There is great dental interest in being able to make reliable statements and prognoses about a patient’s individual caries risk. For the assessment, clinical findings such as oral hygiene, dietary habits, previous carious dental damage, or the presence of carious initial lesions (incipient decalcification) are always in the foreground. However, they receive a useful supplement and increased informative value through the procedures of saliva diagnostics.
Determination of nonbacterial salivary factors
In addition to multiple roles in food intake, digestion, and germ defense, salivary fluid also provides natural protective functions for our oral health. The mere presence of an adequate amount of saliva ensures moistening of the oral mucosa and some cleansing and rinsing function. Determining the saliva flow rate provides information on whether saliva can fulfill these functions.
In addition, saliva contains so-called buffer systems that can neutralize acids from food, beverages or even from the fermentation processes of plaque (dental plaque), at least to a limited extent. Between meals, it contributes to the remineralization (re-storage of mineral substances) of the teeth. Buffer capacity determination provides evidence of the extent to which saliva can fulfill this important function.
Determination of bacterial salivary factors
At the same time, saliva is the basis of life for a large number of microorganisms, without their presence immediately having to be a pathological (diseased) condition. Science now assumes that there are several thousand different types of germs. Together, these form a self-contained, balanced ecosystem into which other germs can only penetrate with difficulty.
However, this balance is shifted, for example, by an oversupply of carbohydrate-containing food due to high sugar consumption and/or insufficient mechanical removal of plaque adhering to the teeth. As a result, a cariogenic (caries-causing) oral environment develops. Saliva tests for Streptococcus mutans and for lactobacilli as well as the determination of the lactate formation potential provide valuable information on the excessive presence of these two marker germs for the development of caries or on the extent to which these germs are capable of producing tooth-damaging lactic acid.
The most important services of salivary diagnostics are presented below:
Determination of non-bacterial salivary factors:
- Determination of salivary flow rate
- Buffer capacity determination
Determination of bacterial salivary factors:
- Saliva test for Streptococcus mutans.
- Saliva test for lactobacilli
- Determination of the lactate formation potential
