Some saliva substitutes for dry mouth erode enamel
Many patients with severe dry mouth turn to saliva substitutes to ameliorate their condition. Yet, according to a new in vitro study, some artificial saliva products have a detrimental side effect: enamel erosion.
The research, published in the Journal of Dentistry, examined 12 spray and three gel saliva, whose effects were then compared to a mouth rinse that was shown to have anti-erosive properties. Some saliva substitutes showed clear advantages over others.
In the lab, researchers prepared 204 bovine enamel specimens, and after analyzing them to ensure they were free of cracks on the surface, scientists randomly separated them into 16 groups of 12 specimens each. Then an artificial mouth was used to create six "attacks" a day in a de- and re-mineralization cycle that mimicked the real-life conditions of someone consuming an erosive beverage. The mouth sprays and gels were used with water as a negative control and the mouth rinse as a positive control. Lastly, the researchers applied the saliva substitute gel or spray, or control material.
Shockingly, four mouth sprays increased erosive loss.
Avoiding acidic products
Besides causing discomfort and difficulty swallowing, eating and speaking, dry mouth, also known as xerostomia (the subjective sensation of dry mouth), is known to leave teeth and gums vulnerable to tooth decay, gingivitis and other oral health infections. This is because without saliva - the mouth's natural cleaning agent - bacteria gathers along the gumline to burrow microscopic holes in the walls of the teeth. These tiny holes are what we call cavities.
Yet, the very saliva substitute products used to prevent these problems may actually worsen them, likely because of their low pH, or acidity level. Thus, it goes without saying that people suffering from xerostomia (the subjective sensation of dry mouth) should steer clear of these specific substitutes that contain low pH levels.
On the upside, the researchers found six substitutes that protected dental enamel. These products had a higher pH.
"It can be recommended that patients suffering from xerostomia and at high risk for dental erosion should use high-viscous saliva substitutes, but should avoid saliva substitutes with low pH or containing citric acid," the authors wrote in the journal.
These findings may help dentists create more individualized treatment plans using the right form of saliva for the right patient.