dendritic cells by HagB, and to determine if prior incubation of HagB with histatin 5 attenuates these responses. Methods: In my first experiment, 0.040 M HagB was mixed with dilutions of histatin 5 and histatin 8 (Sigma, 0.04 to 40.0 M), incubated at 37C for 30 minutes, and added to 2 x 104 human myeloid dendritic cells (Lonza, Walkersville, MD). At 24 hours, culture media was removed, and 6 cytokines and chemokines (pg/ml) were determined in cell-free supernatants (Millipore, Billerica, MA) using the Luminex 100 IS instrument (Luminex, Austin, TX). In my second experiment, 0.040 M HagB was mixed with 40.0 M histatin 5 only (e.g., 1:1000), incubated at 37C for 30 minutes, and added to 2 x 104 human myeloid dendritic cells. At 0, 1, 2, 4, 8, 16, and 24 hours post-inoculation, culture media was removed, and 26 cytokines and chemokines (pg/ml) were determined in cell-free supernatants. Results: In both experiments, human myeloid dendritic cells incubated with HagB produced Th1, Th2, and Th17 cytokines (IL-2, IL-12(p70), IFN-, IL-3, IL-4, IL-5, , IL-15, IL-17); pro-inflammatory cytokines (IL-1, IL-1, IL-6, TNF-, IL-12(p40); anti-inflammatory v cytokines (IL-10, IL-13, IFN2); chemokines (CXCL8/IL-8, CXCL10/IP-10, CCL2/MCP-1, CCL3/MIP-1, MIP-1b, CCL11/eotaxin); and colony stimulating factors (IL-7, G-CSF, GM-CSF). Histatin 5 significantly attenuated (p < 0.05) the IL-8 response induced by HagB at 8 - 16 hours and to a lesser extent, the IL-6, GM-CSF, MCP-1, MIP-1α, MIP-1β, and TNF-α response. Conclusion: Histatin 5 is an important salivary component capable of attenuating an IL-8 response. Together with human beta defensin 3, another peptide previously shown to attenuate pro-inflammatory cytokines, histatin 5 may help control and contain oral infection and inflammation by down regulating IL-8 chemotactic response.

<p>Artemisinin is the parent compound of a novel family of antimalarials. Repetitive administrations of artemisinin to both healthy volunteers and malaria patients have been shown to result in decreased plasma concentrations of the compound, most probably due to an autoinduction of different CYP450 enzymes. The aim of this thesis was to investigate the clinical pharmacokinetics and efficacy of different dosage regimens of the drug, and study the kinetics of the enzyme induction. Moreover, the putative interaction of the compound with blood components was investigated in vitro. </p><p>Artemisinin was found to distribute into red blood cells, competing with oxygen for binding to hemoglobin. The compound was stable in plasma and, in contrast to previous reports, did not bind to red blood cell membranes. </p><p>To circumvent the logistical and ethical problems associated with plasma sampling, suitability of saliva as substitute was investigated. Moreover, due to the large number of collected samples, an HPLC method, enabling a direct injection of saliva and plasma samples, was developed. </p><p>Saliva artemisinin concentrations were found to correlate with its unbound plasma levels, making saliva a suitable body fluid for pharmacokinetic studies of the compound. Based on saliva samples, artemisinin was shown to exhibit a dose-dependent kinetics and efficacy in malaria patients, with a possible sex-effect on the metabolism of the compound during the first treatment day. Moreover, the time-dependent kinetics of the compound was observed in both malaria patients and healthy subjects. A physiological approach was utilized to model the autoinduction in the latter group. A model with a feedback mechanism of enzymes was able to describe the data, with estimations of the half-lives of induction (3.15 hrs) and elimination of enzymes (32.9 hrs), as well as pharmacokinetic parameters of artemisinin. </p><p>In conclusion, artemisinin was found to exhibit a fast induction of enzymes, with time- and dose-dependent drug kinetics and dose-dependent antimalarial efficacy. </p>

Artemisinin is the parent compound of a novel family of antimalarials. Repetitive administrations of artemisinin to both healthy volunteers and malaria patients have been shown to result in decreased plasma concentrations of the compound, most probably due to an autoinduction of different CYP450 enzymes. The aim of this thesis was to investigate the clinical pharmacokinetics and efficacy of different dosage regimens of the drug, and study the kinetics of the enzyme induction. Moreover, the putative interaction of the compound with blood components was investigated in vitro. Artemisinin was found to distribute into red blood cells, competing with oxygen for binding to hemoglobin. The compound was stable in plasma and, in contrast to previous reports, did not bind to red blood cell membranes. To circumvent the logistical and ethical problems associated with plasma sampling, suitability of saliva as substitute was investigated. Moreover, due to the large number of collected samples, an HPLC method, enabling a direct injection of saliva and plasma samples, was developed. Saliva artemisinin concentrations were found to correlate with its unbound plasma levels, making saliva a suitable body fluid for pharmacokinetic studies of the compound. Based on saliva samples, artemisinin was shown to exhibit a dose-dependent kinetics and efficacy in malaria patients, with a possible sex-effect on the metabolism of the compound during the first treatment day. Moreover, the time-dependent kinetics of the compound was observed in both malaria patients and healthy subjects. A physiological approach was utilized to model the autoinduction in the latter group. A model with a feedback mechanism of enzymes was able to describe the data, with estimations of the half-lives of induction (3.15 hrs) and elimination of enzymes (32.9 hrs), as well as pharmacokinetic parameters of artemisinin. In conclusion, artemisinin was found to exhibit a fast induction of enzymes, with time- and dose-dependent drug kinetics and dose-dependent antimalarial efficacy.

