Syndromes with salivary dysfunction predispose to tooth wear: Case reportsof congenital dysfunction of major salivary glands, Prader-Willi, congenital rubella, and Sjogren's syndromes

Four cases-of congenital dysfunction of the major salivary glands as well a s of Prader-Willi, congenital rubella, and Sjogren's syndromes-were identif ied in a series of 500 patients referred for excessive tooth wear. Although there was evidence of consumption of highly acidic drinks, some occlusal p arafunction, and unacceptable toothbrushing habits, salivary dysfunction wa s the salient factor predisposing a patient to tooth wear in these syndroma l cases. The 500 subjects have been characterized either as having medical conditions and medications that predispose them to xerostomia or lifestyles in which workplace- and sports-related dehydration lead to reduced salivar y flow. Normal salivation, by buffering capacity, clearance by swallowing, pellicle formation, and capacity for remineralization of demineralized enam el, protects the teeth from extrinsic and intrinsic acids that initiate den tal erosion. Thus, the syndromes, unrelated in many respects, underline the importance of normal salivation in the protection of teeth against tooth w ear by erosion, attrition, and abrasion.