From the Guidelines
Gum containing hydroxyapatite can help remineralize tooth enamel but is unlikely to repair established cavities, and its effectiveness is still a subject of ongoing research. Hydroxyapatite is a calcium phosphate mineral that's naturally present in teeth, and when used in gum, it can potentially help replace minerals lost during the early stages of tooth decay (demineralization) 1. However, once a true cavity has formed, creating a hole in the tooth, chewing gum cannot reverse this damage. For remineralization to occur, the tooth structure must still be intact. The process works because hydroxyapatite particles can attach to the tooth surface and fill in microscopic defects in enamel.
Some key points to consider:
- Fluoride is well-established as a key component in preventing and controlling dental caries, and it works by inhibiting demineralization of sound enamel and enhancing the remineralization of demineralized enamel 1.
- While hydroxyapatite may have a role in remineralization, it is not a replacement for regular brushing with fluoride toothpaste, flossing, and professional dental care.
- If you suspect you have a cavity, even a small one, it is essential to see a dentist for proper treatment, as untreated cavities will continue to worsen and eventually require more extensive intervention like fillings or root canals.
- For optimal dental health, use hydroxyapatite-containing gum as a supplement to regular oral hygiene practices, but do not rely solely on gum for prevention or treatment of dental caries.
It is crucial to note that the current evidence on hydroxyapatite in gum for remineralization and cavity repair is limited, and more research is needed to fully understand its effects 1. Nonetheless, prioritizing regular fluoride exposure, good oral hygiene, and professional dental care remains the most effective approach to preventing and controlling dental caries.
From the Research
Remineralization of Teeth with Hydroxyapatite
- Hydroxyapatite has been shown to have a remineralizing effect on early carious lesions 2.
- Studies have demonstrated that dentifrices containing hydroxyapatite can offer therapeutic and preventative effects, including remineralization, caries prevention, and less demineralization 2.
- A comparative study found that a toothpaste containing 10% hydroxyapatite achieved comparable efficacy with 500 ppm fluoride in remineralizing initial caries and preventing demineralization 3.
Comparison with Fluoride
- Hydroxyapatite-based gel (15% HAP) was found to be as effective as fluoride-based gel (12,500 ppm F-) in remineralizing initial caries lesions 4.
- Another study found that nano-hydroxyapatite serum and sodium fluoride varnish were similar in remineralizing initial caries, although nano silver fluoride showed the greatest remineralization efficacy 5.
- However, a systematic review and meta-analysis found that the level of evidence for the efficacy of nano-hydroxyapatite was very low, and no conclusive evidence could be obtained due to the high risks of bias and limiting grade of evidence 6.
Mechanism of Action
- Hydroxyapatite is thought to promote remineralization by providing a source of calcium and phosphate ions, which can help to repair early carious lesions 2.
- The use of hydroxyapatite-based products has been shown to produce a more homogenous lesion remineralization compared to fluoride-based products 3.
- Atomic force microscopy images have demonstrated the formation of protective layers on the tooth surface after treatment with hydroxyapatite-based products 5.