The Influence of Saliva on the Dynamics of the Early Enamel Lesion

Hall, Andrew Fraser (1994) The Influence of Saliva on the Dynamics of the Early Enamel Lesion. PhD thesis, University of Glasgow.

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The work presented in this thesis has aimed to address the effect of saliva on the early enamel lesion using an intra-oral model. Preliminary work on model validation was undertaken and demonstrated the ability of stimulated salivary flow, by means of sorbitol gum chewing, in a fluoridated environment, to increase remineralisation of artificial enamel lesions to a greater extent than fluoride alone. Additional work demonstrated the ability of the model to distinguish between fluoridated and non-fluoridated environments. However, a definitive three phase intraoral trial failed to demonstrate any significant difference between fluoridated and non-tluoridated environments or any significant beneficial effect of salivary stimulation, by means of sorbitol gum chewing, in a nonfluoridated environment. Further analysis of this data suggested this was a result of a small baseline lesion size and that larger lesions would perhaps have reacted in such a manner as to demonstrate significant differences between protocols. Additional work to determine plaque and salivary fluoride levels, the ability of saliva to clear substrate from the appliance test site and the reaction of plaque within the appliance trough to various stimuli, yielded some interesting results. Plaque and salivary fluoride levels tended to fall, in some cases significantly, over a 4 week washout period when subjects changed from a fluoridated to a non-fluoridated dentifrice. The rate of clearance by saliva of substrate from the appliance trough was much faster than anticipated. This work demonstrated the ineffectual protection provided by the appliance trough against high salivary flow rates in this area of the mouth. Methodologies were also devised to assess the ability of plaque within the appliance trough to produce organic acid in response to a sucrose stimulus and to determine the ability of saliva to buffer the pH of such acid. With the limited amount of data available, it would appear that a reduced ability of the appliance trough plaque to produce add and an increased ability of saliva to buffer a reduced plaque pH were associated with significant lesion remineralisation. This work has demonstrated the versatility of this model and the potential to demonstrate some of the effects of saliva on artificial lesion remineralisation given lesions which display an appropriate ability to respond to a given protocol. Further work is required to determine the nature of the response of lesions with different characteristics to different intra-oral protocols, particularly in a non-fluoride environment.

Item Type: Thesis (PhD)
Qualification Level: Doctoral
Additional Information: Adviser: Steve Creanor
Keywords: Medicine, Dentistry
Date of Award: 1994
Depositing User: Enlighten Team
Unique ID: glathesis:1994-75525
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 19 Nov 2019 19:33
Last Modified: 19 Nov 2019 19:33

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