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Hyposalivation Caries Risk — ORE Part 1 MCQ

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ModerateDental Public Health & EpidemiologyHyposalivation Caries RiskORE Part 1

A patient has recurrent dental caries despite adequate fluoride exposure and good oral hygiene. Salivary flow testing shows a resting flow of 0.05 mL/min (normal >0.1 mL/min) and a stimulated flow of 0.3 mL/min (normal >0.7 mL/min). What is the most appropriate interpretation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — This indicates hyposalivation and an increased caries risk.

Explanation lettering: D = shown as B · B = shown as C · E = shown as D · C = shown as E

A is correct. Resting flow of 0.05 mL/min and stimulated flow of 0.3 mL/min are both below the normal cut-offs supplied in the stem, demonstrating objective salivary hypofunction (hyposalivation). Reduced saliva compromises cleansing, buffering and remineralisation, making recurrent caries more likely even where plaque control and fluoride exposure are otherwise adequate. The underlying cause should be investigated, particularly medicines, systemic disease such as Sjögren's syndrome, and previous cancer treatment; preventive and symptomatic dry-mouth measures should then be considered. B is contradicted by both measurements. C is the opposite physiological finding. D is incorrect because xerostomia is a subjective symptom, whereas this patient has measured reduced flow. E is not implied by low flow alone and surgery is not routine management.

Reference: NHS Specialist Pharmacy Service. Considerations for artificial saliva products in dentistry, 30 April 2025. https://sps.nhs.uk/articles/considerations-for-artificial-saliva-products-in-dentistry/