Effect of pH of amine fluoride containing toothpastes on enamel remineralization in vitro

Abstract

Background: One of the important factors of the demineralization and remineralization equilibrium of enamel is the pH of the surrounding solutions. Effort has been laid in the formulation of different fluoride compounds and the fluoride content in toothpastes but much less is known about the influence of the pH of the toothpastes on their effectiveness. It was therefore the aim of this study to investigate the influence of different pH levels on enamel remineralization in an in vitro experiment using polarization light microscopy and EDX quantitative element analysis.

Methods: A 5 x 5 mm window on the enamel surface of 40 caries free extracted human premolars was demineralized in a hydroxyethylcellulose solution at pH 4.8. The teeth were divided into 8 groups and the lower half of the window was covered with varnish serving as control. Each group was then immersed in toothpaste slurry containing amine fluoride (1400 ppm) at pH 4.1, 4.5, 5.1 and 6.9 or control toothpaste slurry without fluoride at pH 4.3, 4.7, 5.3 and 7.0. Serial sections were cut through the lesions and investigated with polarization light microscopy and quantitative EDX element analysis.

Results: The PLM results showed a decreased porous volume of the body of the lesion after incubation with fluoridated toothpaste at pH 4.53 and 5.16. No differences between the experimental window and the control window were found in the other groups. The quantitative element analysis showed no differences in the element content of any of the groups.

Conclusion: From the results it can be concluded that slightly acidified fluoridated dentifrices may have a certain positive effect on enamel remineralization.

Figure 1

Polarization light microscopy of experimental lesions. Experimental caries-like lesions after treatment with fluoridated toothpaste at different pH levels. a) pH 4.1; the upper experimental window shows an interrupted band. b) pH 4.5; the upper experimental window shows single porosities. c) pH 5.1; the upper experimental window shows an inhomogeneous lesion. d) pH 6.9; no difference can be seen between the upper experimental window and the lower control window.

Figure 2

Quantitative distribution of the different experimental lesions. Quantitative distribution of lesions according to their morphological appearance in control and experimental windows after fluoride application at different pH levels. There is a clear shift of the lesion morphology towards the less expressed lesions in the experimental windows.

Figure 3

Quantitative distribution of the different control lesions. Quantitative distribution of lesions according to their morphological appearance in control and experimental windows after application of control toothpaste at different pH levels. The different morphologies are more or less equally distributed.