Enamel performs the most important barrier function, protecting the softer parts of the tooth from mechanical damage and the penetration of bacteria. But despite its hardness, it is quite vulnerable, in addition, the strength of the protective layer is uneven – in the cervical part of the tooth, it is much thinner.
In addition, there is a dangerous factor that impedes the fulfillment of the protective mission of enamel – its demineralization, that is, the loss of a part of the necessary minerals and salts by the hard tissue, due to which its structure is disturbed.
Fortunately, modern dentistry includes a procedure for remineralization of thinned enamel, which contributes to its restoration at the initial stage of pathology.
Reasons For Enamel Demineralization
Most often, the cause of demineralization is the contact of enamel with acids that destroy it. In part, they get into the oral cavity with food and drinks, but bacteria are the ones that contribute to the increased acidity to the greatest extent. Microorganisms in the process of their vital activity secrete acids that constantly cover the enamel, thinning it. A favorable condition for the development and reproduction of pathogenic microflora is the presence of a nutrient medium – dental plaque. Therefore, insufficient hygiene is most often and leads to damage to the teeth.
Unfortunately, regular cleaning of the oral cavity is not always reliable protection against demineralization, since it can be provoked by improper nutrition, as well as changes in metabolism.
The most common causes of demineralization are:
- Insufficient hygiene – if cleaning is performed irregularly (less than 2 times a day) or not for long enough (less than 2 minutes). Negligence of rinsing after each meal or not using dental floss when food particles get into the spaces between your teeth can also cause bacteria to grow.
- Unbalanced nutrition – the predominance of foods with a high content of carbohydrates in the diet, as well as a lack of minerals.
- Excessive consumption of acidic foods. These include not only lemons or sour apples, but also many carbonated drinks.
- Changes in metabolism due to natural causes – pregnancy, adolescence, or conversely, “solid” age.
- Changes in metabolism due to any disturbances in the body. These can include both hormonal disruptions and more serious diseases (diabetes, etc.).
- The presence of prostheses or braces – if, when wearing them, oral hygiene is not carefully observed.
- Defects in the bite or structure of the dentition.
- Bad habits.
- Whitening of enamel.
Demineralization can also occur after teeth whitening. Often, the damage is caused by a poorly performed procedure or careless adherence to the rules of patient behavior after it. But since whitening is still “stress” for the enamel, different factors can become the reason for thinning. For example, for this reason, whitening is contraindicated in pregnancy, when the body lacks calcium.
Typically, demineralization precedes damage to the dental crown – the primary stage of caries – which can soon develop into deep caries. Fortunately, at the time noticed the problem, you can prevent the damage by means of enamel remineralization.
It is far from always possible to detect the pathology on its own before the appearance of a carious spot. Therefore, it is so important to regularly check with the dentist, since the doctor during the examination will help to identify the presence of thinning and prescribe Dental Remotherapy, thus avoiding more serious intervention. Even if carious darkening has already appeared, it is still possible to restore the enamel without filling. The main thing is to identify the problem as soon as possible.
Description of the Teeth Remineralization Method
Remineralization of teeth is the artificial saturation of the enamel with important microelements. Thanks to this procedure, hard tissues are strengthened, the sensitivity of the teeth is reduced and the formation of caries is prevented.
The therapy consists of applying enamel preparations containing the necessary substances: calcium, magnesium, phosphorus, and fluorine. The agent is kept on the teeth for a certain time to allow microelements to penetrate through the micro-holes in the enamel and fill them. Electrophoresis can be used to speed up the process. Before the first procedure makes oral sanitation.
Remineralization is necessarily carried out by a course, which it is advisable to repeat periodically. Such supportive therapy promotes the restoration of thinned enamel and long-term preservation of the health of one’s own teeth.
Preparations and agents for mineralization
To remineralize the surface of the teeth, preparations with fluoride, calcium, magnesium, and phosphorus are used, although in some cases fluoride-containing agents can be dispensed with.
Typically, drugs for Remotherapy include:
- Fluorinated varnish.
- Remadent (powder).
- ROCS (gel form).
- A solution with high mineral content.
- Fluorinated discs.
For dental care after remineralization, a paste with a high content of microelements is recommended. You should also choose the right mouthwash and floss to maintain hygiene throughout the day between brushings.
Types of Remotherapy Technique
Remineralizing therapy can be common. In this case, it includes, in addition to changing the lifestyle and diet, a long course of taking vitamin and mineral complexes, which can stretch (taking into account breaks) for a year.
In contrast, local remineralization takes 15–20 procedures. The main thing is to do them regularly: every day, at most every other day.
