Remineralisation – the buzzword for early MI caries management

Key Points

  • Highlights that minimal intervention dentistry aims to preserve dental tissues first and restore only when indicated.

  • Emphasises non-operative treatment of initial caries lesions as an integral part of comprehensive caries management.

  • Discusses the strategies available to aid in arrestment/remineralisation of initial caries lesions on root and coronal surfaces.

  • Points out that all caries remineralisation treatment be complemented with general behaviour modification advice.

Abstract

Minimal intervention (MI) dentistry aims to preserve dental tissues first and restore only when indicated, thus remineralisation of initial (non-cavitated) caries lesions, an integral part of caries management, is an essential treatment strategy in MI. With this understanding, dental practitioners are increasingly embracing the principle of non-operative treatment of initial caries lesions. The purpose of this review was to summarise the most recent literature published in non-operative management of dental caries. Three electronic databases (MEDLINE, EMBASE, Cochrane CENTRAL) were searched, and clinical studies, systematic reviews and meta-analysis were included. This report outlines the strategies and numerous therapeutic materials available to aid in arrestment/remineralisation of initial caries lesions on root and coronal surfaces. However, the level of evidence of effect is variable, as well as the availability in different parts of the world. Options available to practitioners will vary when placing emphasis on the level of evidence supporting them. Strong clinical evidence support the effectiveness of pits/fissure sealants for therapeutic management of active initial caries on occlusal surfaces, and fluoride varnishes for remineralisation of caries lesions on root and coronal smooth surfaces, including proximal surfaces. Other materials formulated to enhance the effectiveness of any chosen remineralisation strategy were discussed. However, it is absolutely necessary that all caries remineralisation treatment be complemented with general behavioural modification in oral health through motivational interviewing directed towards change in oral hygiene to control plaque, dietary attitude modification to reduce the frequency of intake of fermentable sugars, and establishment of risk-based recall visits.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

Figure 1
Figure 2: Decision tree for management of caries lesions on proximal coronal surfaces.
Figure 3: ADA Caries Classification System 2015.
Figure 4: Decision tree for management of caries lesions on occlusal pits and fissure.
Figure 5: Decision tree for management of Caries Lesions on Non-Proximal Coronal Smooth Surfaces.
Figure 6: Decision tree for management of caries lesions on root surfaces.
Figure 7

References

  1. 1

    Tyas M J, Anusavice K J, Frencken J E, Mount G J . Minimal intervention dentistrya review. FDI Commission Project 1–97. Int Dent J 2000; 50: 1–12.

    PubMed  PubMed Central  Article  Google Scholar 

  2. 2

    Fontana M, Gonzalez-Cabezas C . Minimal intervention dentistry: part 2. Caries risk assessment in adults. Br Dent J 2012; 213: 447–451.

    PubMed  PubMed Central  Article  Google Scholar 

  3. 3

    Pitts N B, Ismail A I, Martignon S, Ekstrand K, Douglas G A V, Longbottom C . ICCMS Guide for Practitioners and Educators. Available at https://www.icdas.org/uploads/ICCMS-Guide_Full_Guide_UK.pdf (accessed October 2016).

  4. 4

    Ismail A I, Brodeur JM, Gagnon P et al. Prevalence of non-cavitated and cavitated carious lesions in a random sample of 7–9 year old school children in Montreal, Quebec. Community Dent Oral Epidemiol 1992; 20: 250–255.

    PubMed  Article  Google Scholar 

  5. 5

    Mattos-Graner Rde O, Rontani R M, Gavião M B, Bocatto H A . Caries prevalence in 636month-old Brazilian children. Community Dent Health 1996; 13: 96–98.

    PubMed  Google Scholar 

  6. 6

    Featherstone J D . The caries balance: contributing factors and early detection. J Cal Dent Assoc 31: 129–133.

  7. 7

    Lynch R J, Smith S R . Remineralization agents – new and effective or just marketing hype? Adv Dent Res 2012; 24: 63–67.

