At the start of my paper, I held particular ideas about the act of carrying.
Despite fluoride being widely recognized for its effectiveness in preventing tooth decay, there is a limited amount of research and information about the correlation between dental caries and calcium phosphate. Given my knowledge of enamel remineralization, I opted to investigate how calcium phosphate can contribute to cavity prevention through this process. The search for pertinent resources regarding this subject proved to be difficult; however, throughout my inquiry, I encountered several products that contain calcium phosphate and assert their ability to attain the desired outcome.
Carious lesions develop gradually, taking anywhere from six months to two years. The process of dental caries is constantly changing and includes cycles of demineralization and remineralization (Harris and Garcia-Godoy 45). Enamel is made up of tightly packed hydroxyapatite crystals that contain tricalcium phosphate. Demineralization results in the depletion of tricalcium phosphate.
When a certain amount of this mineral is depleted, it leads to the formation of a cavity due to the collapse of the tooth structure. Remineralization refers to depositing the lost ions back into an area that has experienced demineralization. The first stage involves a specialized acquired pellicle which acts as fly paper by capturing bacteria. As bacteria build up, it forms plaque. This bacterial plaque then generates acids that can ultimately result in enamel structure collapse (Winston 1580).
To achieve remineralization, it is necessary to replace the lost calcium and phosphate during demineralization. Calcium and phosphate are naturally present in saliva (Winston 1580). The concentration of these minerals in saliva can vary among individuals. It has been discovered that men generally have a higher level of salivary calcium compared to women (Sewon 917).
Among the various factors, a significant contributor to elevated salivary calcium is its abundance. A greater presence of calcium in the saliva facilitates a rapid process of remineralization after initial demineralization. A study found that individuals, particularly males, with high levels of salivary calcium had a lower occurrence of decayed, missing, or filled teeth. However, excessive mineral content in the saliva can also lead to drawbacks such as increased bleeding on probing due to heightened plaque accumulation.
Studies have shown that plaque with high levels of calcium hardens rapidly, forming calculus that has properties making it more prone to retaining plaque. This occurrence has been associated with a higher occurrence of periodontitis in males compared to females. The accumulation of calculus is a contributing factor to the onset of gum disease. Additionally, research indicates that an elevated concentration of calcium in saliva is positively linked to gingivitis, which could potentially advance into periodontitis. However, it is important to note that a high level of salivary calcium is also connected to enhanced dental health.
According to Sewon (918), there are individuals who may have fewer tooth decay issues. However, there are certain people who may have insufficient salivary production and minerals. These individuals include those who suffer from reduced salivation, commonly known as xerostomia, as well as those who undergo head and neck radiation treatment, use specific medications, or have certain diseases. Their compromised salivary function puts them at a higher risk for dental caries development because they lack saliva’s buffering properties and its ability to aid in enamel remineralization (Winston 1581).
Research conducted by Shen (2069) examined a sugar-free gum that contains Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP), specifically assessing its ability to aid in remineralization. The use of amorphous calcium phosphate, as opposed to calcium phosphate, was preferred due to its greater solubility (Winston 1583). The study demonstrated that CPP-ACP contributes to enhanced remineralization, and the mere act of chewing the gum promotes increased salivary flow within the mouth.
Our added ingredient, CPP-ACP, is crucial. When saliva and CPP-ACP are combined, they soak the teeth for 20 minutes per session. The outcome was remarkable, with a much higher level of remineralization compared to individuals who didn’t chew this gum.
Chewing any type of gum, including different flavors, can still provide beneficial effects. It is common knowledge that saliva has buffering properties and chewing gum enhances saliva production. However, it should be noted that gum containing sugar can promote the growth of dental plaque, which is a potential drawback.
In reference to bacterial plaque, Shen (2069) asserts that it possesses the ability to generate acids that can be detrimental to enamel. However, if calcium and phosphate were incorporated into toothpaste formulations, what would be the outcome? Generally speaking, toothpastes primarily contain sodium fluoride as their primary ingredient, accompanied by other components intended for aesthetic purposes such as teeth whitening. The concern over the whiteness of one’s teeth may not be a significant issue unless they have numerous fillings. It is worth mentioning that the whitening agents present in toothpastes are abrasive and have the potential to further demineralize enamel, particularly among individuals who have recently undergone orthodontic treatment.
Colgate Total and Enamelon are two different toothpastes with distinct ingredients. Colgate Total contains sodium fluoride and triclosan, known for its powerful antibacterial properties. On the other hand, Enamelon consists of amorphous calcium phosphate along with sodium fluoride.
A study was conducted on “caries-free molars” over a period of 14 days. These teeth were intentionally treated with acid to create carious lesions and then subjected to treatment using both Colgate Total and Enamelon toothpastes mentioned earlier. The levels of remineralization were measured after the treatments.
The results showed that both toothpastes, one containing fluoride and the other containing calcium phosphate and fluoride, demonstrated a reduction in lesion depth ranging from 30 to 42 percent (Hicks 22).
Hicks (25) discovered that both dentifrices were successful in remineralizing the lesion. However, the dentifrice containing calcium phosphate and fluoride exhibited better outcomes in decreasing the depth of the lesion. It is vital to prioritize caries prevention and educate parents about effective preventive measures and supplemental substances for regular home care. Frequently, pediatricians fail to inform mothers about the importance of avoiding putting babies to bed with bottles; instead, they merely inquire if it is being done.
Although many mothers may not openly acknowledge their awareness, I assure you that if they truly comprehended the reasons behind it, they would never try to do it again. Teenagers who wear braces necessitate a fluoride rinse and may even need a toothpaste with a higher level of fluoride prescribed to them. It is highly recommended to use a toothpaste that combines calcium phosphate and fluoride as it possesses the capability to restore minerals in teeth.
Regrettably, the Enamelon dentifrice brand, which contained these beneficial minerals, ceased operations. This poses a challenge for it to rival Crest and Colgate, both of which cater solely to the cosmetic preferences of their customers. Essentially, the issue lies in the necessity of educating consumers.