According to WHO, the addition of fluoride to milk could be considered as an alternative to water fluoridation for community-based caries prevention in childhood. School-based schemes in developing as well as industrial countries have demonstrated substantial benefits on oral health, but there are limited data available on the local events in the oral cavity after consumption of fluoridated milk. The general aim of the present investigations was to investigate the concentration of fluoride obtained in saliva and dental plaque after ingestion of Fmilk and to explore the possible effects on the oral ecology. A series of controlled studies were performed in vivo in which samples of saliva and dental plaque were collected and analysed with respect to fluoride content, microbial composition and acidogenicity. An in vitro study evaluated the effect on enamel lesion formation. In paper I, significantly increased concentrations of fluoride (p&lt;0.05) were disclosed in saliva 15 minutes after drinking the fluoride-containing water or milk. In the plaque samples however, the F-increase remained significantly elevated still after 2 hours. The availability of fluoride from milk was generally somewhat lower than from water but the differences were not statistically significant in either plaque or saliva. In paper II, the fluoride concentration in plaque was further explored after a single intake or habitual consumption of fluoridated milk together with a regular meal. The results showed that cariesinhibiting levels of fluoride persisted up to 4 hours after intake. There were no significant differences between the single intakes when compared with repeated intakes. In paper III, the influence of fluoridated milk on the salivary microorganisms associated with dental caries was evaluated. No significant alterations of the microflora were found compared with baseline. There was a slight reduction in the proportion of mutans streptococci after 2 and 4 weeks during consumption with fluoridated milk but the difference failed to reach statistical significance. In paper IV it was demonstrated that fluoridated milk significantly (p&lt;0.05) could counteract the lactic acid formation in dental plaque as initiated with sucrose. In paper V, laser fluorescence technique was used to monitor the effect of fluoridated milk on enamel lesion formation in an experimental caries model. The results reinforced previous research and showed a hampering effect of fluoridated milk. No side effects were reported in any of the investigations. The findings of this thesis substantiate that milk is a suitable vehicle for fluoride administration and contribute to the understanding and possible explanations for the anti-caries properties of fluoridated milk. The main conclusions were: a) intake of fluoridated milk resulted in significantly elevated fluoride levels in saliva within the first 15 minutes and up to 4 hours in dental plaque when fluoridate milk was consumed together with meal, b) no significant alteration of the salivary microflora was disclosed after habitual intake of fluoridated milk but a delayed carbohydrate-mediated lactic acid formation in suspensions of dental plaque could be demonstrated, c) the fluoride concentrations in plaque were not negatively influence by the food intake, and d) the in vitro findings advocated that fluoride added to milk reduced enamel lesion formation as assessed by laser fluorescence technique in an experimental caries model.According to WHO, the addition of fluoride to milk could be considered as an alternative to water fluoridation for community-based caries prevention in childhood. School-based schemes in developing as well as industrial countries have demonstrated substantial benefits on oral health, but there are limited data available on the local events in the oral cavity after consumption of fluoridated milk. The general aim of the present investigations was to investigate the concentration of fluoride obtained in saliva and dental plaque after ingestion of Fmilk and to explore the possible effects on the oral ecology. A series of controlled studies were performed in vivo in which samples of saliva and dental plaque were collected and analysed with respect to fluoride content, microbial composition and acidogenicity. An in vitro study evaluated the effect on enamel lesion formation. In paper I, significantly increased concentrations of fluoride (p&lt;0.05) were disclosed in saliva 15 minutes after drinking the fluoride-containing water or milk. In the plaque samples however, the F-increase remained significantly elevated still after 2 hours. The availability of fluoride from milk was generally somewhat lower than from water but the differences were not statistically significant in either plaque or saliva. In paper