Get to the root cause of cavities

Mineral ions lost during demineralisation can be replaced by the body’s automatic defence mechanism or remineralisation and arginine, an amino acid, has been found to play a crucial role in the teeth remineralisation process, writes Dr Anirban Chatterjee

More than 70% of school children in India are suffering from dental caries (tooth decay) and more than 90% of the adult population is affected by periodontal disease, according to government estimates. As we all know, oral health is extremely important. It impacts not only our ability to eat and speak but also our overall well-being. Even though enamel, or the outermost covering of our teeth is the hardest material in the human body, it is highly vulnerable to the damaging effects of tooth decay, which when not controlled can lead to full-blown decayed enamel and cavities.

It's important to step back and see what’s happening in our mouths on a submicron level to understand what we as adults and more importantly as parents can do for our children to prevent and/or control tooth decay. Contrary to what most people know there are a lot of good bacteria in our mouths that help create a positive pH balance, and our saliva itself helps keep tooth decay in check. The problem arises when the increased intake of sugary foods creates acid in our mouth leading to demineralisation which as the word suggests is a loss of mineral ions out of the hydroxyapatite crystals in enamel. However, mineral ions lost during demineralisation can be replaced by the body’s automatic defence mechanism –
remineralisation.

The amount of demineralisation and remineralisation depends on many variables, including the availability of calcium and phosphate and the pH of saliva. To maintain good dental health, it is essential that the balance between the loss and gain of minerals or the tooth nourishment cycle is optimally maintained. Nearly a decade ago, the scientific community started investigating the benefits of an additional ingredient, called arginine in toothpastes to help achieve this equilibrium. Arginine is an amino acid that has been found to play a crucial role in the teeth remineralisation process.

When combined with calcium and phosphate ions, it forms a protective layer over the teeth, preventing the demineralisation of the enamel. This layer also aids in the tooth nourishment process, making the teeth stronger and more resistant to decay. A study published in the Journal of Clinical Dentistry found that arginine-containing toothpaste reduced the number of cavities in children by 50% compared to regular fluoride toothpaste. Another study published in the same journal found that arginine can help repair enamel defects and improve overall oral health. One of the major benefits of using arginine for tooth nourishment is that it is a natural ingredient. Unlike other products that contain chemicals and artificial substances, arginine is found in nature and is safe to use. It is also synergistic with fluoride, thus aiding remineralisation and making the teeth more resistant to
acid attack.

In addition to its benefits for tooth nourishment, arginine along with fluoride has also been found to have antibacterial properties. It can help eliminate harmful bacteria in the mouth, prevent plaque formation and reduce the risk of gum disease.

Arginine-containing toothpastes have emerged as one of the standards of daily oral care which can attack the root cause of cavities and provide dental nourishment to ensure strong and healthy teeth for years to come.

According to a study, incorporating two percent arginine into the commercially available NaF toothpaste significantly increased its remineralisation properties, as demonstrated by increased mineral gain, percent remineralisation, surface Ca/P ratio with fluorine concentration, and enamel fluoride uptake. In addition, the treatment solution assessment for 2% Arg-NaF showed significantly higher fluoride concentration with neutral pH, acceptable Na-Cl ratio and availability of free amino acids. ( the percentage of arginine in toothpaste if any that can help increase surface microhardness, the repair effect on wear-resistance and nanomechanical properties as the studies on the same are unclear.)

(The author is a Bengaluru-based dentist, periodontist and implantologist.)