Dentistry >>>> Demineralization of teeth - causes and prevention

Demineralization of teeth - causes and prevention.

The hard tissues of the tooth are formed by enamel, dentin and cementum. Dentin is a type of connective tissue that has much in common with bone tissue in terms of morphology and chemical structure. Dentin mineralization is significantly higher than bone mineralization. Like bone tissue, dentin has cellular structures immersed in the main substance - hydroxyapatite, but the cellular inclusions in dentin are odontoblasts. The main substance of dentine is 70% inorganic compounds (calcium hydroxyapatite) plus 10% water and residual minerals in microscopic doses.

In the dentin of a formed tooth, there is a zone of pre-dentin (secondary dentin), which does not undergo calcification (mineralization). Secondary dentin is formed at the time of the eruption of a tooth and is postponed throughout life, but tends to sharply increase its formation at the time of tooth injury (abrasion, caries, erosion, mechanical damage). This is a protective reaction of the tooth to irritants, but unfortunately, predentin does not replenish the mineral structure of the tooth, since it does not have mineral components (calcium salts).

The hardness of cement is slightly lower than dentin, since it is only 66% formed by inorganic substances (phosphate salts and calcium carbonate).

Tooth enamel is much harder than dentin and has no odontoblast cell inclusions. The increased hardness of enamel is provided by its almost complete composition of inorganic compounds: 96% minerals (octalcium phosphate, apatite crystals - hydroxyapatite, carbonapatite, chlorapatite, fluorapatite). Molecules containing calcium and phosphorus atoms have different ratios of these elements. This is due to the fact that calcium in the hydroxyapatite molecule tends to be replaced by other elements: chromium, barium, magnesium, fluorine and other elements.

Fluorine is of particular importance for tooth enamel strengthening, since in the case of replacement of calcium with fluorine ions, hydroxyapatite increases the resistance to dissolution and demineralization of tooth tissues. But if, in percentage terms, fluorine atoms begin to predominate in the composition of hydroxyapatite over calcium atoms (that is, hydroxyfluoroapatites predominate), the disease develops fluorosis, which changes the color of the teeth, leading to the destruction of enamel and its destruction. Fluoride is normally useful for strengthening tooth enamel, and in excess it has a destructive effect.

The processes of tooth demineralization (a decrease in the mineral components of enamel, dentin, cement) have the same reasons as the demineralization of bone tissue. They are associated with metabolic disorders and a decrease in the consumption of mineral components useful for tooth tissues.

Food and water, insufficiently enriched with calcium, phosphorus, magnesium, fluorine, will lead to a decrease in the supply of microelements to the tooth structure. But here a balance must be observed, since it was noticed that an excess of fluoride in water harms the hard structures of the tooth, as described above, and fluorides supplied with food are less well absorbed by the body. Calcium-containing compounds are needed by the body exclusively normally, since their excessive amount can lead to hypercalcemia and (calcification , and the deficiency will result in hypocalcemia, hypophosphatemia.

Violation of the metabolism of trace elements (calcium, phosphorus, etc.) can take place at different levels:

impaired absorption of compounds in the intestine,
violation of food digestion (dysbiosis, celiac disease),
functional disorders of the digestive process,
insufficient activity of catalysts (enzymes) that increase the absorption of mineral compounds,
acquired or congenital diseases of the endocrine system, incorrectly regulating metabolic processes in the body through hormones.

Therefore, preventive and therapeutic measures to prevent and inhibit the processes of tooth demineralization should include several areas:

Diagnostics and correction of endocrine disorders,
Treatment of chronically ongoing gastrointestinal diseases,
Analysis of the state of the body, taking into account the presence or absence of a complete set of trace elements and vitamins necessary for the full functioning of the body,
Changing the diet towards an increase in products containing the necessary substances for building hard tooth tissues,
High-quality dental care, which prevents the development of caries and depulpation of the tooth, since with the depulpation of the tooth, its trophism (nutrition) stops, and therefore the supply of the components necessary for the tooth.