II, the fluoride concentration in plaque was further explored after a single intake or habitual consumption of fluoridated milk together with a regular meal. The results showed that cariesinhibiting levels of fluoride persisted up to 4 hours after intake. There were no significant differences between the single intakes when compared with repeated intakes. In paper III, the influence of fluoridated milk on the salivary microorganisms associated with dental caries was evaluated. No significant alterations of the microflora were found compared with baseline. There was a slight reduction in the proportion of mutans streptococci after 2 and 4 weeks during consumption with fluoridated milk but the difference failed to reach statistical significance. In paper IV it was demonstrated that fluoridated milk significantly (p&lt;0.05) could counteract the lactic acid formation in dental plaque as initiated with sucrose. In paper V, laser fluorescence technique was used to monitor the effect of fluoridated milk on enamel lesion formation in an experimental caries model. The results reinforced previous research and showed a hampering effect of fluoridated milk. No side effects were reported in any of the investigations. The findings of this thesis substantiate that milk is a suitable vehicle for fluoride administration and contribute to the understanding and possible explanations for the anti-caries properties of fluoridated milk. The main conclusions were: a) intake of fluoridated milk resulted in significantly elevated fluoride levels in saliva within the first 15 minutes and up to 4 hours in dental plaque when fluoridate milk was consumed together with meal, b) no significant alteration of the salivary microflora was disclosed after habitual intake of fluoridated milk but a delayed carbohydrate-mediated lactic acid formation in suspensions of dental plaque could be demonstrated, c) the fluoride concentrations in plaque were not negatively influence by the food intake, and d) the in vitro findings advocated that fluoride added to milk reduced enamel lesion formation as assessed by laser fluorescence technique in an experimental caries model.

Xylitol, classified as a natural sugar substitute, has for about 35 years been known as an agent that may act against caries. The mechanism of action; how it inhibits mutans streptococci (MS) and the clinical dose-response relationship are not however fully investigated. The general aim of the investigations was to evaluate the effect of xylitol on oral ecology in children and adolescents. A series of experimental and controlled clinical trials were performed in which samples of saliva and plaque was collected and analysed with respect to xylitol content, pH, microbial composition and lactic acid production. In paper I, significantly reduced proportions of xylitol-sensitive MS in saliva were demonstrated after 18 weeks of regular use of two dose regimens of xylitol-containing tablets (1.7g and 3.4g xylitol/day) but the acidogenicity in dental plaque was not affected. In paper II, the effect on interdental plaque-pH of two different single dose intakes (2.0g and 6.0g) of xylitol was evaluated. The higher xylitol dose counteracted the pH-drop significantly (p&lt;0.05) when the chewing was followed by a sucrose rinse while the lower dose did not differ from the control. In paper III, the xylitol concentrations in saliva after use of different common xylitol-containing products (0.1g-1.3g) were investigated. Statistically significant elevations of salivary xylitol levels were demonstrated for all products during the first 8-16 min when compared with baseline (p&lt;0.05) but the individual variation was considerable. In samples of supragingival dental plaque, a high dose rinse (6.0g) increased the xylitol concentrations for a longer period (&gt;30 min) than a low dose rinse (2.0g). In paper IV, it was demonstrated that 6.0g of xylitol in chewing gums, every day in 4 weeks, gave significantly less visible plaque and a significantly reduced sucrose-induced lactic acid formation (p&lt;0.05) in saliva. Furthermore, the proportion of MS decreased significantly (p&lt;0.05) compared to baseline. In paper V, the salivary uptake of [14C]-xylitol was compared with a specific assay determining xylitol-sensitive MS and a fair positive correlation (p&lt;0.05) between the two assays was found. In a controlled trial, the proportions of MS and the salivary xylitol uptake decreased significantly (p&lt;0.05) in the xylitol gum test group after 4 weeks compared to baseline which was in contrast to the control gum group. No serious adverse effects were reported in any of the investigations. The main conclusions from this thesis were: a) various xylitol-containing products increased the xylitol levels in saliva and plaque, b) 6.0g of xylitol could counteract the interdental pH-drop after sugar consumption and reduce lactic acid formation in saliva c) a daily dose of 6.0g xylitol reduced the amount of visible plaque and altered the salivary microbial composition, d) a transient shift of MS strains in saliva was demonstrated during periods of regular intake of xylitol products but no long-term impact was found after its termination. The relatively high amount of xylitol needed for a beneficial effect on the oral ecology calls for a further development of effective and safe routes for administration.

