It was an interesting year in Dental Caries research. For this update series we started with about 100 articles, and pared it down to 50 that we believe broaden our knowledge and will help us better diagnose and treat our patients. Over the next several weeks we will walk through the research, feel free to ask questions or provide your experience in the comments section.
The series will be organized by unpacking what we refer to as the “Usual Suspects” or patterns we have identified as being the common reasons patients suffer from dental caries. Our ability to recognize and identify these patterns allow us to focus our diagnosis and treatment of the disease. The first we will tackle is saliva flow. Low saliva flow is the number one self-reported risk factor in our data base of nearly 13,000 patients. 63% of these patients self-report dry mouth or low saliva. When beginning the conversation with patients, starting with saliva is smart.
An interesting study that came out in December looked at saliva flow and its relationship to dental caries and periodontal disease:
This study examined the relationship between stimulated salivary flow rate and oral health status in an adult population. Multinomial multivariate logistic regression analysis was used to examine the associations of salivary flow rate with dental caries status and periodontal status at the individual level among 2,110 Japanese adults with ≥10 teeth. Then, a spline model was used to examine the nonlinear relationship between salivary flow rate and teeth with dental caries or periodontal disease in multilevel analysis. Odds ratios were calculated for a 1.0-mL/min reduction in salivary flow rate at a point.
After adjusting for confounding variables, participants with a flow rate ≤3.5 mL/min had significantly higher odds ratios for high caries status, and participants with a flow rate ≤1.4 mL/min had a higher odds ratio for broad periodontal disease, than did those with a flow rate >3.5 mL/min. In spline models, the odds ratio for teeth with dental caries or periodontal disease increased with reduced saliva secretion. The present findings suggest that decreased saliva secretion affects both dental caries and general periodontal health status. (Shimazaki Y, Fu B, Yonemoto K, Akifusa S, Shibata Y, et al. Stimulated salivary flow rate and oral health status. J Oral Sci. 2016 Dec 28. 2110 Japan Ad >10 teeth).
So, not only does decreased saliva flow impact risk for dental caries, but also risk for periodontal disease. How does this information impact how you assess your patients?