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CORRECTION OF MORPHOFUNCTIONAL ALTERATIONS IN SALIVARY
GLANDS INDUCED BY CONSUMPTION OF HARD ALKALINE
GROUNDWATER USING CITRIC ACID SUPPLEMENTATION
Teshaeva Dilbar Shukhratovna
UDK: 616.316/612.313.5
https://orcid.org/0009-0008-8080-2156
teshayeva.dilbar@bsmi.uz
Assistant of the Department of Anatomy and Clinical Anatomy (OHTA), Bukhara State
Medical Institute named after Abu Ali ibn Sina.
Uzbekistan, Bukhara city, Gijduvan street, 23. info@bsmi.uz
Abstract:
The chronic consumption of hard, alkaline groundwater has been associated with
morphofunctional changes in salivary glands, potentially impairing oral health and glandular
secretory activity. This study investigates the corrective effect of citric acid supplementation
on the structure and function of salivary glands in individuals consuming such water sources.
Histological examination, salivary pH, and flow rate analysis were conducted in
experimental models to assess glandular morphology and function. Results demonstrated
that citric acid mitigates structural alterations and restores near-normal secretory function,
suggesting its potential as a simple, accessible corrective measure for populations reliant on
mineral-rich groundwater.
Keywords:
Salivary glands, groundwater, hardness, alkalinity, citric acid, morphofunctional
changes, oral health
Introduction
In the current era, the conservation of drinking water and the protection of potable water
sources have become pressing global challenges. One proposed solution involves the
efficient utilization of groundwater resources. However, due to the differences in the
chemical composition between groundwater and conventional drinking water supplied
through municipal systems, the regular consumption of groundwater can lead to several
physiological alterations in the organism. Since it initially contacts the oral cavity, the
digestive system is considered to be directly affected.
This study investigates the morphofunctional changes occurring in the salivary glands and
saliva of white laboratory rats subjected to the consumption of groundwater. A variety of
analytical methods were employed to assess these alterations. Furthermore, the study
explores the use of citric acid as a corrective agent to mitigate the adverse effects induced by
groundwater intake.
In many arid and semi-arid regions, populations rely on hard, alkaline groundwater for daily
consumption. Such water often contains elevated concentrations of calcium, magnesium,
and bicarbonate ions, which can influence the div’s physiological systems. Prolonged
intake may lead to structural and functional changes in the salivary glands, potentially
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resulting in xerostomia, altered saliva composition, and subsequent oral health issues.
Recent research suggests that mild dietary acidulants, such as citric acid, may help restore
salivary gland function by balancing pH levels and stimulating salivation. This study aims to
evaluate the potential corrective role of citric acid on morphofunctional alterations in
salivary glands induced by high-mineral groundwater consumption.
Materials and Methods
Experimental Design:
A total of 40 adult Wistar rats were divided into four groups (n=10):
Group I (Control): Received distilled water
Group II: Received hard, alkaline groundwater
Group III: Groundwater + citric acid supplementation (0.5% in drinking water)
Group IV: Groundwater + post-treatment with citric acid after 30 days
Water Analysis:
Groundwater was analyzed for pH, total hardness (as CaCO₃), and mineral content using
standard laboratory methods.
Histological Evaluation:
Parotid and submandibular glands were excised and processed for hematoxylin and eosin
(H&E) staining. Morphological parameters including acinar integrity, ductal dilation, and
lymphocytic infiltration were assessed.
Saliva Collection and Analysis:
Saliva samples were stimulated using pilocarpine and analyzed for flow rate, pH, and
bicarbonate content
.
Results
1. Stimulates Saliva Production
Citric acid activates taste receptors, especially sour ones, which triggers more saliva
production.
Increased saliva helps naturally cleanse the mouth, flushing out food particles and bacteria.
2. Helps Maintain Oral pH Balance
More saliva means a more stable pH level in the mouth, reducing acidity.
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This helps protect tooth enamel from erosion and limits the growth of harmful bacteria.
3. May Have Mild Antibacterial Effects
While not a replacement for oral hygiene, citric acid has mild antibacterial properties that
can reduce some bacterial load temporarily.
Water Composition:
The groundwater had a pH of 8.2 and total hardness exceeding 350 mg/L as CaCO₃.
Salivary Flow and pH:
Group II exhibited significantly reduced salivary flow (p<0.05) and elevated pH compared
to controls. Groups III and IV showed partial to full restoration of flow rates and pH toward
physiological levels.
Histological Findings:
Group II glands showed acinar degeneration, ductal expansion, and mild inflammation.
These changes were significantly reduced in Group III and nearly absent in Group IV,
indicating a restorative effect of citric acid.
Discussion
The data demonstrate that prolonged ingestion of hard, alkaline groundwater induces
structural and functional disturbances in salivary glands. These effects are likely linked to
altered ionic balance and systemic pH buffering mechanisms. Citric acid, as a natural
chelating and acidifying agent, appears to counteract these effects by stimulating salivation,
improving ionic solubility, and normalizing pH. These findings are consistent with prior
reports on the protective effects of dietary acids on oral and digestive secretory systems.
Conclusion
Citric acid supplementation effectively mitigates the adverse morphofunctional effects of
consuming hard, alkaline groundwater on salivary glands. This approach may offer a simple,
low-cost intervention to support oral health in affected populations, particularly in regions
where water softening infrastructure is lacking.
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