Saliva Stimulation and Caries Prevention

Abstract

The protective role of saliva is demonstrated by the rampant caries seen in human subjects with marked salivary hypofunction, and in desalivated animals. In normal cases, however, the relationship between saliva flow and coronal or root caries experience is doubtful, and to examine the concept that stimulation of saliva might have protective effects against caries, one must look beyond a simple correlation between caries and flow rate. Protective properties of saliva which increase on stimulation include salivary clearance, buffering power, and degree of saturation with respect to tooth mineral. These benefits are maximized when saliva is stimulated after the consumption of fermentable carbohydrates, by reducing the fall in plaque pH leading to demineralization and by increasing the potential for remineralization. Plaque acid production is neutralized, and experimental lesions in enamel are remineralized, when gum is chewed to stimulate saliva after a carbohydrate intake. The pH-raising effects are more easily explained by the buffering action of the stimulated saliva than by clearance of carbohydrates. The remineralization action depends upon the presence of fluoride. These findings suggest that the protective actions of saliva can be mobilized by appropriate salivary stimulation, and that in addition to established procedures such as tooth cleaning and fluoride regimens, eating patterns which lead to saliva stimulation to increase the potential for saliva protection might be included in recommendations for caries prevention. Confirmation of this concept in clinical tests is required.

Higher Dental Caries Prevalence and Its Association with Dietary Habits and Physical Limitation in Epidermolysis Bullosa Patients: A Case Control Study

“…Although a direct relationship between saliva characteristics and dental caries has not been established for individuals with a normal saliva production, there are studies that show that in adverse conditions, such as salivary gland atrophy, the reduced amount and/ or lack of saliva is associated with the presence of rampant caries. 18 Our results showed that even though the values for all salivary parameters (saliva flow rate, pH, and buffer capacity) obtained from individuals with EB were slightly lower than for those without EB, there were no significant differences between cases and controls. Similar results were observed by a study of Wright et al, 19 in which individuals with EB did not show a decreased saliva flow in comparison to unaffected subjects.…”

<b>Protocolo clínico para avaliação e controle do processo saúde-doença cárie</b>

“…É possível sugerir ao cliente trocas interessantes como biscoito recheado por pipoca salgada, substituir chicletes e balas por outros sem sacarose e concentrar o consumo de alimentos cariogênicos após o almoço, quando o fluxo salivar está bem estimulado. Deve-se salientar que nas últimas horas da noite o consumo de sacarose deve ser evitado porque apesar da escovação, moléculas permanecem na cavidade bucal e durante o sono ocorre diminuição do fluxo salivar, o que intensifica o desafio cariogênico (8). Chicletes contendo xylitol também são uma boa opção.…”

Cárie dentária: um novo conceito

“…Além disso, um dramático declínio da cárie dentária tem sido documentado, sem uma aparente mudança no nível de estreptococos mutans na saliva 4 . Muitos trabalhos 5,7,9,13,15,20,27,29,30,39,53,54,55,58 procuram esclarecer a correlação entre a cárie dentária e a presença de microrganismos, fluxo salivar, capacidade tampão da saliva e sacarose (dieta cariogênica) não chegando a um resultado conclusivo e definitivo em relação à influência desses fatores no controle dessa "doença". A relação, às vezes contraditória, entre esses fatores e a atividade de cárie, já apresentada na literatura, sugere que os métodos de diagnóstico de pacientes de risco sejam revistos 52,58 .…”