Infectious diseases e.g. gastric ulcer, caries and perodontitis, are caused by bacteria in a biofilm. Adhesion of bacteria to host ligands e.g. proteins, polypeptides and glycoproteins, is a key event in biofilm formation and colonization of surfaces such as mucosa and tooth tissues. Thus, host ligands could contribute to the susceptibility to infectious diseases. The general aim of this doctoral thesis was to study the effect of phosphorylated polypeptides and gp-340 in saliva and milk on oral bacterial adhesion and aggregation. Statherin is a non-glycosylated, phosphorylated polypeptide in saliva. The polypeptide inhibits precipitation and crystal growth of calcium phosphate and mediates adhesion of microorganisms. By using a hybrid peptide construct, the domain for adhesion of Actinomyces isolated from human infections and from rodents was found to reside in the C-terminal end, and the adhesion was inhibitable. With alanine substitution the peptide recognition epitope in the C-terminal end was delineated to Q and TF, where QAATF was an optimal inhibitory peptide. In contrast, human commensal Actinomyces bound to the middle region in a non-inhibitable fashion. Gp-340 is another protein in saliva, and it is a large, multifunctional glycoprotein. Four novel size variants (I-IV) of salivary gp-340 were distinguished within individuals, and their glycoforms were characterized. All four size variants were identical in the N-terminal amino acid sequence and shared core carbohydrates. Low-glyco lung gp-340, high-glyco saliva gp-340, and size variants I-III aggregated bacteria differently. Human milk, which shares many traits with saliva, could inhibit adhesion of Streptococcus mutans to saliva-coated hydroxyapatite (s-HA), a model for teeth, in an individually varying fashion. Human milk caseins, lactoferrin, secretory IgA, and IgG inhibited the binding avidly. By using synthetic peptides the inhibitory epitope in b-casein was mapped to a C-terminal stretch of 30 amino acids. Inhibition by human milk, secretory IgA and the b-casein-derived inhibitory peptide was universal among a panel of mutans streptococci. The main conclusions are: (i) statherin mediates differential binding of commensal versus infectious Actinomyces strains with small conformation-dependent binding epitopes, (ii) salivary gp-340 has individual polymorphisms that at least affect binding of bacteria, (iii) human milk inhibits S. mutans adhesion to s-HA in an individually varying fashion, and the C-terminal end of human milk β-casein is one inhibitory component. Together these results suggest that the studied host ligands can influence the composition of the oral biofilm. Statherin may protect the host from colonization of bacteria associated with infections. Gp-340 size variants may affect functions related to host innate immune defences such as interactions with a wide array of bacteria, and human milk may have a protective effect in infants from colonization of mutans streptococci.

