The determination of the salivary flow rate is a simple procedure to record the amount of saliva produced during the chewing process and to link this to a statement about the individual caries risk, which is significantly increased by a reduced salivary secretion rate. Saliva that flows not only sufficiently but as abundantly as possible protects the dentition. The more saliva flows, the more serous (thin) it is. Oral mucous membranes and teeth are well moistened, and food residues are more easily removed from the interdental spaces by the rinsing function. If the flow of saliva is reduced (oligosialia) or even stops altogether (xerostomia), this has fatal consequences for the teeth, periodontium (tooth-supporting apparatus) and oral mucosa, which are at the mercy of bacterial attacks due to the lack of protective function of saliva.
Indications (areas of application)
- The test result illustrates to a patient suffering from reduced salivary secretion that the less salivation he has, the more effort he must invest in his oral hygiene and prophylactic measures in order to keep tooth damage to a minimum.
- A number of medications can affect salivary secretion. Here, the determination of the flow rate is suitable for monitoring progress and, if necessary, as an argumentation aid in the interdisciplinary discussion, if a drug change must be considered.
Contraindications
- None
Before the examination
According to the manufacturer’s instructions (KariesScreenTest by Aurosan), the patient should refrain from doing anything that could influence salivary secretion at least one hour before the start of the test:
- Do not eat anything
- Drink nothing
- Do not chew gum
- Do not smoke
- Do not brush teeth
- Do not use mouth rinses
The procedure
Salivary flow rate can be determined quickly and without much effort:
- First, the patient stimulates salivary flow for 30 seconds by chewing a kerosene pellet.
- In the following five minutes, chewing must continue intensively. The saliva produced in the process, the patient collects in a calibrated vessel.
- After that, the amount of saliva achieved is read.
| Salivary flow rate of an adult | |
| ≥ 1 ml per minute | normal |
| < 0.7 ml per minute | too low, oligosialy |
| < 0,1 |
After the examination
It makes sense to follow up with a buffer capacity determination if the flow rate is decreased, as the ability of saliva to neutralize acids may also be impaired with reduced salivary flow. In cases of oligosialia and xerostomia, possible causes should be sought. The following medications result in decreased secretion rates:
- ACE inhibitors
- Alpha-2 agonists
- Alpha-1 receptor blockers
- Anorectic
- Anti-allergic (H1 antihistamines)
- Anticholinergics [via peripheral receptor blockade].
- Antidepressants [via central receptor blockade]
- Antiemetics
- Antiepileptic drugs
- Antihistamines
- Antiparkinsonian drugs
- Antipsychotics (neuroleptics)
- Antisympathotonics
- Anxiolytics
- Beta blockers
- Bronchodilators (β2-mimetics)
- Carbonic anhydrase inhibitors, local
- Diuretics
- Dopamine agonists
- Dopamine antagonists
- Drugs
- Hypnotics
- Magnesium sulfate
- Narcotics, centrally acting analgesics.
- Parasympatholytics
- Perchlorate
- Sedatives
- Spasmolytics
- Sympathomimetics, indirect
- Cytostatics
Measures that positively affect the salivary flow rate should be encouraged to the patient:
- Two to three times a day chewing gum to stimulate salivary flow and as a caries prophylaxis, here are preferably xylitol-containing products to be preferred, since xylitol can not be metabolized by the bacteria.
- Chewing preferably high-fiber (fiber-rich) foods to stimulate salivary flow and for better self-cleaning of the teeth.
Furthermore, consistent caries prophylaxis must be practiced:
- Regular home fluoridation with fluoridated toothpaste.
- Supplements z.B. by weekly brushing concentrated fluoride gel.
- Regular fluoridation in the dental office.
- Close-meshed recall (presentation in the practice at shorter intervals, for example, every two to three months).
- Motivation of the patient to significantly sugar-reduced dietary behavior.
Possible complications
The simple procedure is not equally accepted by all patients. Rejection to saliva collection is lower if the patient can be unobserved during the five minutes.
