Effectiveness of caries prevention in patients with low mineralization level of permanent teeth

Introduction. Since the 1980s, numerous studies have been conducted proving that tooth susceptibility to caries and resistance to caries depend on the degree of enamel mineralisation. The highest risk of caries development is observed during the period of enamel maturation after tooth eruption in the oral cavity. Tertiary mineralisation of teeth occurs particularly intensively during the period when the tooth erupts in the oral cavity. Tooth maturation depends significantly on the mineral components and properties of saliva. The effectiveness of preventive measures for dental caries has been studied by many authors, but the literature available to us contains scattered data on the prevention of dental caries with low mineralisation.

The aim of the study: to investigate the effectiveness of caries prophylaxis in patients with low mineralized permanent teeth.

Materials and methods. The study involved 67 people who were diagnosed with low enamel mineralisation based on clinical and morphological indicators. After signing an informed consent form, patients were divided into four groups with different types of prophylaxis for a randomised controlled trial. All children, regardless of the method of caries prevention, had the intensity of the carious process, average fluorescence loss, enamel resistance test, and simple hygiene index determined before the start of the study, after 6 months, and after one year.

Results. During daily home prevention, as well as professional remineralization in patients with a low level of enamel mineralization, the level of mineralization significantly improves, and caries susceptibility decreases, the average fluorescence loss index improves. When using a combined approach, the resistance of tooth enamel during the year of observation improves from 57,1±3,1 to 29±2,2 % (р<0,05), and the intensity of the carious process remains at the same level. When using home hygiene products, the enamel resistance also improves from 55,1±2,1 to 49,3±2 % over the year of observation, but the intensity of the carious process increases. According to the results of the study, it was found that in patients 9–15 years old with a low level of mineralization of hard tooth tissues, prevention based on a combination of home and professional methods is the most effective method of preventing caries.

Conclusion. In patients aged 9–15 years with a low level of mineralization of tooth enamel, home daily use of preparations containing calcium and phosphorus and hydroxyapatite can increase the level of enamel mineralization, however, when using a calcium-phosphorus-based gel in conjunction with professional application of hydroxyapatite preparations in a dental office, enamel caries resistance doubles, which reduces the increase in caries intensity in this group of patients.

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