    PubMed  Article  Google Scholar 

  8. 8

    Kidd E A, Pitts N B . A reappraisal of the value of the bitewing radiograph in the diagnosis of posterior approximal caries. Br Dent J 1990; 169: 195–200.

    PubMed  Article  Google Scholar 

  9. 9

    Forgie A H, Pine C M, Pitts N B . The use of magnification in a preventive approach to caries detection. Quintessence Int 2002; 33: 13–16.

    PubMed  Google Scholar 

  10. 10

    Nyvad B, Machiulskiene V, Baelum V . Reliability of a new caries diagnostic system differentiating between active and inactive caries lesions. Caries Res 1999; 33: 252–260.

    PubMed  Article  Google Scholar 

  11. 11

    Nyvad B, Machiulskiene V, Baelum V . Construct and predictive validity of clinical caries diagnostic criteria assessing lesion activity. J Dent Res 2003; 82: 117–122.

    PubMed  Article  Google Scholar 

  12. 12

    Banting D W . The diagnosis of root caries. J Dent Educ 2001; 65: 991–996.

    PubMed  Google Scholar 

  13. 13

    Young D A, Nový B B, Zeller G G, Hale R, Hart T C, Truelove E L . The American Dental Association Caries Classification System for clinical practice: a report of the American Dental Association Council on Scientific Affairs. J Am Dent Assoc 2015; 146: 79–86.

    PubMed  Article  Google Scholar 

  14. 14

    Lunder N, von der Fehrb F R . Approximal Cavitation Related to Bite-Wing Image and Caries Activity in Adolescents. Caries Res 1996; 30: 143–147.

    PubMed  Article  Google Scholar 

  15. 15

    Pitts N B, Rimmer P A . An in vivo Comparison of Radiographic and Directly Assessed Clinical Caries Status of Posterior Approximal Surfaces in Primary and Permanent Teeth. Caries Res 1992; 26: 146–152.

    PubMed  Article  Google Scholar 

  16. 16

    Gao X, Lo E C, Kot S C, Chan K C . Motivational Interviewing in Improving Oral Health: A Systematic Review of Randomized Controlled Trials. J Periodontol 2014; 85: 426–437.

    PubMed  Article  Google Scholar 

  17. 17

    Resnicow K, McMaster F . Motivational Interviewing moving from why to how with autonomy support. Int J Behav Nutr Phys Act 2012; 9: 1–9.

    Article  Google Scholar 

  18. 18

    Brad Lundahl and Brian L. Burke . The Effectiveness and Applicability of Motivational Interviewing: A Practice-friendly Review of Four Meta-Analyses. J Clin Psychol 2009: 65: 1232–1245.

    Article  Google Scholar 

  19. 19

    Clarkson J E, Amaechi B T, Ngo H, Bonetti D . Recall, Reassessment and Monitoring; In Pitts N B (editor): Detection, Assessment, Diagnosis and Monitoring of Caries. Monogr Oral Sci; 21. Basel: Karger, 2009.

    Google Scholar 

  20. 20

    National Institute for Clinical Excellence (NICE): Guide on dental recall: recall interval between routine dental examinations. Clinical guideline 19. 2004. Available at https://www.nice.org.uk/guidance/CG19 (accessed November 2016).

  21. 21

    Amaechi B T, van Loveren C . Fluorides and Non-fluoride Remineralization Systems. In van Loveren C. Toothpastes. Monogr Oral Sci; 23. Basel: Karger, 2013

    Google Scholar 

  22. 22

    Zero D T . Dentifrices, mouthwashes, and remineralization/caries arrestment strategies. BMC Oral Health 2006; 6 (Suppl 1): S9.

    PubMed  PubMed Central  Article  Google Scholar 

  23. 23

    Biesbrock A R, Faller R V, Bartizek R D, Court L K, McClanahan S F . Reversal of incipient and radiographic caries through the use of sodium and stannous fluoride dentifrices in a clinical trial. J Clin Dent 1998; 9: 5–10.

    PubMed  PubMed Central  Google Scholar 

  24. 24

    Lippert F . Mechanistic observations on the role of the stannous ion in caries lesion deand remineralization. Caries Res 2016; 50: 378–382.

