Edgar W M, Higham S M, Manning R H
Department of Clinical Dental Sciences, School of Dentistry, Liverpool, England.
Adv Dent Res. 1994 Jul;8(2):239-45. doi: 10.1177/08959374940080021701.
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.
在唾液分泌功能显著减退的人类受试者以及唾液腺切除的动物中出现的猖獗龋齿，证明了唾液的保护作用。然而，在正常情况下，唾液流量与冠部或根部龋齿经历之间的关系尚不确定。为了研究刺激唾液可能对龋齿具有保护作用这一概念，必须超越龋齿与流速之间的简单相关性。刺激后增加的唾液保护特性包括唾液清除率、缓冲能力以及相对于牙齿矿物质的饱和度。当在摄入可发酵碳水化合物后刺激唾液时，通过减少导致脱矿质的菌斑pH值下降并增加再矿化的可能性，这些益处可最大化。当在摄入碳水化合物后咀嚼口香糖以刺激唾液时，菌斑酸产生被中和，釉质中的实验性病变得以再矿化。pH值升高的作用更容易用刺激唾液的缓冲作用来解释，而不是碳水化合物的清除。再矿化作用取决于氟化物的存在。这些发现表明，唾液的保护作用可以通过适当的唾液刺激来调动，并且除了诸如牙齿清洁和氟化物治疗方案等既定程序外，导致唾液刺激以增加唾液保护潜力的饮食模式可能会被纳入龋齿预防建议中。需要在临床试验中证实这一概念。
