Erosive potential of saliva stimulating tablets with and without fluoride in irradiated head and neck cancer patients.
BACKGROUND
Patients irradiated in the head and neck region often suffer from severe dry mouth and use acidic saliva stimulating products, which may cause erosion of teeth.


OBJECTIVE
To determine saliva stimulating effects and erosive potential (EP) of acidic saliva stimulating tablets (Xerodent) with and without fluoride in irradiated head and neck cancer patients.


METHODS
Nineteen irradiated patients (median age 57 years) sucked Xerodent tablets with and without fluoride. Saliva collections were divided into three 10-min sessions in the sequence: unstimulated whole saliva, Xerodent stimulated saliva without fluoride, and with fluoride. Saliva pH was determined without loss of CO(2) and in combination with inorganic measures used to calculate the degree of saturation of hydroxyapatite (HAp) and fluorapatite (FAp). EP was determined directly in all saliva samples by monitored dissolution of HAp crystals.


RESULTS
Saliva flow rates increased significantly (15-fold) when sucking both tablets (p<0.001). Major changes in saliva composition caused undersaturation of HAp in some samples. However, no dissolution of HAp occurred in the saliva obtained with any of the two tablets. This was most likely due to the limited drop in pH resulting in saliva that was still supersaturated with respect to FAp.


CONCLUSIONS
Both Xerodent with and without fluoride were evaluated as non-erosive, however, for additional caries protection the fluoride variant is preferable.
Lajer
Christel
C
Department of Otolaryngology Head and Neck Surgery, Rigshospitalet, University of Copenhagen, Denmark. christel.lajer@rh.regionh.dk
Buchwald
Christian
C
Nauntofte
Birgitte
B
Specht
Lena
L
Bardow
Allan
A
Jensdottir
Thorbjörg
T
D001031:Apatites / Q000032:analysis; D003731:Dental Caries / Q000517:prevention & control; D017886:Durapatite / Q000032:analysis; D005260:Female; D005459:Fluorides / Q000008:administration & dosage*; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D018788:Radioactive Hazard Release; D012463:Saliva / Q000737:chemistry / Q000187:drug effects / Q000378:metabolism*; D012469:Salivary Glands / Q000528:radiation effects; D014077:Tooth Erosion / Q000139:chemically induced*; D014987:Xerostomia / Q000209:etiology / Q000628:therapy*
D001031:Apatites; D017886:Durapatite; C025105:fluorapatite; D005459:Fluorides