, Volume 100, Issue 1, pp 67–75 | Cite as

Comparison of three strip-type tests and two laboratory methods for salivary buffering analysis

  • Zeinab CheaibEmail author
  • Carolina Ganss
  • Andreas Lamanda
  • Melek Dilek Turgut
  • Adrian Lussi
Original Article


This study evaluated the correlation between three strip-type, colorimetric tests and two laboratory methods with respect to the analysis of salivary buffering. The strip-type tests were saliva-check buffer, Dentobuff strip and CRT® Buffer test. The laboratory methods included Ericsson’s laboratory method and a monotone acid/base titration to create a reference scale for the salivary titratable acidity. Additionally, defined buffer solutions were prepared and tested to simulate the carbonate, phosphate and protein buffer systems of saliva. The correlation between the methods was analysed by the Spearman’s rank test. Disagreement was detected between buffering capacity values obtained with three strip-type tests that was more pronounced in case of saliva samples with medium and low buffering capacities. All strip-type tests were able to assign the hydrogencarbonate, di-hydrogenphosphate and 0.1% protein buffer solutions to the correct buffer categories. However, at 0.6% total protein concentrations, none of the test systems worked accurately. Improvements are necessary for strip-type tests because of certain disagreement with the Ericsson’s laboratory method and dependence on the protein content of saliva.


Strip-type test Buffer capacity Buffer value Human saliva Titratable acidity 



This study was supported by the University of Bern, Switzerland. We thank Dr. Stefanie Hayoz from the Institute of Mathematical Statistics and Actuarial Science, University of Bern for the statistical data analysis and Dr. Ekaterina Rakhmatullina, Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, for help in revision of the manuscript.


