Saliva Tests and Dietary Assessment for Caries Evaluation and Treatment Planning

Objective: Patients often return to dentists with new carious lesions and are mostly blamed for inappropriate oral hygiene measures. Certain parameters could have been overlooked by dentists during caries assessment such as dietary and salivary data.  This can lead to leaving the causative factor untreated. Accordingly, the aim of this study was to determine if information obtained from saliva tests and dietary questionnaire during caries assessment could modify the line of treatment presented to the patient. Method: Informed consent was obtained from 26participants. Dental caries was assessed using DMFT index. Chair side GC saliva-Check testing kits were used to evaluate saliva level of hydration, pH, consistency, quantity and buffering capacity. Test kits from Ivoclar, Vivadent were also used  for Mutans streptococci and lactobacilli count and tests were performed under standardized conditions. Result: Each patient provided a set of own data. Dietary information indicated that the frequency of intake, form, consistency, retention time and the position of cariogenic food consumed in a meal are  contributing factors to dental caries and need to be identified and controlled .Spices consumption showed lack of caries activity in spite of the altered saliva tests parameters. It was also found that low level of hydration and sticky and frothy saliva need to be identified and corrected  . Mutans streptococci and lactobacilli count correlated with caries status  and impose a specific line of treatment. Conclusion: Dentists should not only depend on explorers but need other tools such as saliva tests and diet assessment as adjuncts to select the correct  treatment modalities for  caries and develop strategies for prevention of newer lesions.Also, mouth rinses , pH neutralizers , disinfectants and remineralizing agents could be prescribed according to results of saliva tests and not blindly.