Effect of Saliva Composition on Experimental Root Caries

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Abstract
The aim of this study was to determine the effect of saliva composition on caries lesion development independently of the flow rate of unstimulated whole saliva (UWS) and other caries-related variables such as lesion progression time, oral hygiene level, and fluoride exposure. We hypothesized that this could be done by developing experimental root caries under carefully controlled conditions in situ in test subjects with UWS flow rates within a narrow window of normalcy. Fifteen female and 5 male subjects (66 ± 6 years) were selected for the study according to their UWS flow rates between 0.2 and 0.4 ml/min. All subjects developed experimental root caries lesions during a 62-day period in which UWS as well as stimulated whole saliva (SWS) were repeatedly collected and analysed for flow rate, pH, buffer capacity, inorganic, and organic composition. Caries lesion development was determined by quantitative microradiography. The mean UWS flow rate was 0.30 ± 0.05 ml/min. Significant negative correlations were obtained between UWS total phosphate concentration and mineral loss (ΔZ; rs = –0.72, p < 0.001) and UWS total protein concentration and ΔZ (rs = –0.70, p < 0.01). SWS and its constituents had only limited or no effect on ΔZ. Qualitative UWS protein analysis (SDS-PAGE) revealed that subjects with low ΔZ values had broader and more stained amylase bands than subjects with high ΔZ values. These findings were confirmed quantitatively by HPLC. We conclude that, within a group of subjects with normal UWS flow rates, the UWS composition was more important for caries lesion development than the SWS composition. Furthermore, high UWS concentrations of phosphate, protein, and amylase were caries-protective.