Biological factors in dental caries: role of remineralization and fluoride in the dynamic process of demineralization and remineralization (part 3)

Dental caries is a complex disease process that afflicts a large proportion of the world, regardless of gender,

age and ethnicity, although it does tend to affect more with a low socioeconomic status to a greater extent.

Remineralization may be enhanced by providing low levels of calcium and phosphate, in conjunction with

minimal amounts of fluoride. It is truly remarkable the difference that a very small amount of fluoride

(<1ppm) has upon demineralization and remineralization. This is because fluoride acts as a catalyst and

influences reaction rates with dissolution and transformation of various calcium phosphate mineral phases

within tooth structure and resident within plaque adjacent to tooth surfaces. The incorporation of minimal

amounts of fluoride into HAP yields FHAP that resists demineralization to similar level as FAP. New and

emerging methods have been and are in the process of being developed. These hold great promise for preventing

and reversing caries, especially in the one-fifth of the population that accounts for two-thirds of the

caries experience. Still, the mainstay in caries prevention and remineralization is frequent exposure to low

levels of fluoride. This may be accomplished with fluoridated toothpastes, supplemented with fluoride

mouthrinses,CPP-ACP containing chewing gum and application of fluoride varnishes.The role of systemic

fluorides appears to be limited and primarily has a topical effect.

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