    PubMed  Article  PubMed Central  Google Scholar 

  25. 25

    ten Cate J M, Arends J . Remineralization of artificial enamel lesions in vitro: III. A study of the deposition mechanism. Caries Res 1980; 14: 351–358.

    PubMed  Article  PubMed Central  Google Scholar 

  26. 26

    Fontana M, Platt J A, Eckert G J et al. Monitoring of sound and carious surfaces under sealants over 44 months. J Dent Res 2014; 93: 1070–1075.

    PubMed  PubMed Central  Article  Google Scholar 

  27. 27

    Mertz-Fairhurst E J, Curtis J W Jr, Ergle J W, Rueggeberg F A, Adair S M . Ultraconservative and cariostatic sealed restorations: results at year 10. J Am Dent Assoc 1998; 129: 55–66.

    PubMed  Article  PubMed Central  Google Scholar 

  28. 28

    Handelman S . Effect of sealant placement on occlusal caries progression. Clin Prev Dent 1982; 4: 11–16.

    PubMed  PubMed Central  Google Scholar 

  29. 29

    Mertz-Fairhurst E, Schuster G, Fairhurst C . Arresting caries by sealants: Results of a clinical study. J Am Dent Assoc 1986; 112: 194–197.

    PubMed  Article  PubMed Central  Google Scholar 

  30. 30

    Griffin S O, Oong E, Kohn W, Vidakovic B, Gooch B F . CDC Dental Sealant Systematic Review Work Group. The effectiveness of sealants in managing caries lesions. J Dent Res 2008; 87: 169–174.

    Article  Google Scholar 

  31. 31

    Oong E M, Griffin S O, Kohn W G, Gooch B F, Caufield P W . The effect of dental sealants on bacteria levels in caries lesions. a review of the evidence. J Am Dent Assoc 2008; 139: 271–278.

    PubMed  Article  Google Scholar 

  32. 32

    Beauchamp J, Caufield P W, Crall J J et al. Evidence-based clinical recommendations for the use of pit and fissure sealants: a report of the American Dental Association Council on Scientific Affairs. J Am Dent Assoc 2008; 139: 257–268.

    PubMed  Article  Google Scholar 

  33. 33

    Gooch B F, Griffin S O, Grey S K et al. Preventing dental caries through school-based sealant programmes: updated recommendations and reviews of evidence. J Am Dent Assoc 2009. 140: 1356–1365.

    PubMed  Article  Google Scholar 

  34. 34

    Tellez M, Grey L, Grey S, Lim S, Ismail A I . Sealants and dental caries: dentists' perspectives on evidence-based recommendations. J Am Dent Assoc 2011; 142: 1033–1040.

    PubMed  Article  Google Scholar 

  35. 35

    Ahovuo-Saloranta A, Forss H, Walsh T et al. Sealants for preventing dental decay in the permanent teeth. Cochrane Database Syst Rev 2013; 3: CD001830.

    Google Scholar 

  36. 36

    Mickenautsch S, Yengopal V . Validity of sealant retention as surrogate for caries prevention: a systematic review. PLoS ONE 2013; 8: e77103.

    PubMed  PubMed Central  Article  Google Scholar 

  37. 37

    Handelman S, Washburn F, Wopperer P . Two-year report of sealant effect on bacteria in dental caries. J Am Dent Assoc 1976; 93: 967–970.

    PubMed  PubMed Central  Article  Google Scholar 

  38. 38

    Handelman S L . Microbiologic aspects of sealing carious lesions. J Prev Dent 1976; 3: 29–32.

    PubMed  PubMed Central  Google Scholar 

  39. 39

    Fujimoto Y, Iwasa M, Murayama R, Miyazaki M, Nagafuji A, Nakatsuka T . Detection of ions released from SPRG fillers and their modulation effect. Dent Mat J 2010; 29: 392–397.

