Hydroxyapatite as Remineralization Agent for Children's Dental Care

Abstract

Children are prone to develop dental caries. This is supported by epidemiological data confirming early childhood caries (ECC) as a highly prevalent disease affecting more than every second child worldwide. ECC is known to result from an imbalance between re- and demineralization where demineralization dominates due to frequent acid production by cariogenic bacteria present in oral biofilms. The application of oral care formulations containing remineralizing agents helps to prevent dental caries. As young children are sensitive and usually swallow (intended or unintended) a majority of toothpaste or other oral care products during daily dental care, all ingredients, especially the actives, should be non-toxic. Biomimetic hydroxyapatite [HAP; Ca5(PO4)3(OH)] is known to have favorable remineralizing properties combined with an excellent biocompatibility, i.e., it is safe if accidently swallowed. Several clinical trials as well as in situ and in vitro studies have shown that HAP remineralizes enamel and dentin. Remineralization occurs due to deposition of HAP particles on tooth surfaces forming mineral-mineral bridges with enamel crystals, but also indirectly through calcium and phosphate ions release as well as HAP's buffering properties in acidic environments (i.e., in plaque). HAP induces a homogenous remineralization throughout the subsurface enamel lesions. This review summarizes the current evidence showing HAP as an effective remineralizing agent in oral care products for children. Additional studies showing also further beneficial effects of HAP such as the reduction of biofilm formation and the relief of hypersensitivity in children with molar incisor hypomineralization (MIH). It can be concluded that HAP is an effective and safe remineralizing agent for child dental care.

Risk of Dental Caries and Erosive Tooth Wear in 117 Children and Adolescents' Anorexia Nervosa Population—A Case-Control Study

“… Oral effects of eating disorders and oral care recommendations to health professionals and patients. HAP- oral care products containing synthetic hydroxyapatites, CPP-ACP- oral care products containing calcium-phosphate agents, F - oral care products containing fluoride products ( 74 , 75 , 77 , 80 ). …”

Incorporation of Fluoride into Human Teeth after Immersion in Fluoride-Containing Solutions

“…Fluoride-free prophylactic systems have been investigated in the last decade. It has been shown that they can be as efficient as fluoride-containing systems to prevent dental caries [ 8 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 ]. Thus, they may present a viable alternative to fluoride-containing agents in oral care.…”

Management for Caries Prevention in ADHD Children

“…Emotional Dysregulations (ED) represent a major health risk present in about 5% of children and are associated with diverse forms of childhood psychiatric disorders and symptoms such as Attention-Deficit/Hyperactivity Disorder (ADHD) [ 1 ]. Early Childhood Caries (ECC) is still one of the most prevalent disease that can lead to serious health issues in young growing children worldwide [ 2 ]. It is possible that the association between ADHD and ECC is more pronounced in children with clinically relevant emotional deficits as in the case of ADHD but may be unnoticeable during typical dental care.…”

“…In clinical and experimental research, biomimetic hydroxyapatite and calcium-phosphate oral care products are considered, especially for children and adolescents from high-risk groups [ 6 , 25 , 26 , 27 , 28 ]. A mode of action is known due to the deposition on tooth surfaces of hydroxyapatite particles that form mineral–mineral bridges with enamel crystals, as well as indirectly through the release of calcium and phosphate ions and hydroxyapatite’s buffering properties in acidic environments, i.e., in dental plaque [ 2 , 28 ].…”