The procedure of Remotherapy in dentistry consists of the “impregnation” of the enamel with a special preparation. Methods differ from each other only in the way the nutrient is applied.
The drug can be applied using:
- Electrophoresis – the introduction of funds using an electric current.
- Applications – the imposition of a useful composition on the teeth.
The electrophoresis apparatus delivers the agent into the tooth enamel due to the effect of weak impulses of electric current, which ensure the successful penetration of substances.
Applications are made in two ways. The first method involves the application of strips of cloth (gauze) or elastic film soaked in the medicine. The second is the use of special mouth guards, which are removable silicone structures, on the inner surface of which the drug is applied.
The latter method is convenient for the patient since with the help of mouthguards, you can do remineralization yourself at home. The doctor should start treatment since it is he who assesses the situation, sanitizes the oral cavity, selects the method of therapy, the remedy, and makes the first procedure. Thereafter, he can instruct the patient to regularly make restoration “masks” for the teeth himself. The dentist will also advise on which toothpaste and rinse to use during remineralization.
Advantages and Disadvantages
- Safety of the procedure.
- Restoration of the integrity of the enamel.
- Decreased tooth sensitivity.
- Prevention of the development of diseases at an early stage.
- Convenience for the patient – often after the first procedure, you can continue the course of treatment yourself.
Remineralization is also prescribed for children since the condition of milk teeth largely determines whether permanent teeth will be healthy. Remotherapy can be indicated during pregnancy and lactation – during this period, the body spends many trace elements, including calcium.
Remotherapy is indicated only at the very beginning of the disease. The result, like the choice of funds, depends on the individual characteristics of the organism. Enamel is saturated with minerals only after its complete cleansing and sanitation. That is, a stone, plaque, as well as areas affected by caries, are removed from it. But if caries have penetrated deeply and when removing infected tissues, the integrity of the surface will have to be violated, then only filling will be the way out. When choosing methods and means, the doctor should know about the personal characteristics of the patient’s body.
For example, if the use of fluoride is contraindicated, then you will have to select funds without its content, the effect of which may be slightly different.
In addition, the result of treatment largely depends on the state of health, metabolism, and even age. In some patients, the effect may be strong, while in others it may be weaker. A relative disadvantage can be considered a ban on eating within 2 hours after the Remotherapy procedure. But this can hardly be called a drawback, but rather a slight inconvenience.
Indications and Contraindications
Remotherapy is often used in dentistry, it belongs to the category of therapeutic and prophylactic procedures, therefore it has almost no contraindications.
Usually, remineralization is prescribed by a doctor in the following cases:
- Detection of demineralization symptoms – changes in the color and roughness of the enamel.
- The initial stage of caries is when there is already a change in the color of the enamel, but there is no damage yet.
- The high sensitivity of enamel to hot, cold, and sweet foods.
- Increased plaque formation.
- Microtrauma to the enamel due to exposure to substances or mechanical damage.
- The need to restore enamel after whitening or removing the tartar.
- Planning the installation of the orthodontic system.
- Periods of special need of the body for minerals.
Periods of special need for minerals usually occur during hormonal surges:
in adolescence, during pregnancy, as well as during the onset and course of menopause. During breastfeeding, a woman also needs teeth mineralization, as she spends a lot of essential substances for milk production.
Remineralization is such a safe procedure that it has practically no contraindications, except for intolerance to the drug’s ingredients. For example, the patient may have contraindications to the use of fluoride, which is often included in formulations for remineralizing the surface of the teeth. It promotes the production of dentin, slows down the growth of bacteria, and the formation of a protective film on the enamel. But sometimes the use of fluoride is undesirable due to its excess in the body or the presence of certain disturbances in the functioning of systems. In such cases, the doctor can choose therapy agents containing
- Calcium, and
- Magnesium, but without fluoride.
Execution Technology in Dentistry
Before Remotherapy, the oral cavity is usually sanitized, during which tartar and plaque are removed with ultrasound or sandblasting machine, existing inflammations are treated to eliminate foci of infection.
The next stage of preparation for the remineralization of enamel is its drying since, in order to assimilate the mineral composition, it is required to apply it to a dry surface.
After that, a remedy is applied to the prepared teeth, which includes calcium, phosphorus, and magnesium. The solution saturated with trace elements is kept on the enamel for up to 20 minutes, then it is coated with a composition containing sodium fluoride to protect against caries and harmful environmental influences.
Dental Remotherapy is carried out in a course that includes 10–20 procedures. The doctor may prescribe a daily treatment or every other day. The number and frequency of sessions depend on the initial state of the patient’s enamel and the characteristics of his body.