    Article  Google Scholar 

  40. 40

    Suzuki N, Yoneda M, Haruna K et al. Effects of SPRG eluate on oral biofilm and oral malodour. Arch Oral Biol 2014; 59: 407–413.

    PubMed  Article  Google Scholar 

  41. 41

    Yoneda M, Suzuki N, Hirofuji T . Antibacterial Effect of Surface Pre-Reacted Glass Ionomer Filler and Eluate–Mini Review. Pharm Anal Acta 2015; 6: 349.

    Google Scholar 

  42. 42

    Ito S, Iijima M, Hashimoto M, Tsukamoto N, Mizoguchi I, Saito T . Effects of surface pre-reacted glass-ionomer fillerson mineral induction by phosphoprotein. J Dent 2011; 39: 72–79.

    PubMed  Article  Google Scholar 

  43. 43

    Seppa L, Hausen H, Tuutti H, Luoma H . Effect of a sodium fluoride varnish on the progress of initial caries lesions. Scand J Dent Res 1983; 91: 96–98.

    PubMed  Google Scholar 

  44. 44

    Autio-Gold J T, Courts F . Assessing the effect of fluoride varnish on early enamel carious lesions in the primary dentition. J Am Dent Assoc 2001; 132: 1247–1253.

    PubMed  Article  Google Scholar 

  45. 45

    Weinstein P, Domoto P, Koday M, Leroux B . Baby Bottle Tooth Decay. Results of a promising open trial to prevent baby bottle tooth decay: A fluoride varnish study. J Dent Child 1994; 61: 338–341.

    Google Scholar 

  46. 46

    Autio J, Courts F . Effect of fluoride varnish on caries progression. J Dent Res 2000; 79: 143–628.

    Article  Google Scholar 

  47. 47

    Peyron M, Matsson L, Birkhed D . Progression of approximal caries in primary molars and the effect of Duraphat treatment. ScandJ Dent Res 1992; 100: 314–318.

    Google Scholar 

  48. 48

    Fure S, Lingstrom P . Evaluation of different fluoride treatments of initial root carious lesions in vivo. Oral Health Prev Dent 2009; 7: 147–154.

    PubMed  Google Scholar 

  49. 49

    Schaeken M J, Keltjens H M, Van Der Hoeven J S . Effects of fluoride and chlorhexidine on the microflora of dental root surfaces and progression of root-surface caries. J Dent Res 1991; 70: 150–153.

    PubMed  Article  Google Scholar 

  50. 50

    Emilson C G, Ravald N, Birkhed D . Effects of a 12-month prophylactic programme on selected oral bacterial populations on root surfaces with active and inactive carious lesions. Caries Res 1993; 27: 195–200.

    PubMed  Article  PubMed Central  Google Scholar 

  51. 51

    Gluzman R, Katz R V, Frey B J, McGowan R . Prevention of root caries: a literature review of primary and secondary preventive agents. Spec Care Dentist 2013; 33: 133–140.

    PubMed  PubMed Central  Article  Google Scholar 

  52. 52

    Hawkins R, Noble J, Locker D et al. A comparison of the costs and patient acceptability of professionally applied topical fluoride foam and varnish. J Public Health Dent 2004; 64: 106–110.

    PubMed  Article  PubMed Central  Google Scholar 

  53. 53

    Seppa L . Effect of dental plaque on fluoride uptake by enamel from sodium fluoride varnish in vivo. Caries Res 1983; 17: 71–75.

    PubMed  Article  Google Scholar 

  54. 54

    Seppä L . Effects of a sodium fluoride solution and a varnish with different fluoride concentrations on enamel remineralization in vitro. Scand J Dent Res 1988; 96: 304–309.

    PubMed  Google Scholar 

  55. 55

    Seppä L, Pöllänen L, Hausen H . Caries-preventive effect of fluoride varnish with different fluoride concentrations. Caries Res 1994; 28: 64–67.

    PubMed  Article  Google Scholar 

  56. 56

    Oogard B . The cariostatic mechanism of fluoride. Compendium 1999; 20: 10–17.

