Oral Adverse Side Effects of Simvastatin in Relation to Salivary and Serum Copper

Hyperlipidemia is a medical condition characterized by abnormal increase lipids in circulation considered risk factors for cardiovascular disease. Aims of the study To determine oral adverse side effects of simvastatin treatment (oral manifestations, taste detection threshold of the four basic tastes, salivary flow rate, teeth mobility by millers mobility index) and estimation the level of copper in saliva and serum of patients with hyperlipidemia on simvastatin (20 mg tablet / day) at least for one year and compare all of these to healthy control subjects. Methods Forty patients on simvastatin treatment age between (35-60) years and forty ages and sex matched healthy control subjects were participated in this study. Intraoral examination was done for all subjects to detect any oral manifestation and each subject was fulfilling case sheet information with consent form. Fifteen different concentrations of the four basic tastes solutions were used for estimation of taste detection threshold. Sip and spit with deionized water used as mouth wash interval. Serum and unstimulated saliva was obtained from each subject. Millers mobility index was used to estimate teeth mobility. Salivary and serum copper was estimated by flame atomic absorption assay. Results This study showed that there were no oral manifestations in patients on simvastatin treatment just complaining of dry mouth and bitterness. The taste detection thresholds of sweet, sour and bitter were highly significantly higher in those patients than that in control subjects, while saltiness was not affected. Salivary flow rate was significantly decreased in those patient than that in control subjects. The Millers score 0 and 1 were highly significantly higher in patient on treatment with no patients presented with score 2 and 3 only presented in control subjects. Salivary and serum copper were highly significantly decreased in patients than those in control subjects. There was highly significant positive linear correlation between salivary flow rate and the mean of detection threshold of sweetness and sourness, and highly significantly negative linear correlation with the mean of detection threshold of saltiness and bitterness in both groups.