Effect of selected beta-blockers on supragingival calculus formation
The purposes of this study were (1) to confirm that individuals who regularly take beta-blockers systemically form less supragingival calculus than nonmedicated individuals; (2) to determine whether 8- blockers also affect the prevalence of cervical caries; (3) to determine whether beta-blockers are secreted into the saliva in detectable amounts; and (4) to determine whether systemic use of beta-blockers affects salivary PH, salivary flow rate, and the salivary concentrations of free and bound calcium and phosphate ions.
A total of 57 subjects, 29 of whom were medicated with f -blockers, and who ranged in age from 45 to 77, were the subjects of this study. The plaque and calculus indices were scored using the Silness and Loe and Volpe-Manhold methods. Cervical caries and cervical restorations were counted, the subjects¹ saliva was collected, and the salivary flow was determined. Finally, a complete oral prophylaxis was performed. After eight weeks of normal oral hygiene, a second comparison of each of the above quantities was made.
With the exception of the calculus indices and the incidence of cervical restorations, no significant differences were found for any of the measured quantities between the medicated and nonmedicated groups at either examination. The medicated group showed significantly lower mean calculus values than the nonmedicated group at both examinations, and a higher incidence of cervical restorations at the baseline examination, suggesting that beta-blockers decrease the rate of mineralization in the oral cavity.
Since beta-blockers did not appear to alter stimulated salivary pH, flow rate, phosphate, ionic calcium, or total calcium concentrations, their effect on the mineralization processes must be attributed to other mechanisms. The hypotheses appear plausible: changes in salivary mineralization rates caused by either physiochemical effects of the secreted beta-blockers in the saliva, or by alterations in the salivary protein/glycoprotein composition, enzymes, and oral bacterial flora owing to systemic pharmacological effects of beta-blockers. [M.R.]
Breuer, M.M., S.A. Mboya, H. Moroi and S.S.Turesky, J Periodont, 67:428, 1996