Amorphous Calcium Phosphate (ACP)
Although ACP is currently not indicated as “strong” in the evidence-based literature, ACP has anticariogenic properties to promote the remineralization of enamel and cementum, as well as balancing the pH of saliva and reducing dentinal sensitivity. Regular application of ACP with fluoride increases levels of calcium and phosphate levels in biofilm and tooth structure. In fact, an addition of 2% ACP, e.g., Recaldent to as little as 450 ppm fluoride can significantly increase the incorporation of fluoride ions into biofilm and co-localize calcium and phosphate ions with fluoride ions at the tooth surface. An adjunct treatment of ACP and a 1,100 ppm over-the-counter fluoridated dentifrice (toothpaste) can decrease bacteria and increase mineralization. Patients who benefit from ACP include conditions such as orthodontic, white spot lesions (WSL), tooth whitening, oncology, hypersensitivity, high caries risk, xerostomia, and acid erosion due to chronically consuming acidic drinks and food. Calcium phosphate with fluoride can be added to teeth with various applicators. Custom mouthguards can be used for longer application times.