Analysis of salivary pH changes induced by metabolic acidosis in chronic kidney disease and the impact on oral microbiota and periodontitis: Narrative review

Background: To be able to regulate the balance between acids and bases in the body, physiologically the human body has a regulatory mechanism that can control acid-base concentration. Disorders that occur in the mechanism of regulating this balance can cause diseases that can occur in the oral cavity. Purpose: This narrative review aims to provide an explanation of the relationship between changes in salivary pH due to metabolic acidosis of chronic kidney disease, periodontitis and the oral microbiota. Methods: Articles in PubMed, Google Scholar, and ScienceDirect were searched using the keywords metabolic acidosis, periodontitis, chronic kidney disease, salivary pH, and oral microbiome. Results and Discussion: Chronic kidney disease causes the salivary pH to become more alkaline resulting in a change in the composition of the oral microbiota and an increase in the pathogenic bacteria that cause periodontitis. Conclusion: Changes in salivary pH due to chronic kidney disease lead to an increased risk factor of someone to be diagnosed with periodontitis and an increase in the diversity of the oral microbiome.