saliva testing service - savina dental clinics malta and gozo

What does oral balance mean in relation to saliva testing?

Oral balance is the equilibrium that exists between the demineralising effect on a tooth surface caused by acids, which are balanced out by the remineralising and buffering effects of saliva. Even though oral balance is influenced by other factors such as fluoride exposure and oral hygiene, the dominant stimulus is the daily battle between oral acids and saliva.

Oral balance must be maintained at all cost. Otherwise, when saliva flow reduces, oral health problems such as tooth decay or infections can occur.

If you have any pressing dental issues or questions regarding saliva testing, you can book an appointment online or contact us directly on (+356) 2125 7253 (Skyparks Business Centre, Malta International Airport), or (+356) 2155 7323 (Dingli Street, Victoria, Gozo). For international patients, it is recommended to request a free e-consultation where we can discuss your individual case and treatment options.

Benefits of saliva to your health

Saliva offers your teeth the most powerful defence against decay. Saliva contains a variety of hormones, antibodies, cytokines, antimicrobial constituents and enzymes which all play a significant role in the protection of your intraoral structures against damage caused by different pathogenic microbes and irritants. It also adds nutrients and minerals to toughen your teeth. Some of the benefits of saliva to your health include;

Remineralising the enamel

Saliva contains important elements like calcium, bicarbonate and phosphate. These elements not only remineralise the enamel, but they also help repair early tooth decay and damage.

Lubricating oral tissues

Saliva moisturizes the inside of the mouth, including the oral tissues, which help us speak, taste, breathe and swallow better.

Maintaining oral mucosa health

Saliva is also a mineralising agent; As it washes through the teeth, mouth and gums, it adds minerals and nutrients, which help to toughen the oral mucosa.

Assisting the sense of taste

The enzymes found in the saliva act as solvents for taste substances. Saliva dissolves these taste substances and the latter diffuse to the taste receptor sites.

What happens when saliva fails to protect your teeth (update)

When saliva stops protecting your teeth, the clearance of food particles and bacteria from the mouth is reduced. The potential for remineralisation and buffering of acid also diminishes. As a result, oral balance is affected, leading to demineralisation. When demineralisation occurs, the external surface of your tooth softens, leading to:

Teeth erosion

Teeth erosion may occur from either internal or external acid sources like gastric reflux or acidic drinks or food

Labial wear

The labial (outside) surfaces of your teeth may wear or erode when brushing your teeth.

Increased occlusal and incisal attrition: Your teeth may undergo tooth wear, resulting in wedge-shaped lesions.

Situations that call for saliva testing

get saliva tested at savina dental clinics malta and gozo

To diagnose new clinical conditions

When a patient goes to a dentist with new oral health problems, their saliva may be tested to help determine the reason why the oral balance is not supporting demineralisation. Once diagnosed, a lasting solution can be found to correct or control these problems.

When doing restorative treatment

Saliva testing is done before any major restorative treatment to determine the cause of the condition such as what induced the loss of tooth structure. It also helps to determine whether a different undiagnosed oral balance issue may compromise the success of the restorative treatment.

Risk assessment for all patients

Over the years, we all experience a lot of changes in lifestyle, habits, diet and health status, which can unsuspectingly impact our oral balance. For instance, diet changes can lessen the amount of saliva in your mouth.

Risk assessment measures help identify your current oral balance situation before a permanent loss of tooth structure occurs. Regular risk assessment should be considered as routine for all dental patients.

Saliva testing parameters

Testing the right saliva parameters is crucial to understanding why it is not protecting the teeth as it should. These parameters include:

Resting saliva

Saliva is termed as resting or unstimulated when no external or pharmaceutical stimulation is present.

Stimulated saliva

Stimulated Saliva is derived when mechanical stimuli or pharmacological agents such as paraffin wax is used.

The 5 steps involved in saliva testing

The effectiveness of saliva is influenced by several properties including pH, viscosity, buffering capacity and flow rates. During saliva testing, each of these aspects is measured to get the most accurate results. The steps involved in saliva testing include;

Resting saliva hydration

The first phase of the test is done to assess how hydrated a patient’s mouth. The normal resting saliva flow rate is approximately 0.3-0.4ml/min. Resting saliva is derived from the submandibular glands.

While you may be asked to drool saliva into a collection cup, a simpler technique is to visually assess the production of saliva from the small salivary glands found in the lips.

Resting saliva flow (viscosity)

The second phase is done to measure the viscosity of saliva at rest. This test can be done visually. Healthy resting saliva is clear in colour and consistently watery. If the resting saliva is stringy, frothy, or is very thick, this could mean that the content of water is low due to a low production rate.

Resting saliva pH

This step measures the PH of unstimulated saliva. This is done by asking the patient to spit the saliva in their mouth into a testing cup.

A low pH indicates that the mouth is more acidic than normal. When the pH is low, acidic challenges result in mineral loss and demineralisation at a level that the saliva alone cannot repair.

Stimulated saliva quantity

This test measures the quantity of saliva produced. Stimulated saliva is produced by the parotid gland. This saliva is important as it helps flush away acids from diet, dental plaque and internal sources like gastric reflux.

The testing of stimulated saliva quantity requires you to obtain a sample over a period of 5 minutes. You will be asked to chew on a piece of paraffin wax to stimulate salivary flow. Spit the saliva into the testing cup after every 30 seconds of chewing for about 5 minutes.

Stimulated saliva buffering capacity

Stimulated saliva buffering capacity measures the ability of saliva to neutralize acids in the mouth, which can come from dental plaque, your diet, or from internal sources like gastric reflux. The saliva you provide in the step above is used to test for bicarbonate. Bicarbonate is the most important buffering element in saliva.

How long does the test take?

On average, a saliva test takes about ten minutes to complete.

Is saliva the future of diagnostics?

Saliva has proven to be a very successful tool for diagnostics. According to Science Direct, it has become an important resource for assessing pathological and physiological conditions in humans. The use of saliva also provides a simple and non-invasive method of collecting samples. These samples have been proven to produce rapid and highly accurate results. They are also a great addition to the early detection of oral problems.

Have You Tried Our Free e-Consultation Service?

If you are worried about a dental related issue or have questions about any of the treatments we offer, please contact us using our new free e-Consultation service. One of our highly-qualified team will respond to your query as soon as possible. Our e-Consultation service is live 9am – 6pm Monday to Friday.

If you would like to schedule an in-person consultation at Savina Dental, please book your appointment using this form.

You can also read more about all our dental treatments at Savina Dental Clinic or check out our customer testimonials section.

Savina Clinic – Dental & Implantology Centres are friendly, state-of-the-art practices in Malta and Gozo dedicated to comprehensive quality dental care. Savina Dental is an innovative dental practice in Malta and prides itself on the high-quality customer service, low waiting room times, attention to detail and the advanced dental technology at their disposal.

Joseph Xuereb

Joseph Xuereb
Principal Dental Surgeon & Owner of Savina Dental Clinics, Dr Joseph Xuereb BChD (Hons), MFGDP(UK), MGDS RCS(Eng), FFGDP RCS(UK), FICD is a general dental practitioner with a special interest in Implant and Restorative Dentistry. Dr Joseph & the teams’ full biographical information can be found here.