Impact of smoking on oral cavity by comparing carbon monoxide and carboxyhemoglobin levels with salivary pH in smokers of Salem district

Abstract

Saliva is the first biological fluid exposed to the smoke and other contents of the cigar, which can cause structural and functional changes in saliva. Salivary pH is an important biomarker for detecting oral diseases. Cigarette smoke contains many toxic gases, of which, carbon monoxide (CO), plays a deleterious role in causing systemic illness in a person. As a result, a measure of exhaled CO (eCO), similar to exhaled Nitric Oxide, has been evaluated as a potential breath biomarker to detect smoking status and validate smoking cessation to prevent other systemic defects caused by smoking. The present study would investigate the effect of CO and carboxyhemoglobin (HbCO%) on the pH of the oral cavity of individuals with smoked tobacco habit. For this study, 60 male patients aged 18–55 years with smoking habit of a minimum of two cigarettes or beedis per day for a minimum period of one year reporting to the Department of Oral Medicine and Radiology were divided based on their smoking habit and type of smoked tobacco into two groups with each group consisting of 30 participants. To determine the eCO levels and HbCO% levels, a breath analyzer (piCOTM Smokerlyzer®) was used. Patients were asked to hold their breath for 15 s, place their lips tightly around the mouthpiece of the breath analyzer, and gently exhale through the mouthpiece as long as possible. CO levels in exhaled breath (eCO) in parts per million and HbCO% in the percentage of red blood cells carrying CO (HbCO%) were displayed on the display monitor. A digital pH meter was used to calculate the salivary pH from unstimulated saliva samples. The salivary pH readings, along with the eCO and HbCO%, were recorded in the tabular column for each patient. In the present study, the cigarette smokers had a higher mean value of eCO levels. Similarly, cigarette smokers had higher mean HbCo% levels than beedi smokers. It was also observed that salivary pH of smokers was found to be altered when compared to non-smokers. The current study found that the level of CO in exhaled breath correlates with the HbCO% present in the blood, alerting tobacco users to the hidden fatality and therefore serving as an indicator in tobacco cessation programs to raise awareness of the effects of smoking on oral health. Furthermore, along with CO levels the pH of saliva was altered, demonstrating the dangers of tobacco and its products.