Saliva contains host factors which can modify the carious process.

1. Modifies the environment of the tooth.

,,,,,a. Saliva alters plaque (biofilm) and pellicle since it supplies components

--------------,for both.

-------The salivary proteins can affect bacterial attachment.

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    -b. Salivary buffers.

-------An excellent buffer system using H₂CO₃/HCO₃- and H₂PO₄- /HPO₄=.

2. Remineralization of decalcified areas is due to the buffering of the acid and the presence of high Ca++ and HPO₄= ion levels locally.
 

3. Modifies enamel shortly after eruption into the mouth.

-------- A maturation effect.

 

4. Anti-caries agents in saliva.

--------IgA and lactoperoxidase are examples of two such agents.

Preventive measures:

Maintain and enhance salivary flow.  Use sugarless gum, especially containing pure Xylitol.  Additionally, Xylitol has an antimicrobial effect.

 

Maintain salivary fluoride levels.  Should be at 0.07 ppm or greater.

Use amorphous calcium phosphate, such as MI Paste™ (GC America) to replace missing Ca++ and HPO₄= ions.

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