    Google Scholar 

  57. 57

    Oogard B, Seppa L, Rolla G . Professional topical fluoride applications – clinical efficacy and mechanism of action. Ad Dent Res 1994; 8: 190–201.

    Article  Google Scholar 

  58. 58

    Eakle W S, Featherstone J D, Weintraub J A, Shain S G, Gansky S A . Salivary fluoride levels following application of fluoride varnish or fluoride rinse. Community Dent Oral Epidemiol 2004; 32: 462–469.

    PubMed  Article  Google Scholar 

  59. 59

    Cochrane N J, Reynolds E C . Calcium Phosphopeptides — Mechanisms of Action and Evidence for Clinical Efficacy. Adv Dent Res 2012; 24: 41–47.

    PubMed  Article  Google Scholar 

  60. 60

    Karlinsey R L, Pfarrer A M . Fluoride plus functionalized βTCP: a promising combination for robust remineralization. Adv Dent Res 2012; 24: 48–52.

    PubMed  PubMed Central  Article  Google Scholar 

  61. 61

    Kirkham J, Firth A, Vernals D, Boden N, Robinson C, Shore R C, Brookes S J, Aggeli A . Self-assembling peptide scaffolds promote enamel remineralization. J Dent Res 2007; 86: 426–430.

    PubMed  Article  PubMed Central  Google Scholar 

  62. 62

    Lv X, Yang Y, Han S, Li D, Tu H, Li W, Zhou X, Zhang L . Potential of an amelogenin based peptide in promoting reminerlization of initial enamel caries. Arch Oral Biol 2015; 60: 1482–1487.

    PubMed  Article  PubMed Central  Google Scholar 

  63. 63

    Brunton P A, Davies R P, Burke J L et al. Treatment of early caries lesions using biomimetic self-assembling peptidesa clinical safety trial. Br Dent J 2013; 215: E6: 741–746.

    Article  Google Scholar 

  64. 64

    Silvertown J D, Wong B P, Sivagurunathan K S, Abrams S H, Kirkham J, Amaechi B T . Remineralization of natural early caries lesions in vitro by P11–14 monitored with photothermal radiometry and luminescence. J Investig Clin Dent 2017 10.1111/jicd.12257.

  65. 65

    Mei M L, Chu C H, Lo E C M, Samaranayake L P . Fluoride and silver concentrations of silver diammine fluoride solutions for dental use. Int J Paediatr Dent 2013; 23: 279–285.

    PubMed  Article  PubMed Central  Google Scholar 

  66. 66

    Rosenblatt A, Stamford T C M, Niederman R . Silver diamine fluoride: a caries silver-fluoride bullet. J Dent Res. 2009; 88: 116–125.

    PubMed  Article  PubMed Central  Google Scholar 

  67. 67

    Horst J A, Ellenikiotis H, Milgrom P L . UCSF Protocol for Caries Arrest Using Silver Diamine Fluoride: Rationale, Indications and Consent. J Calif Dent Assoc 2016; 44: 16–28.

    PubMed  PubMed Central  Google Scholar 

  68. 68

    Mei M L, Ito L, Cao Y, Li Q L, Lo E C M, Chu C H . Inhibitory effect of silver diamine fluoride on dentine demineralisation and collagen degradation. J Dent 2013; 41: 809–817.

    PubMed  Article  PubMed Central  Google Scholar 

  69. 69

    Knight G M, McIntyre J M, Craig G G, Mulyani, Zilm P S, Gully N J . Inability to form a biofilm of Streptococcus mutans on silver fluorideand potassium iodide-treated demineralized dentin. Quintessence Int 2009; 40: 155–161.

    PubMed  PubMed Central  Google Scholar 

  70. 70

    Chu C H, Lo E C, Lin H C : Effectiveness of silver diamine fluoride and sodium fluoride varnish in arresting dentin caries in Chinese pre-school children. J Dent Res 2002; 81: 767–770.

    PubMed  Article  Google Scholar 

  71. 71

    Zhi Q H, Lo E C M, Lin H C . Randomized clinical trial on effectiveness of silver diamine fluoride and glass ionomer in arresting dentine caries in preschool children. J Dent. 2012; 40: 962–967.

