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An Update on Demineralization/Remineralization

Mark E. Jensen, MS, DDS, PhD; Robert V. Faller, BS

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Draftee rejection due
to poor oral health

Over 40 years ago the JDHA carried this quote by L. S. Fosdick, "It is quite possible that in the not too distant future, mass control of caries may be achieved; but until that time, each dentist and hygienist should become acquainted with the fundamental mechanism of the caries process, and pass this information on to the patient, along with suitable methods of control." We took Dr. Fosdick at his word and moved the management of dental caries from a personal concern to a national concern . . . developing sensitive scales for the measurement of dental caries.


The single greatest reason for rejecting draftees from enlisting in World War II was poor oral health. We saw a personal concern next become a social concern and, finally, a significant concern for national security.


From water fluoridation to our professional recommendations of an OTC product, fluoride touches the lives of our patients on a daily basis. Unlike the concerns of the 1940's and 1950's, where the focus was on CURE, our focus today is on PREVENTION.

Today we face a different set of patient questions; while fluoride is still considered a phenomenal discovery, most patients take the benefits for granted. We no longer are asked, "WHEN will I get my fluoride treatment?", but rather we face more complex questions such as "Who should get fluoride, when and how much . . . does fluoride affect permanent teeth, should we give a topical fluoride treatment to a caries free child, and what do we do when we see rampant caries?" The evidence to support these decisions has become increasingly more important in the practice of dentistry today. Some basic background on "evidence-based dentistry" and how it applies to demineralization/remineralization has been added to this course. What is the evidence supporting your clinical decision, and what is the strength of his evidence? These questions, in addition to those above, have been asked with increasing frequency for students and practitioners alike. In the forever changed world that allows both patients and practitioners to instantly access information over the Internet, we must be prepared to face these questions with scientific support. In sharing these remarks with you, I hope you will take away practical thoughts on the role fluoride might have in your practice and be able to access a wealth of data to support your decisions in practice, a subject we have pretty much taken for granted partly because . . .

Experts / Advisory
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