Chair-side saliva parameters assessment and caries experience evaluation

INTRODUCTION: Carioreceptivity-based, individualized prevention protocols allow a minimally invasive approach in many patients, in all age groups. The long-term success of such protocols depends not only on the actual caries experience of the patients, but also on the possible responses based on natural defense mechanisms. Therefore the salivary flow, the buffer capacity of stimulated and non-stimulated saliva and mostly the Streptococcus Mutans and Lactobacilli number are highly important in deciding whether a long-term remineralization therapy can be successfully applied for early stage caries lesions. Similar tests may record the the acidogenicity of dental biofilms. These risk factors can be entered into a computer-based risk assessment program (such as Cariogram). METHODOLOGY: An extensive literature search was performed on Medline/PubMed using as key-words: Streptococcus Mutans, Lactobacilli, saliva volume, pH and buffer capacity. The methodology of selecting the reviewed literature and the inclusion criteria were based on articles published in the last ten years. RESULTS: Besides topically applied remineralization products, either in-office or at-home, changes in the diet can diminish the number of cario-active bacteria, especially Lactobacilli. Latest researches show that dentifrices, especially toothpastes containing xylitol and/or probiotics can have a significant cario-protective effect. CONCLUSIONS: Dental caries assessment is very important for specific age groups, because most risk factors have specific consequences in different age groups. Pre-teen and teenage patients need more individualized caries management strategies in order to avoid the onset of new caries lesions. Root caries risk may be decreased by an intensive and continuous preventive care.