    PubMed  Article  Google Scholar 

  72. 72

    Mei L, Lo ECM & Chu CH . Clinical use of silver diamine fluoride in dental treatment. Compendium 2016; 37: 93–98.

    PubMed  Google Scholar 

  73. 73

    Llodra J C, Rodriguez A, Ferrer B, Menardia V, Ramos T, Morato M . Efficacy of silver diamine fluoride for caries reduction in primary teeth and first permanent molars of schoolchildren: 36-month clinical trial. J Dent Res 2005; 84: 721–724.

    PubMed  Article  Google Scholar 

  74. 74

    Tan H P, Lo E C M, Dyson J E, Luo Y, Corbet E F . A randomized trial on root caries prevention in elders. J Dent Res. 2010; 89: 1086–1090.

    PubMed  Article  Google Scholar 

  75. 75

    Zhang W, McGrath C, Lo E C M, Li J Y . Silver diamine fluoride and education to prevent and arrest root caries among community-dwelling elders. Caries Res 2013; 47: 284–290.

    PubMed  Article  Google Scholar 

  76. 76

    LI R, Lo E C M, Liu B, Wong MCM, Chu CH . Randomized clinical trial on arresting dental root caries through silver diammine fluoride applications in community-dwelling elders. J Dent 2016; 51: 15–20.

    PubMed  Article  Google Scholar 

  77. 77

    Yee R, Holmgren C, Mulder J, Lama D, Walker D, van Palenstein Helderman W : Efficacy of silver diamine fluoride for arresting caries treatment. J Dent Res 2009; 88: 644–647.

    PubMed  Article  Google Scholar 

  78. 78

    Mei L, ZHAO S, ITO L, Lo ECM & Chu CH . Prevention of secondary caries by silver diamine fluoride. Int Dent J 2016; 66: 71–77.

    PubMed  Article  Google Scholar 

  79. 79

    Chu C H, Lo E C M . Promoting caries arrest in children with silver diamine fluoride: a review. Oral Health Prev Dent 2008; 6: 315–321.

    PubMed  Google Scholar 

  80. 80

    GAO S, ZHAO S, Hiraishi N, Duangthip D, Mei L, Lo ECM & Chu CH . Clinical Trials of Silver Diamine Fluoride in Arresting Caries among Children: A Systematic Review. JDR Clin Transl Res 2016; 1: 201–210.

    Article  Google Scholar 

  81. 81

    Shimizu A, Kawagoe M . A clinical study of effect of diamine silver fluoride on recurrent caries. J Osaka Univ Dent Sch 1976; 16: 103–109.

    Google Scholar 

  82. 82

    Li R, Lo E C M, Liu B Y, Wong M C M, Chu C H . Randomized clinical trial on preventing root caries in community-dwelling elders. JDR Clin Transl Res 2017; 2: 66–72.

    Article  Google Scholar 

  83. 83

    Craig G G . Clinical evaluation of a diamine silver fluoride/potassium iodide as a dentine desensitizing agent: 2 year follow-up. Aust Dent J. 2012; 57: 308–11

    PubMed  Article  Google Scholar 

  84. 84

    Knight G M, McIntyre J M, Craig G G . Ion uptake into demineralized dentine from glass ionomer cement following pretreatment with silver fluoride and potassium iodide. Aust Dent J 2006; 51: 237–241.

    PubMed  Article  Google Scholar 

  85. 85

    Caufield P W, Navia J M, Rogers A M, Alvarez C . Effect of topically-applied solutions of iodine, sodium fluoride, or chlorhexidine on oral bacteria and caries in rats. J Dent Res 1981; 60: 927–932.

    PubMed  Article  Google Scholar 

  86. 86

    Yamazaki H, Margolis H C . Enhanced Enamel Remineralization under Acidic Conditions in vitro. J Dent Res 2008; 87: 569–574.

