Relationship of Drinking Water to Dental Calculus in Saudi Arabia: Riyadh in Comparison to Eastern Province

Aim: The aim of this study was to detect the influence of drinking water on the occurrence and severity of
dental calculus in Saudi Arabia through comparing the amount of dental calculus on teeth surfaces and the
type of drinking water in addition to other contributing factors between two provinces in the Kingdom of
Saudi Arabia which were Riyadh and Eastern Province and to define the mineral elements in drinking water
causing such effect.
Materials and Methods: 304 patients aged ≥18 years who live in the Kingdom of Saudi Arabia (Riyadh
and Eastern Province) were randomly selected and equally divided into two groups: Riyadh group and
Eastern Province group. The study was carried out in the period April through June 2018. Each patient was
clinically examined using Oral Calculus Index (OCI) (Greene and Vermillion 1964)1
and Saliva pH Test (pH
indicator papers full range). Also, each patient answered a questionnaire about: oral hygiene habits, the
last visit for dental scaling, the type of drinking water, the amount of daily water consumption, and tobacco
smoking. Laboratory analysis of drinking water samples for (Ca) and (PO4) mg/L ppm was performed. The
data obtained were documented in a patient examination form then statistically analyzed using Chi-Square
Test and Multinomial Logistic Regression.
Results: There was a statistically significant relationship between the type of drinking water and calculus
p <0.05. Also, there was a statistically significant relationship between provinces and calculus p <0.05.
There was a significant difference between the two provinces p <0.05 in the type of drinking water and
saliva pH. However, there was an insignificant difference between the two provinces p >0.05in oral hygiene
habits (brushing, flossing, mouthwash), the last visit for dental scaling, the amount of daily water
consumption, and tobacco smoking. Eastern Province that depended more on water from trucks than Riyadh
had higher alkaline saliva pH and higher calculus risk than Riyadh.
Conclusion: The results of this study indicate that drinking water influences the occurrence and severity of
dental calculus. It’s important to comply with the international standards of (Ca), (PO4), and (Mg)
concentration mg/L ppm in drinking water. Periodic analysis is advised.