Anticariogenic efficacy of a saliva biomimetic in head‐and‐neck cancer patients undergoing radiotherapy

Background The aim of this study was to investigate the effect of treatment with the saliva biomimetic, casein phosphopeptide‐amorphous calcium phosphate ( CPP ‐ ACP ) and SnF 2 /NaF compared with SnF 2 /NaF alone on coronal surface caries progression in head‐and‐neck cancer patients undergoing radiotherapy. Methods Twenty‐four participants were randomized into two groups. Both groups used 0.4% SnF 2 gel and a 0.32% NaF toothpaste; the test group also applied a crème containing 10% CPP ‐ ACP three times daily while the control group used an identical crème without CPP ‐ ACP (placebo). Resting saliva flow rate and saliva fluoride concentrations were determined. Caries status was assessed using ICDASII at baseline and 12‐weeks postradiotherapy. Data were statistically analysed using a linear mixed effects model. Results Both groups showed significantly reduced resting saliva flow rate ( P < 0.001) postradiotherapy. There were no significant differences in flow rates and fluoride concentration between groups. The CPP ‐ ACP group exhibited a significant ( P < 0.05) 51% reduction in coronal surface caries progression compared with the placebo group. Conclusion Resting salivary flow rate was significantly reduced in head‐and‐neck cancer patients following radiotherapy and use of CPP ‐ ACP with SnF 2 /NaF significantly lowered caries progression compared with SnF 2 /NaF alone.