The Role of Critical pH

Critical pH is the term given to the highest pH at which there is a net loss of minerals from tooth enamel. This is the pH at which saliva and plaque fluid cease to be saturated with calcium and phosphate, thereby permitting hydroxyapatite to dissolve. Critical pH is generally accepted to be 5.5, but it can be a little higher or lower depending on individual factors. During the demineralization process, acid diffuses between the rods and reaches deeper areas of the enamel and into dentin, where carbonated hydroxyapatite crystals are more susceptible to dissolution. The calcium and phosphate ions that are lost from the tooth diffuse out into dental plaque fluid and saliva. If the acid attack is chronic and prolonged, progressively greater amounts of calcium and phosphate minerals diffuse out of the tooth, causing the crystalline structure of the tooth to shrink in size, while pores enlarge. Eventually, a carious lesion develops; its rate of development is a function of the degree of undersaturation of fluid in its environment and rates of diffusion of ions into and out of enamel.1,15