September 28, 2015
Remineralization of teeth is essential to avoid the development of dental cavities. It is a natural process that takes place when a favorable environment exists in the mouth. Essentially enamel, which is a hard layer of mineralized tissue, is not stable in composition. It is in a continuous state of change as acid produced in the mouth by bacteria leads to demineralization. On the other hand, the combined effect of good dental hygiene, saliva and fluoride encourage remineralization. Cavities will form when the process of demineralization exceeds that of remineralization.
Favorable Conditions for Remineralization
The most favorable environment would be non-acidic saliva with pH level ranging from 7.5 to 8.5 wherein calcium, phosphate, and bicarbonate occur in abundance in the saliva. At a pH level below 5.5, hydroxyapatite which is the main mineral found in the enamel begins to dissolve.
There are several products that contribute towards remineralization. However, certain steps help to minimize damage in the first place.
Acid in the saliva is formed when we eat sugars and bacteria present in the oral cavity feed on it. So every time we consume sugary foods the pH level drops. One way to improve the chances of remineralization is to avoid frequent consumption of sweetened drinks, citrus fruits and juices as they are acidic.
Dehydration, a primary factor that inhibits saliva production, can be easily minimized by drinking lots of plain water.
Another simple step is to increase saliva by chewing a sugar free gum that contains xylitol. This is a natural sweetener that also inhibits bacteria.
Use of Fluoride
Fluoride has several beneficial effects. It works by forming fluorapatite in the enamel which is more resistant to demineralization. Additionally, it has anti bacterial properties that inhibit the growth of acid producing bacteria. It has been demonstrated that it is the presence of fluoride within the mouth that is necessary than having it as a supplement. This can be achieved through fluoride pastes, varnishes or even fluoridated water
Use of Recaldent
Another product that is helpful is the use of amorphouscalcium phosphate or ACP. It works by forming a layer that releases calcium as well as phosphorous required for repair of enamel. Casein phosphopeptide or CPP, is a milk protein which offers an increase in exposure time when it is added to ACP. This combined product is known as Recaldent, which becomes active when there is an increase in acid levels in the saliva. It further enhances the effect of fluoride. It may be applied as a local use gel or is incorporated in some toothpastes.
NovaMin contains calcium, phosphorous, sodium, and silica, which works by raising pH to ideal level. It forms hydroxyl carbonate apatite when it comes into contact with saliva. NovaMin also has antibacterial action and produces enamel that is two times harder than fluoride. It is available both in toothpastes as well as an air polishing powder.
Tri-Calcium Phosphate (TCP)
Another product that enhances the rate of remineralization is tri-calcium phosphate. It forms a harder layer of enamel than other remineralizing products. This may be incorporated in varnishes and is also available in certain toothpastes.