    PubMed  Article  Google Scholar 

  87. 87

    Tavss E A, Mellberg J R, Joziak, M, Gambogi R J, Fisher S W . Relationship between dentifrice fluoride concentration and clinical caries reduction. Am J Dent 2003; 16: 369–374.

    PubMed  Google Scholar 

  88. 88

    American Dental Association Council on Scientific Affairs. Professionally applied topical fluoride: evidence-based clinical recommendations. J Am Dent Assoc 2006; 137: 1151–1159.

  89. 89

    Baysan A, Lynch E, Ellwood R, Davies R, Petersson L, Borsboom P . Reversal of primary root caries using dentifrices containing 5: 000 and 1: 100 ppm fluoride. Caries Res 2001; 35: 41–46.

    PubMed  PubMed Central  Article  Google Scholar 

  90. 90

    Stookey G K, Mau M S, Isaacs R L, Gonzalez-Gierbolini C, Bartizek R D, Biesbrock A R . The relative anticaries effectiveness of three fluoride-containing dentifrices in Puerto Rico. Caries Res 2004; 38: 542–550.

    PubMed  Article  PubMed Central  Google Scholar 

  91. 91

    Biesbrock A R, Gerlach R W, Bollmer B W, Faller R V, Jacobs S A, Bartizek R D . Relative anti-caries efficacy of 1100; 1700: 2200, and 2800 ppm fluoride ion in a sodium fluoride dentifrice over 1 year. Community Dent Oral Epidemiol 2001; 29: 382–389.

    PubMed  Article  PubMed Central  Google Scholar 

  92. 92

    Bartizek R D, Gerlach R W, Faller R V, Jacobs S A, Bollmer B W, Biesbrock A R . Reduction in dental caries with four concentrations of sodium fluoride in a dentifrice: a meta-analysis evaluation. J Clin Dent 2001; 12: 57–62.

    PubMed  PubMed Central  Google Scholar 

  93. 93

    Nordström A, Birkhed D . Preventive effect of high-fluoride dentifrice (5: 000 ppm) in caries-active adolescents: a 2year clinical trial. Caries Res 2010; 44: 323–331.

    PubMed  Article  PubMed Central  Google Scholar 

  94. 94

    Ekstrand K, Martignon S, Holm-Paedersen P . Development and evaluation of two root caries controlling programmes for home-based frail people older than 75 years. Gerodontology 2008; 25: 67–75.

    PubMed  Article  PubMed Central  Google Scholar 

  95. 95

    Cross K J, Huq N L, Palamara J E, Perich J W, Reynolds E C . Physicochemical characterization of casein phosphopeptide-amorphous calcium phosphate nanocomplexes. J Biol Chem 2005; 280: 15, 362–315, 369.

    Article  Google Scholar 

  96. 96

    Cochrane N J, Cai F, Huq N L, Burrow M F, Reynolds E C . New approaches to enhanced remineralization of tooth enamel. J Dent Res 2010; 89: 1187–1197.

    PubMed  Article  PubMed Central  Google Scholar 

  97. 97

    ten Cate J M, Cummins D . Fluoride Toothpaste Containing 1.5% Arginine and Insoluble Calcium as a New Standard of Care in Caries Prevention. J Clin Dent 2013; 24: 79–87.

    PubMed  PubMed Central  Google Scholar 

  98. 98

    Lynch E, Brauer D S, Karpukhina N, Gillam D G, Hill R G . Multi-component bioactive glasses of varying fluoride content for treating dentin hypersensitivity. Dent Mater 2012; 28: 168–178.

    PubMed  Article  Google Scholar 

  99. 99

    Mneimne M, Hill R G, Bushby A J, Brauer D S . High phosphate content significantly increases apatite formation of fluoride-containing bioactive glasses. Acta Biomater 2011; 7: 1827–1834.

    PubMed  Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to B. T. Amaechi.

Additional information

Refereed Paper

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Amaechi, B. Remineralisation – the buzzword for early MI caries management. Br Dent J 223, 173–182 (2017). https://doi.org/10.1038/sj.bdj.2017.663

Download citation

Further reading

Search

Quick links