The Use of Milk as a Saliva Substitute

Xerostomia, a clinical manifestation of salivary gland dysfunction, affects many people. These individuals frequently sip liquids to alleviate the discomforts associated with hyposalivation. Milk appears to have many of the chemical and physical properties of a good saliva substitute. Besides the obvious benefit of providing moisture and lubrication for the dehydrated mucosa, milk buffers oral acids, reduces enamel solubility, and contributes to enamel remineralization. These anticariogenic factors are generally attributed to the high calcium and phosphate content along with the milk phosphoproteins that strongly adsorb to enamel. Patients with xerostomia frequently have difficulty in obtaining proper nutrition due to problems associated with lubricating, masticating, tasting, and swallowing food. Milk is a food with high nutritional quality that would certainly benefit most patients with xerostomia. Because of the nutritional, anticariogenic, and moisturizing properties of milk, patients with xerostomia may find milk of value as a saliva substitute to help reduce the oral health problems associated with hyposalivation. Summary Xerostomia is a serious condition frequently affecting the elderly, those undergoing radiation therapy, and individuals with Sjogren's syndrome. The dry mucosa and rampant dental caries associated with the loss of salivary flow presents a frustrating situation for both the patient and the dental practitioner. Xerostomia patients frequently use saliva substitutes to relieve some of the discomforts associated with this condition. Milk appears to be a good saliva substitute. It provides moisture and lubrication for the dehydrated mucosa. Milk aids the patient in masticating, swallowing, and cleansing the mouth of oral debris. Experiments in vivo and in vitro support the hypothesis that, under normal circumstances, milk is not generally cariogenic and may have anticariogenic potential. These anticariogenic factors are attributed to milk's ability to buffer acids produced from sugars, inhibit demineralization of enamel, and facilitate the remineralization phenomenon that occurs with early enamel lesions. The calcium and phosphorus content seems to be a factor in the cariostatic mechanism of milk. Casein also seems to be involved in the reduction of enamel demineralization. Casein phosphopeptides may be responsible for some anticariogenicity by concentrating calcium and phosphate in plaque.