Congenital heart disease (CHD) is one of the most common congenital anomalies with an incidence of approximately 8–10 cases per 1000 live births. Technical development and continuing improvement in surgical methods have led to early interventions and an increased survival and consequently also a new group of patients in dentistry. The general aim of this thesis was to study the caries prevalence and some possible background factors in children with complex CHD.Paper I examined the caries prevalence in 41 children with complex CHD and 41 healthy age- and gender-matched controls. CHD children had higher dmfs-values 5.2 ± 7.0 vs. 2.2 ± 3.5 in the controls (p &lt; 0.05). CHD children on digoxin medication had higher dmfs values 10.1 ± 8.5 vs. 3.7 ± 5.3 in the other CHD children (p &lt; 0.05). CHD children had received more fluoride varnish treatments and fluoride tablets (p &lt; 0.01).Paper II investigated attitudes and experiences of dental health information and advice, dental care, and service in 33 parents of children with complex CHD and 33 parents of age- and gender-matched controls. Differences were displayed in the professional group that provided the parents with dental health information and advice, attitudes to reception at the dental clinic, and experience of sedation before operative dental treatment (p &lt; 0.05).Paper III examined 183 Swedish general dentists’ experiences of and attitudes to dental care for children with CHD. Eighteen % of the dentists had received special education or information to treat children with CHD, while almost half of the dentists had one or more patients with CHD and a majority of them stated that their CHD patients had a caries problem. The dentists had a different opinion regarding the provision of dental treatment for children with CHD compared to the current situation (p &lt; 0.001).Paper IV studied salivary secretion, salivary buffering capacity, viable count of bacteria (TVC), mutans streptococci (MS) and lactobacilli (LBC), calcium, chloride, magnesium, potassium, sodium, and IgA in 24 children on heart failure medication and 24 healthy controls. Seven children (29 %) had stimulated secretions below 0.5 ml/min compared to no child among the controls (p &lt; 0.01). TVC were 1.4 × 106 ± 1.2 × 107 in the cardiac group vs. 2.7 × 106 ± 2.9 × 107 in the control group (p &lt; 0.05). MS ratio of TVC constituted 0.11 ± 0.35 % vs. 0.01 ± 0.02 % for the controls (p &gt; 0.05).Paper V studied the endogenous pH and titratable acidity and dissolution of calcium and phosphate from dental hard tissues by 13 pharmaceutical preparations used in paediatric cardiology. Six of the preparations had an endogenous pH below the critical value for enamel dissolution.It is concluded that (i) children with complex CHD had a higher caries experience in the primary dentition than healthy matched controls, (ii) children on digoxin medication had a higher caries experience than other children with complex CHD, (iii) children with complex CHD had received more caries prevention than healthy controls, (iv) parents of children with complex CHD were less satisfied with the reception and care they received than parents of healthy children, (v) general dentists had a different opinion regarding the provision of dental treatment to children with CHD compared to the current situation (vi) children on heart failure medication can have a low saliva secretion, (vii) pharmaceutical preparations used on long-term basis in paediatric cardiology may pose a hazardous threat to dental hard tissues due to their acidity.

Se realizó investigación de tipo casi-experimental cruzado comparativo en el Puericultorio Pérez Araníbar, con el objetivo de determinar el pH salival sometido a cuatro diferentes situaciones: dieta cariogénica y no cariogénica con y sin cepillado previo. Se trabajó con una muestra de 30 niños agrupados según sexo (niños y niñas) y según grados de afectación por caries dental: 0, no presenta; 1, 1 a 4 lesiones; 2, más de 4 lesiones. Se recolectó saliva total con el método Spitting, tomándose cuatro muestras: 5 minutos antes, 10, 20 y 40 minutos después del desayuno. / The research was realized in Pérez Aranibar Puericulture Institution. The purpose of this research was to determinate the salivary pH when it is submitted to four different situations: cariogenic and non cariogenic diet with and without previous toot brushing. The study included 30 children who were grouped according to sex (boy and girl) and the different decay affectation grade: 0, doesn’t show; 1, 1 to 4 lesions; 2, more than 4 lesions. The total saliva was gathered using the Spitting method and four samples of saliva: 5 minutes before, 10, 20 and 40 minutes after breakfast were taken.

