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Caries Process and Prevention Strategies: Demineralization/ Remineralization

Course Number: 372


acidogenic – Something that produces acid, such as cariogenic bacteria.

aciduric – Capable of growth in an acidic environment.

buffering agent – Adjusts the pH of any solution such as saliva or plaque fluid and can resist changes in pH. Beneficial in the prevention of dental caries.

carbonated hydroxyapatite – The hydroxyapatite in human enamel is not pure, and contains carbonate ions. The presence of carbonate ions makes the enamel structure much more soluble and less resistant to acid dissolution. Chemically, the hydroxyapatite that comprises enamel is often described as a calcium-deficient carbonated hydroxyapatite.

cariogenic bacteria – Bacteria present in the oral biofilm of dental plaque that will lead to the occurrence of carious lesions when all other necessary factors are present.

demineralization – The chemical process by which minerals (mainly calcium) are removed from the dental hard tissues - enamel, dentin, and cementum. The chemical process occurs through dissolution by acids or by chelation, and the rate of demineralization will vary due to the degree of supersaturation of the immediate environment of the tooth and the presence of fluoride. In optimal circumstances, the minerals may be replaced through the process of remineralization.

dental plaque – An organized community of many different microorganisms that forms itself into a biofilm and is found on the surface of the tongue and all hard surfaces in the oral cavity. Dental plaque is present in all people and can vary from being comprised of totally healthy microorganisms (commensals) to being very harmful (pathogenic), predisposing the patient to dental caries or periodontal diseases. Note: Dental plaque is not food debris, nor does it contain food debris. Dental plaque can only be completely removed by mechanical means such as toothbrushing or prophylaxis. Food debris can be removed by rinsing.

fluorapatite – A crystal structure in tooth mineral (Ca10 (PO4)6 F2) resulting from the replacement of hydroxyl ions (OH-) in the hydroxyapatite structure with fluoride ions (F-). Fluorapatite (also commonly referred to as fluoroapatite, fluorhydroxyapatite or fluorohydroxyapatite) is stronger and more acid resistant than hydroxyapatite.

GERD – Gastroesophageal reflux disease; the reflux of hydrochloric acid generated in the stomach that travels to the mouth. Erosion will occur upon the acid’s contact with enamel surfaces.

glycolysis – Glycolysis is essential to all living organisms, and is the process whereby energy is released from sugars by the formation of pyruvate.

hydroxyapatite – Crystals of calcium phosphate – (Ca10 (PO4)6 OH2) that form the mineral structure of teeth and bone. Enamel comprises approximately 98% hydroxyapatite (by weight). Much of the hydroxyapatite in enamel, however, is a calcium-deficient carbonated hydroxyapatite, the crystals of which are readily dissolved by acids. The addition of fluoride creates fluorapatite, which is less soluble and more acid-resistant.

ions – Atoms or molecules that carry either a positive or a negative electric charge in a solution. For example, sodium chloride (NaCl, common table salt) in water dissociates into Na+ and Cl– ions.

pellicle – A layer of salivary glyco-proteins that forms on the tooth surface and is present within minutes of oral hygiene or professional prophylaxis. The pellicle layer is protective against caries, as it slows the diffusion of calcium and phosphate ions away from the tooth surface. Sometimes referred to as the Acquired Pellicle, it varies in thickness in different parts of the mouth and is reduced during oral hygiene or by dietary acids. In addition to protecting against caries, it is the layer to which microorganisms first attach to the tooth surface in the formation of the dental plaque biofilm.

remineralization – The chemical process by which minerals (mainly calcium) are replaced into the substance of the dental hard tissues - enamel, dentin and cementum. The process requires an ideal environment that includes supersaturation with calcium and phosphate ions, and adequate buffering. In the presence of fluoride, remineralization is enhanced.

translucent – Permitting the passage of light; especially: transmitting and diffusing light so that objects beyond cannot be seen clearly.

white spot lesion – One of the early clinical signs of dental caries, before cavitation has occurred. The stage at which the disease can be reversed by remineralization.