[Caries receptivity: a modern diagnostic protocol. II. The most important tests]. / Cariorecettività: un moderno protocollo diagnostico. Parte II: I test più significativi.

ABSTRACT

In this, the second part of the paper, the main clinical tests available today for carrying out early diagnosis of carioreceptivity are reviewed. On its own, measurement of the DMF-T index can classify an individual as carioactive or evaluate his "experience of caries", but it does non determine with any degree of certainty the probability of future caries. Measurement of stimulated salivary flow is important only when this is greatly reduced, as happens, for example, in xerostomy, but the finding of an almost normal flow is not on its own sufficient to make a diagnosis of carioreceptivity certain. Assessment of salivary pH is not a reliable parameter for the screening of carioreceptivity although it may be an indicator of diseases (e.g. diabetes) or bad habits (e.g. heavy smokers) in the patient in question. So examination with very sophisticated methods is of little importance. The buffer potential of saliva, assessed with a colorimetric test, is the most reliable parameter as it measures an important property of saliva at individual level the capacity to protect from local acidity. Some studies seem to point to the validity of the combined evaluation of DMF, pH, salivary flow and buffer power of saliva in the prediction of caries at the level of groups of individual, but this has little or no validity in the screening of individual carioreceptive subjects. Specific microbiological cultures for cariogenic microorganisms are the most reliable tests for the diagnosis of carioreceptivity, particularly Dentocult for the search for Streptococcus mutans which is the most important factors in caries. The search for lactobacilli also identifies bad hygienic and dietary habits in the patients.