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  • Lacy Walker

Getting Cavities? Your Oral pH Matters


Saliva is nature's built-in tooth remineralizer, but it does more than just keep your mouth moist—it also contains minerals that help keep your teeth strong.


A healthy and stable oral microbiome means a healthy you. Your mouth is home to billions of bacteria, both good and bad and when the oral pH balance is tipped too far toward the bad bacteria, it can lead to problems like cavities and gum disease. Keeping your oral microbiome healthy is essential for maintaining your overall health. Maintaining a healthy oral pH keeps saliva alkaline, which allows it to do its job of remineralizing your teeth.


What is oral pH?

According to the Oxford Dictionary, pH is defined as a quantitative measure of the acidity and basicity of an aqueous solution. Your saliva is an aqueous solution comprised mostly of 99% water and influences oral pH balance. Your oral pH is a reflection of your overall health, and a healthy mouth is a reflection of a healthy body. Imbalances in the oral microbiome have been linked to a variety of diseases, including cavities and gum disease.


Why is your saliva important?

Saliva is essential because it helps lubricate the mouth, contains an enzyme such as amylase that helps break down the food we ingest into simpler sugars, and assists in the repair and remineralization of early tooth decay. Saliva also consists of a variety of electrolytes such as potassium, calcium, bicarbonate, and phosphates which helps neutralize buffered acids to return the pH level to a normal value. Just because you have a lack of salivary flow, it isn’t always a negative thing because the quality of saliva is just as important.


A saliva pH of 7 usually indicates a healthy dental and periodontal situation. The saliva contributes to the maintenance of the oral pH by two mechanisms. First, the flow of saliva eliminates carbohydrates that could be metabolized by bacteria and remove acids produced by bacteria. Second, acidity from drinks and foods, as well as from bacterial activity, is neutralized by the buffering activity of saliva. (1) Maintaining a neutral oral pH, removing dental plaque daily, visiting your dental office regularly, and applications of topical fluorides can assist in reducing your chances of developing cavities and gum disease.


What affects your oral pH?

Like our bodies, our teeth require periods of rest and replenishment, and our teeth are replenished and remineralized through our saliva. A lower pH value influences the bacterial population of the biofilm, producing a shift in the oral microbiome and promoting the acidogenic bacteria. (2) Your saliva removes unwanted bacteria and delivers important minerals that preserve the protective enamel layer and if there is an insufficient amount of saliva, it can contribute to cavities and gum disease.

Your dietary habits can also impact your oral pH leading to the development of caries or gum disease. The foods you eat can have a direct impact on your oral pH because acidic food and beverages can lead to demineralization of the enamel on your teeth, while alkaline foods can help to remineralize it. Dental caries results from the interaction between the plaque on the teeth’s surface and the fermentable sugars from the diet. These consequences upon the buffering capacity of the saliva and a lower pH weaken the normal remineralization process. (2, 3)


Why does it matter?

Dental caries is the most prevalent chronic oral disease, and it is directly influenced by the pH of saliva, the bacteria present, and dietary habits. It’s not just about the quantity of saliva, it is about the quality of that saliva. Saliva has a higher buffering capacity, contains ions, and is considered basic. Good-quality saliva mineralizes the plaque and calcifies it because there are so many excess ions in the saliva.


On the flip side, a patient with no calculus on their dentition might think they have really good home care. However, the saliva is acidic and breaks down the calculus, which eventually demineralizes the teeth and increases the production of bacteria that contribute to dental caries. (3)


When the cycle of remineralization is disrupted, we are at risk for cavities. Long-term demineralization caused by acidic saliva can permanently damage enamel. Though enamel is the hardest substance in the body, it can be compromised by long-term acid exposure penetrating the surface and causing it to break down.


When a cavity is small, typically, there is no pain. However, when left untreated and reaches the dentin, the second layer of the tooth, patients can experience sensitivity to hot or cold substances in conjunction with pain. If left untreated for too long, it could result in the bacteria reaching the pulp of the tooth, which usually causes more intense pain or discomfort. It’s essential to be checked regularly, have optimal home care, and avoid acidic food and beverages. If you choose to have a sugary, acidic beverage such as a regular carbonated beverage, it is best to avoid sipping it throughout the day and consume it during a meal.

Salivary Diagnostics (Saliva Testing)


The field of salivary testing is an emerging field in the world of dentistry and is a noninvasive diagnostic option to monitor health and disease. The key to managing dental caries is addressing the various causes, and the use of a saliva test can assess your level of risk for caries, oral cancer, and periodontal disease.

Ask your healthcare professional to assess your saliva, educate you on the importance of your saliva and help you determine your level of risk for developing cavities or other complications associated with having an oral pH imbalance.


References

1. Baliga, S., Muglikar, S., & Kale, R. (2013). Salivary pH: A diagnostic biomarker. Journal of Indian Society of Periodontology, 17(4), 461–465. https://doi.org/10.4103/0972-124X.118317

2. Laura-Cristina Rusu, Alexandra Roi, Ciprian-Ioan Roi, Codruta Victoria Tigmeanu and Lavinia Cosmina Ardelean. The Influence of Salivary pH on the Prevalence of Dental Caries. Reviewed: June 28th, 2022 Published: July 19th, 2022. https://www.intechopen.com/online-first/82735

3. Johnston, Andrew. Strange, Michelle. TIPisode Saliva with Brian Novy A Tale of Two Hygienists. https://www.ataleoftwohygienists.com/listen/saliva-with-dr-brian-novy-tipisode/


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