Enamel remineralization: controlling the caries disease or treating early caries lesions?

Abstract

The emphasis currently given to new technologies for enamel remineralization suggests that the changes in the understanding of the dental caries disease, which occurred in the last century, were either not yet adopted or were forgotten. Just like in the past, when the disease was "treated" by restoring cavities, there is presently a misunderstanding on the concept of incipient lesion remineralization. The aim of this paper was to review some concepts about caries, the natural phenomenon of enamel remineralization and the effect of fluoride (F) on it, and also to discuss the clinical relevance of remineralizing products recently launched in the marketplace aiming to "treat early caries lesions".

Development of caries adjacent to composite restorations after exposure to dentifrices with different fluoride concentrations

“…The literature shows that fluoridated dentifrice has a significant effect on the reduction of caries 2,3 ; however, its unsupervised use by small children may result in undesired ingestion of the fluoride. This has encouraged the development of dentifrices with low fluoride concentrations and of techniques for reducing their consumption, as alternatives for reducing the risk of dental fluorosis 7,8,14,15 .…”

“…The use of fluoride is considered one of the most effective methods for the control of dental caries because it interferes with the dynamics of the carious process, acting to inhibit demineralization and strengthening remineralization 1,2 . One of its most common uses is in fluoride dentifrice, considered one of the products with the greatest cariostatic effect when used daily 3,4 .…”

“…On the other hand, the fluoride does not interfere with the factors responsible for the caries (diet and biofilm) or with the behavior of the individual 2 . In patients with previous experience of caries and who have restorations, if the carie is not treated, a lesion adjacent to the restoration, called recurrent caries, could occur 2,10 .…”

“…In patients with previous experience of caries and who have restorations, if the carie is not treated, a lesion adjacent to the restoration, called recurrent caries, could occur 2,10 . This type of lesion presents a problem with high personal and social cost and is one of the main reasons for the replacement of restorations 10 .…”

Roles of Nanotechnological Approaches in Periodontal Disease Therapy

“…Certain agents in nanoscale can be incorporated in these conventional dentifrices to aid in repelling the deposition of bacterial biofilms (plaque and tar) and/or prevent dental caries by remineralization of early carious lesions, and in desensitization of abraded teeth (Hannig and Hannig, 2010). The process of re-deposition of minerals that are lost by tooth enamel is called enamel remineralization (Cury and Tenuta, 2009). Some ceramics like calcium phosphates and nanosized calcium carbonate particles (also called hydroxyapatite) has been reported to be a suitable ingredient for dentifrices that can be effectively used in the process of enamel remineralization.…”