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Objectives To investigate the effect of saliva substitutes on enamel erosion in vitro. Methods A total of 204 bovine enamel samples were embedded in acrylic resin and allocated to 17 groups (n = 12). The specimens were eroded in an artificial mouth (3 days; 6 × 30 s/days, flow rate: 2 ml/min) using citric acid (pH: 2.5). Immediately after the erosive attacks, saliva substitutes (12 sprays, 3 gels) were applied. Between the erosive cycles the specimens were rinsed with artificial saliva (flowrate: 0.5 ml/min). A SnCl2/AmF/NaF-containing mouthrinse was used as positive control, water spray served as negative control. Enamel loss was measured profilometrically and the data were analyzed using one-way ANOVA followed by Scheffe’s post hoc tests (p Results Four saliva substitutes increased enamel erosion, probably due to the low pH or the content of citric acid. Several saliva substitutes were able to reduce enamel erosion significantly by 60–90% (in the range of the positive control). The protective potential of these products was in the range of the positive control (reduction of enamel loss to 30% of negative control). The erosion-protective potential of these high-viscous products is probably related to their film-forming properties, leading to a mechanical protection of the surface. Conclusion Saliva substitutes containing a very low pH exhibit a distinct erosive potential, while most high-viscous products present an erosion-protective effect. It can be recommended that patients suffering from xerostomia and at high risk for dental erosion should use high-viscous saliva substitutes, but should avoid saliva substitutes with low pH or containing citric acid. Clinical significance It can be recommended that patients suffering from xerostomia and at high risk for dental erosion should use high-viscous saliva substitutes, but should avoid saliva substitutes with low pH or containing citric acid.

Objective The study aimed to evaluate the erosive effects of acids flowing with different velocities and duration on dentin previously pre-treated with distilled water or human saliva. Methods Bovine dentin surfaces were submitted to a 10 min demineralisation with hydrochloric or citric acid (pH 2.3, 37 °C) in an artificial mouth at flow rates of 3, 2.25, 1.5, 0.75 or 0.15 ml/min or in 30 ml of the respective acid without movement (each subgroup n = 16 specimens). Prior to the demineralisation, half of the specimens of each group were either pre-treated with distilled water or human saliva for 120 min. After 2, 5 and 10 min demineralisation, profilometric traces of dentin loss were performed perpendicular to the direction of acid flow at three sites (A–C) with intervals of 500 μm. The first profile (A) was taken in a distance of 1.5 mm from the acid starting to flow over the sample. Thus, median dentin loss at each site was calculated and statistically analysed by five-way ANOVA. Results Dentin loss increased with increasing acid flow rate and demineralisation time and was higher for demineralisation with citric acid compared to hydrochloric acid. For given flow rates of 0.15 to 3 ml/min, measurement of dentin loss yielded highest values for site A and decreasing values for sites B and C. For all groups, no significant differences of dentin loss were observed between specimens pre-treated with distilled water or human saliva. Conclusion Under the conditions of this study, both duration of demineralisation and acid flow rate but not pre-treatment with distilled water or saliva influence the extent of dentin erosion.

The complexity of the oral environment, and ethical problems associated with studies of oral diseases in humans inevitably directed the attention to development of laboratory models, that simulate the human oral microcosm. These developments and in particular the in vitro 'artificial mouth' systems have progressed from simple and basic apparatus devised by Magitot and Miller at the end of 19th century to the currently available, highly sophisticated, computer-controlled, multi-station artificial mouth systems. These advances have metamorphosed from the early studies devised primarily to investigate factors affecting the carious process to the present designs that evaluate growth, pathogenicity, metabolism and mineralization of dental plaque under highly controlled conditions. The modern 'artificial mouth systems' can evaluate microbial interactions in simulated dental plaque and similar biofilms and monitor their physical, chemical, biological and molecular features to a very high degree of accuracy. We review and trace here the historical aspects and developments leading to the currently available artificial mouth systems and discuss their contribution to the study of oral flora, especially related to many variants of dental caries.