Demineralization in Special Populations

To favor remineralization over demineralization, it is essential to address both sides of the mineral balance. Fluoride remains the most effective agent for enhancing remineralization, as it significantly accelerates the process. Its high electronegativity allows it to attract calcium and other cations, facilitating the formation and precipitation of apatite crystals, particularly fluorapatite, which is more resistant to acid dissolution. This property makes fluoride a critical component in preventing caries and promoting enamel repair.

At the same time, efforts must be made to reduce demineralization, which is triggered by acid production following meals, snacks, or the consumption of sugary beverages like coffee with sugar or soft drinks. The two most effective strategies for reducing demineralization are:

1. Limiting the frequency of acid challenges, such as reducing how often sugary snacks and drinks are consumed throughout the day.

2. Improving oral hygiene, which lowers the overall cariogenic potential of dental plaque. Older plaque biofilms generate significantly more acid - by a logarithmic factor - compared to younger plaque (e.g., less than 12 hours old). Therefore, regular brushing (at least twice daily, and especially at bedtime), flossing, and routine plaque control are essential in minimizing demineralization and maximizing the opportunity for remineralization.