Shayegan, A., Arab, S., Makanz, V. M., & Safavi, N. (2024). Comparative evaluation of remineralizing efficacy of calcium sodium phosphosilicate, ginger, turmeric, and fluoride. Dental research journal, 21, 55.
Background
Dental enamel consists mostly of calcium hydroxyapatite crystals. Dental caries occurs when the intraoral pH falls below the optimum range, for enamel this is a pH less than 5.5. At this pH, demineralisation of the enamel occurs and this can lead to the formation of a white spot lesion. White spot lesions are the earliest sign of dental caries however, they are reversible through good oral hygiene and good diet habits. Many other materials can assist in the remineralisation of the enamel such as fluoride and calcium sodium phosphosilicate. Natural substances like turmeric, cocoa, ginger and grape seed can also assist in enamel remineralisation. The aim of this study was to evaluate the potential remineralizing effect of calcium sodium phosphosilicate, ginger, and turmeric.
Methods
This in vitro study used 35 extracted human teeth and compared the effectiveness of different substances in promoting remineralisation of the enamel. The substances compared include calcium sodium phosphosilicate toothpaste, fluoride toothpaste, vegan toothpaste, turmeric powder, ginger powder, fluoride varnish and distilled water (control). The teeth were all permanent molars and they selected to be without carious lesions, fractures, white spots, or surface irregularities. A surface of 3mm x 3mm of enamel was taken from the treth and left to undergo demineralisation/ remineralisation treatments. The samples were placed in a demineralisation solution with a pH of 4.4 for 7 days at 37°C and then given their remineralisation treatment (applied twice daily, 2 minutes for 10 days). Results were assessed using quantitative photo-induced fluorescence (QLF) testing which detected the depth of the lesion.
Results
Solutions with the highest statistical significance were turmeric and enamelast fluoride varnish (P < 0.0001), and calcium sodium phosphosilicate toothpaste (Sensodyne Repair & Protect), (P < 0.01). Figure 1 shows the effectiveness of each remineralisation treatment.
Figure 1: Graphs showing the effect of each solution by comparing before demineralisation (PD), after demineratlisation (DEM) and after remineralisation (REM).
Conclusion
The results of this study shows that different materials can be effective in remineralising white spot lesions, particularly calcium sodium phosphosilicate, fluoride and turmeric. Calcium sodium phosphosilicate toothpaste showed greater remineralisation compared to standard fluoride toothpaste even though both contained the same amount of fluoride (1450 ppm). There was no statistically significant difference between the standard fluoride toothpaste and vegan toothpaste which shows that calcium sodium phosphosilicate combined with fluoride may be more crucial in remineralisation than fluoride alone. Turmeric showed a greater statistical significance than fluoride varnish (22, 600 ppm fluoride) showing greater remineralisation potential. Overall, these results show the variety of substances which can be used to promote remineralisation and the use of natural substances should be explored more to improve patients oral care and promote preventative practice.
Research Summary Written By: Ishmyne Bhamra, University of Manchester – BDS4