Con el objetivo de determinar la efectividad antibacteriana in vitro de una infusión a base de Camelia sinensis y Minthostachys mollis sobre flora salival mixta, se recolectó saliva no estimulada de 30 estudiantes universitarios y se sembró en el medio Agar Tripticasa soya. Utilizándose el método de difusión por discos para las soluciones de té verde, muña, té verde y muña, y los controles positivo (Clorhexidina) y negativo (Agua destilada), las placas se incubaron a 37° C / 24 horas. El análisis estadístico determinó la efectividad antibacteriana de las infusiones a base de té verde, y té verde y muña, no encontrando efectividad en la infusión a base de muña, y que existían diferencias significativas entre las medias de las muestras. Así mismo, la infusión a base de té verde resultó ser similar en cuanto a su efectividad antibacteriana con respecto a la clorhexidina. De los resultados obtenidos se concluye que se ha evidenciado la efectividad antibacteriana de una infusión a base de té verde y muña sobre la flora salival mixta, sin embargo, se observó una efectividad antibacteriana menor con respecto a la infusión a base de té verde y la clorhexidina. Debido a los resultados del presente estudio que demuestran la efectividad del té verde similar a la clorhexidina, es necesario la continuación de estudios in vivo para comprobar dicho hallazgo y promover su uso como enjuagatorio bucal, así como estudios de asociación de infusión de té verde con aceite esencial de muña o con infusión de muña a mayor concentración.

Durante el embarazo la mujer experimenta una serie de cambios fisiológicos algunos de éstos ocurren a nivel salival como son : pH, flujo y viscosidad salival que van a constituir un factor determinante en el desarrollo de la caries dental. Objetivo: Determinar la relación entre los cambios de pH, flujo y viscosidad salival con el desarrollo de caries dental en mujeres gestantes del primer trimestre. Material y Métodos: Se evaluaron muestras de saliva sin estimular a 30 gestantes del primer trimestre y 30, no gestantes que asistieron al consultorio de Dental del HONADOMANI San Bartolomé, cuyas edades estaban entre 20 a 35 años a las cuales se les determinó el pH mediante un Analizador, flujo mediante un recipiente milimetrado, viscosidad salival con la ayuda del viscosímetro de Ostwald y caries dental mediante el índice CPOD. Resultados: Para el grupo gestante fueron: pH = 6.44, flujo = 5.37 ml., viscosidad = 1.46cp., CPOD = 12.27 y para el grupo no gestante: pH = 7.20, flujo = 4.07ml., viscosidad = 1.48 cp. y CPOD 10.17. Conclusiones: Hay diferencia estadísticamente significativa en el pH, siendo los valores de las gestantes menores al de las no gestantes, Asimismo existe una correlación inversa entre pH salival y CPOD. Existe una diferencia significativa en el flujo salival ya que las mujeres gestantes presentaron un flujo salival mayor, que las mujeres no gestantes, no encontrándose una relación entre flujo salival y CPOD. No existe una diferencia significativa en la viscosidad salival en mujeres gestantes y no gestantes y no se encontró una relación entre viscosidad salival y CPOD. Existe una diferencia significativa en el CPOD, así las mujeres gestantes presentaron un CPOD mayor que el de las mujeres no gestantes. / During pregnancy women suffer a lot physiological changes, some of them occurs at salival aspect, like they are: pH, flow and salivary viscosity, that are going to be a determinant factor in the develop of dental caries. Objetive: To determine the relation ship between the changes of pH, flow and salivary viscosity against the develop of dental caries in first three month period pregnancy women. Material and Methods: lt was evaluated samples of saliva without stimulation from 30 first three-month period pregnants, and 30 no-pregnants that attended to the dental assistance of HONADOMANI San Bartolome, with ages between 20 to 35 years old, who were evaluated for pH through a analizer, flow using a milimeter beaker, for salivary viscosity whit the Ostwald viscosimeter, and dental caries by the DMFT index. Results: For the pregnant group it was presented: pH = 6.44, Flow = 5.37 ml. Viscosity = 1.46, DMFT = 12.27. and for the group no-pregnant :pH = 7.20, Flow = 4.07ml- viscosity = 1.48 and DMFT = 10.17. Conclusions: There was statistically significant difference in pH, being the pregnants scores lower than no-pregnants. Furthermore, there was a indirect correlation between salivary pH and DMFT. A significant difference exist between the salivary flow because pregnant women showed a higher salivary flow than the no - pregnant group, finding no correlation between salivary flow and DMFT. A significant difference exist in the DMFT, so the pregnant women showed a higher DMFT than the no-pregnant group.