  1. 1.
    Zandona AF, Zero DT. Diagnostic tools for early caries detection. J Am Dent Assoc. 2006;137:1675–84.PubMedGoogle Scholar
  2. 2.
    Lussi A, Jaeggi T. Erosion—diagnosis and risk factors. Clin Oral Investig. 2008;12:5–13.Google Scholar
  3. 3.
    Leone CW, Oppenheim FG. Physical and chemical aspects of saliva as indicators of risk for dental caries in humans. J Dent Educ. 2001;65:1054–62.PubMedGoogle Scholar
  4. 4.
    Fejerskov O, Thylstrup A. Different concepts of dental caries and their implications. In: Thylstrup A, Fejerskov O, editors. Textbook of clinical cariology. Copenhagen: Munksgaard; 1994. pp. 209–18.Google Scholar
  5. 5.
    Lussi A. Erosive tooth wear—a multifactorial condition of growing concern and increasing knowledge. In: Lussi A, editor. Dental erosion from diagnosis to therapy. Basel: Karger; 2006. p. 1–8.Google Scholar
  6. 6.
    Edgar WM, Higham SM. Role of saliva in Caries models. Adv Dent Res. 1995;9:235–8.PubMedGoogle Scholar
  7. 7.
    Dawes C. Salivary flow patterns and the health of hard and soft oral tissues. J Am Dent Assoc. 2008;139:18S–24S.PubMedGoogle Scholar
  8. 8.
    Gopinath VK, Arzreanne AR. Saliva as a diagnostic tool for assessment of dental caries. Arch Orofac Sci. 2006;1:57–9.Google Scholar
  9. 9.
    Holbrook WP, Furuholm J, Gudmundsson K, Theodòrs A, Meurman JH. Gastric reflux is a significant causative factor of tooth erosion. J Dent Res. 2009;88:422–6.PubMedGoogle Scholar
  10. 10.
    Bardow A, Moe D, Nyvad B, Nauntofte B. The buffer capacity and buffer systems of human whole saliva measured without loss of CO2. Arch Oral Biol. 2000;45:1–12.PubMedGoogle Scholar
  11. 11.
    Lenander-Lumikari M, Loimaranta V. Saliva and dental caries. Adv Dent Res. 2000;14:40–7.PubMedGoogle Scholar
  12. 12.
    Ericsson Y. Clinical investigations of the salivary buffering action. Acta Odontol Scand. 1959;17:131–65.Google Scholar
  13. 13.
    Moritsuka M, Kitasako Y, Burrow MF, et al. Quantitative assessment for stimulated saliva flow rate and buffering capacity in relation to different ages. J Dent. 2006;34:716–20.PubMedGoogle Scholar
  14. 14.
    Bratthall D, Tynelius-Bratthall G. Diagnostika als Grundlage kausaler Behandlung Professionelle Prävention in der Zahnartzpraxis 1994:63–64.Google Scholar
  15. 15.
    Nagler RM, Hershkovich O. Relationships between age, drugs, oral sensorial complaints and salivary profile. Arch Oral Biol. 2005;50:7–16.PubMedGoogle Scholar
  16. 16.
    Lamanda A, Cheaib Z, Turgut MD, Lussi A. Protein buffering in model systems and in whole human saliva. PLoS ONE. 2007;2:e263.PubMedGoogle Scholar
  17. 17.
    Bradford MM. A rapid and sensitive method for the quantitation of microgram quantities of protein utilizing the principle of protein–dye binding. Anal Biochem. 1976;72:248–54.PubMedGoogle Scholar
  18. 18.
    Ericson D, Bratthall D. Simplified method to estimate salivary buffer capacity. Scand J Dent Res. 1989;97:405–7.PubMedGoogle Scholar
  19. 19.
    Messer LB. Assessing caries risk in children. Aust Dent J. 2000;45:10–6.PubMedGoogle Scholar
  20. 20.
    Lussi A, Jaeggi T, Zero D. The role of diet in the aetiology of dental erosion. Caries Res. 2004;38(Suppl 1):34–44.PubMedGoogle Scholar
  21. 21.
    Attin T, Knöfel S, Buchalla W, Tütüncü R. In situ evaluation of different remineralization periods to decrease brushing abrasion of demineralized enamel. Caries Res. 2001;35:216–22.PubMedGoogle Scholar
  22. 22.
    Ertuğrul F, Elbek-Cubukçu C, Sabah E, Mir S. The oral health status of children undergoing hemodialysis treatment. Turk J Pediatr. 2003;45:108–13.PubMedGoogle Scholar
  23. 23.
    Kitasako Y, Moritsuka M, Foxton RM, et al. Simplified and quantitative saliva buffer capacity test using a hand-held pH meter. Am J Dent. 2005;18:147–50.PubMedGoogle Scholar
  24. 24.
    Leung KC, McMillan AS, Leung WK, et al. Oral health condition and saliva flow in southern Chinese with Sjögren’s syndrome. Int Dent J. 2004;54:159–65.PubMedGoogle Scholar
  25. 25.
    Meurman JH, Rantonen P. Salivary flow rate, buffering capacity, and yeast counts in 187 consecutive adult patients from Kuopio, Finland. Scand J Dent Res. 1994;102:229–34.PubMedGoogle Scholar
  26. 26.
    Ericsson Y. Clinical determination of salivary buffering. Sven Tandlak Tidskr. 1953;46:379–86.PubMedGoogle Scholar
  27. 27.
    Van Slyke D. On the measurement of buffer values and the relationship of buffer value to the dissociation constant of the buffer and the concentration and reaction of the buffer solution. J Biol Chem. 1922;52:525–70.Google Scholar
  28. 28.
    Barbour ME, Shellis RP. An investigation using atomic force microscopy nanoindentation of dental enamel demineralization as a function of undissociated acid concentration and differential buffer capacity. Phys Med Biol. 2007;52:899–910.PubMedGoogle Scholar
  29. 29.
    Izutsu KT. Theory and measurement of the buffer value of bicarbonate in saliva. J Theor Biol. 1981;90:397–403.PubMedGoogle Scholar
  30. 30.
    McMaugh D. A comparative analysis of the colour matching ability of dentists, dental students, and ceramic technicians. Aust Dent J. 1977;22:165–7.PubMedGoogle Scholar
  31. 31.
    Vazquez G, Alvarez E, Navaza JM. Density, viscosity, and surface tension of sodium carbonate + sodium bicarbonate buffer solutions in the presence of glycerine, glucose and sucrose from 25 to 40°C. J Chem Eng Data. 1998;43:128–32.Google Scholar
  32. 32.
    St Jonston JH. The Surface tension of protein solutions. Part III. Biochem J. 1927;13:1314–27.Google Scholar
  33. 33.
    Hammershøj M, Prins A, Qvist KB. Influence of pH on surface properties of aqueous egg albumen solutions in relation to foaming behaviour. J Sci Food Agric. 1998;79:859–68.Google Scholar

Copyright information

© The Society of The Nippon Dental University 2011

Authors and Affiliations

  • Zeinab Cheaib
    • 1
    Email author
  • Carolina Ganss
    • 2
  • Andreas Lamanda
    • 3
  • Melek Dilek Turgut
    • 4
  • Adrian Lussi
    • 1
  1. 1.Department of Preventive, Restorative and Pediatric DentistryUniversity of BernBernSwitzerland
  2. 2.Department of Conservative and Preventive Dentistry, Dental ClinicJustus Liebig UniversityGiessenGermany
  3. 3.BurgdorfSwitzerland
  4. 4.Department of Paediatric Dentistry, Faculty of DentistryHacettepe UniversityAnkaraTurkey

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