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Demineralization and Remineralization


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Demineralization and Remineralization have a vital impact on the strength and hardness of dental enamel.

Demineralization diagramWHAT IS DEMINERALIZATION? Demineralization is the process of removing minerals, in the form of mineral ions, from dental enamel. "Demineralization" is another term for "dissolving the enamel." Dental enamel is a crystalline latticework composed of various minerals, the principal component of which is a complex calcium phosphate mineral called hydroxyapatite ("hi-drox-e-appetite"). A substantial number of mineral ions can be removed from hydroxyapatite latticework without destroying its structural integrity; however, such demineralized enamel transmits hot, cold, pressure and pain much more readily than normal enamel. For example, if you feel something like a toothache, but the dentist says you don't have a cavity, chances are good you are feeling the results of a severely demineralized spot on your tooth that hasn't yet formed a cavity. Your dentist may also tell you that your enamel is soft at that spot, and that s/he can actually penetrate your enamel with a probe. Dentists frequently recommend brushing with a prescription high-dose fluoride gel to retard demineralization. When too many minerals are dissolved from an area of the hydroxyapatite's latticework, you have a cavity. Cavities are the loss of the hydroxyapatite's crystalline latticework structure. Fortunately, the latticework can be strengthened and restored through the process of remineralization.

WHAT IS REMINERALIZATION? Remineralization is the process of restoring minerals - again, in the form of mineral ions - to the hydroxyapatite's latticework structure. Remineralization is like replacing the missing rungs in a rickety ladder to make it strong and stable again - except that remineralization is three-dimensional, and the lost "rungs" (i.e. different mineral ions) must be replaced with "rungs" having the exact same shape, size and the same electrical charge as those lost from the lattice. Both remineralization and demineralization occur on the surface of the tooth. If you examine the cross-section diagram of a tooth, you will see there is no connection between the bloodstream and the enamel. Therefore, taking mineral supplements has virtually no impact on remineralizing the teeth. (It's also worth noting that this is true in reverse too: An event that draws on minerals in the blood, such as pregnancy or healing a broken bone cannot extract minerals from the teeth, as is widely believed.).

WHAT CAUSES DEMINERALIZATION? Strong, stable acids, mostly: To a certain extent, these are found in acid foods, such as tomatoes or oranges; but they're also formed by oral bacteria that feed on starches and sugars in your mouth, especially refined sugars, secreting acids as by-products.

WHY DO STRONG STABLE ACIDS CAUSE DEMINERALIZATION?  Dental enamel is mineral, a "living stone." In your mouth, as in the rest of nature, acids dissolve minerals, transforming them from solid mineral molecules into mineral ions that exist only in solution. Strong stable acids do not break down easily, so very small quantities can keep on dissolving the minerals in your enamel. In the presence of these acids, millions, even billions, of calcium and other mineral ions are removed from the hydroxyapatite latticework. Eventually, the enamel loses its structural integrity.

HOW DOES THE BODY FIGHT DENTAL DEMINERALIZATION?  To counter demineralization, the body had to solve an interesting problem: If dental minerals are only soluble in acids, how can it create replacement mineral ions in a way that also doesn't dissolve enamel, as strong stable acids do? The solution is so elegant, so simple, and so invisible that you don't even realize it's happening! This natural mechanism is enhanced be eating unprocessed foods, rich in minerals, including trace minerals, such as natural and organic foods.

Tooth RemineralizationWHAT IS THIS NATURAL REMINERALIZATION MECHANISM?  Our bodies utilize carbon dioxide from our breath and water from our saliva to create a mild, unstable acid, carbonic acid. Carbonic acid is the heart of the natural remineralization process. Like all acids, carbonic acids can dissolve minerals in our saliva (present from our food); however, unlike strong stable acids, carbonic acid quickly and easily converts to carbon dioxide and water. When this happens, the mineral ions that are dissolved in it precipitate out as solid mineral ions again - but not necessarily as the original mineral molecules: If a particular mineral ion is near a demineralized portion of the hydroxyapatite crystal that requires that ion, the ion is incorporated into the dental enamel! Though natural remineralization is always taking place, the level of activity varies according to conditions in the mouth. In fact, for remineralization to proceed, six conditions or events must occur at the same time:

FIRST, sufficient minerals must be present in the saliva. Since foods are the principal source of minerals for the teeth, an adequate diet, or insufficient time chewing foods (which transfers minerals to the saliva) may result in mineral-poor saliva.

SECOND, a molecule of carbonic acid must be produced. Only a miniscule fraction of the carbon dioxide from the breath is converted to carbonic acid.

THIRD, the carbonic acid molecule must be produced in proximity to a mineral molecule, which it then dissolves into its ionic components.

FOURTH, this all has to occur in proximity to a demineralized spot in the hydroxyapatite latticework that requires that exact mineral ion.

FIFTH, that spot of the tooth has to be clean, so that the mineral-deficient spot is accessible. If it is, then the mineral ion is attracted to the "hole" in the lattice by the opposite electric charges of the ion and the "hole." Many different ions have the correct charge, but only the correct ion has the correct shape and size to fit into the "hole."

FINALLY, the carbonic acid must convert to carbon dioxide and water before any of the above circumstances change! When all this happens, a mineral ion is precipitated out of solution into the structure of the enamel. All mammals (dogs, monkeys, lions, mice, etc.) utilize this same carbonic acid remineralization mechanism. In the wild, animals generally have strong enamel, so we know that with a natural diet, this subtle and invisible process really is able to maintain the strength of enamel! This also indicates that with a pre-modern diet, humans probably also had strong enamel naturally. For strong enamel in today's world, though, the natural remineralization process needs to be augmented.

TODAY, WHY IS NATURAL REMINERALIZATION FREQUENTLY INADEQUATE TO MAINTAIN STRONG ENAMEL?

As you can see, natural remineralization is a pretty "iffy" occurrence. In contrast, demineralization is enormously accelerated by the refined sugars and processed foods in most of our diets. The destruction caused by the strong stable acids abundantly present in our mouths is constant and unremitting.

To restore the body's natural equilibrium, either remineralization must be enhanced or demineralization must be reduced.

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