Remineralization of Teeth

Before going on about remineralization, just what is the mineral part of teeth and how does it get demineralized?

Teeth are made up of four kinds of tissues: pulp, cementum, enamel and dentin. Pulp is the softest, deepest part of the tooth and contains the nerves and blood vessels that bring nutrients to the tooth. Cementum is a hard covering around the pulp down into the roots, and dentin is an inner covering that is also very hard but fills most of the inside rather than outside of the tooth. Enamel crowns the tooth, making up the visible part and adding strength for chewing. Three of the four tooth tissues are hard, but all can be compromised and become worn down or soft and weak. Pulp is already soft, but as long as it's covered, it serves its purpose painlessly and efficiently beneath the harder coatings. Once exposed, however, the network of nerve endings throughout and surrounding the pulp are open to air, liquid and bacteria contact, all of which can cause significant pain.

Cells in the body multiply to form teeth tissues, and the hard parts are made up mostly of minerals. Crystals of calcium phosphates grow close together in a network to form the enamel, and although it is stronger even than bone or concrete, once it starts to break down through acid erosion or injury, it doesn't grow back in its original, hardest enamel form. But in the short term, and as part of the ongoing process mentioned earlier, enamel can retain strength if remineralization keeps happening to neutralize acids and bacteria [source: Madrigal].

Our bodies support remineralizing teeth as long as there are minerals available to send as needed. Saliva carries calcium and phosphates to the sites of demineralization naturally, but the mouth can only compensate so much when it's overcome with bacteria and plaque for too long. Plaque can start to harden on teeth if it's not removed after eating, and when this hardening starts, enamel begins breaking down from the overactive bacteria in the plaque growth. Demineralization then wins out and cavities can run rampant.

When plaque gets out of control, remineralization of the hard tissues below the gum line is affected too, and the risk of gum inflammation and disease increases. Saliva needs to be present and circulating, often through moving the jaw or chewing. Diet, hygiene and overall physical health also impact how well teeth can remineralize and protect themselves naturally. Dry mouth from medications and tooth decay from over-consumption of soda and starchy and sugary foods are just two enemies of remineralization [source: ADA].

If teeth can't remineralize enough to outpace the loss of minerals, can anything be done to regain balance, or do the bad guys in your mouth win? We'll look at some artificial means of remineralizing, next.

Scientists are still working on ways to re-create natural remineralization, and in the not-too-distant-future, technologies for regrowing teeth themselves may even be realized [source: Madrigal]. In the meantime, however, most methods of remineralizing teeth involve enhancing the natural process. Some of these mineral regrowth boosters include:

These three types of products help with remineralization individually or when used together. CPP-ACP, for instance, is used in chewing gums, toothpastes, rinses, dental work compounds (such as those used for filling cavities) and even in milk products.

As with practicing good oral hygiene to prevent tooth and gum problems before they begin, most artificial remineralizing efforts will work best before significant demineralization occurs. Enamel can't be regrown -- yet -- but it can heal itself in moderation if it isn't overwhelmed by bacteria. As much as products can help improve the natural process of remineralization, they can't get very far if damage and wear has turned to decay.

Remineralization can be a lifelong, balanced process with some early intervention and regular maintenance. We'll look remineralization from childhood to old age, next.

Even before a child is born, he can receive stores of calcium and fluoride for tooth health from a mother's diet, or systemically. Although some advocate avoiding fluoride for health reasons, the American Dental Association (ADA) and others promote its use for healthy teeth and gums [source: ADA]. As we grow, regular dental visits and conscientious oral care with topical, or applied fluoride, help keep mouth bacteria at bay and the remineralization process of saliva normalized enough to neutralize day-to-day demineralization. Poor dietary choices, such as consuming a lot of soda, sugary and starchy foods, and sticky teeth-hugging candies and fruits work fast to break down the mineral integrity of enamel. Snacking throughout the day is particularly damaging to teeth, whereas brushing soon after meals and avoiding corrosive foods in between is a good lifelong habit.

Short-term, or acute, illnesses and long-term, or chronic, diseases also affect oral health a great deal, and medications used to combat germs and disease progression often rob the mouth of moisture needed to fight bacteria around the teeth and gums. Whenever dry mouth sets in, saliva can't keep up with bacterial growth and enamel and dentin can break down quickly.

Dry mouth also occurs in some people naturally, and treating this condition with oral or topical treatments may be necessary. Treating it in the short-term may be as simple as chewing sugarless gum, but checking with a dentist no matter the cause or frequency is advisable.

A healthy body is capable of fighting off infection and bacteria, and it keeps body processes in balance in a condition called homeostasis. Our mouths have their own balance of demineralization and remineralization, and keeping this ongoing process in check and neutralized will help keep teeth strong enough to break down foods that benefit the body from the toes up.