Remineralization of tooth enamel. Clinician's perspective

Operating principle

Plaque that forms daily contains a huge amount of bacteria. By releasing acids of various compositions, bacteria destroy the enamel, as if dissolving the calcium molecules in it, and thereby deprive it of its protective properties. The compounds included in the RemarsGel complex have the ability to gradually penetrate the tooth enamel and replace lost calcium. “RemarsGel” actually “repairs” the area of ​​tooth enamel that has lost its strength, strengthens it and helps restore the natural protection of the tooth.

During the process of brushing teeth with “RemarsGel”, calcium nitrate from tube No. 1 is mixed with ammonium hydrogen phosphate from tube No. 2. As a result of a safe chemical reaction, a brushite crystal is formed on the surface of the teeth, similar in composition to the main component of tooth enamel (hydroxyapatite crystal). Due to its small size, the brushite crystal penetrates deeply into tooth tissue, restores enamel damaged by caries, closes microcracks and quickly relieves tooth sensitivity (even after professional whitening). After a course of using RemarsGel, the enamel becomes smooth and shiny, and a feeling of smoothness of the surface of the teeth appears, as if after polishing.

Remineralization of tooth enamel. Clinician's perspective

July 23, 2018

Toothpaste with a remineralizing effect can compensate for the lack of minerals and become a successful additional remedy in the treatment of demineralization. Introducing the new ROCS biocomplex toothpaste.

The enamel of our teeth is regularly exposed to aggressive attack, from the simplest food acids from fruits and juices to the acids used during dental procedures. In addition, there are factors that cause or simply enhance the loss of the mineral component of enamel endogenously: these are diseases associated with impaired mineral metabolism, and a number of hormonal disorders or conditions.

The disappearance of minerals from tooth enamel is called “demineralization” (“decalcification”). At the same time, in our body there is a constant process of compensation for the demineralization process - this is physiological remineralization, which is provided by the protein fractions of saliva, as well as a number of its other properties. But very often locally (in the area of ​​several or a whole group of teeth), as a result of excessive demineralizing load, processes arise that become decompensated, and then chalky-colored spots or stripes appear on the teeth. A symptom that often accompanies demineralization is enamel sensitivity. In this situation, the teeth already need specialized help - remineralizing therapy (abbreviated as remotherapy).

Various manufacturers have already proposed many products and preparations for remotherapy, in particular those based on casein/amorphous calcium phosphate, silicon compounds, tricalcium phosphate and other components. All of them either have restrictions for use or insufficient clinical effectiveness, or are difficult to access for mass consumption. Balanced mineral complexes for self-use by patients are rightly considered today to be the most logical, very accessible, without contraindications and time restrictions for use, and at the same time effective for remotherapy.

ROCS Medical Minerals is , without exaggeration, a unique and most sought after mineral complex by specialists, created taking into account the clinical logic of enamel remineralization. The main active component of the complex is calcium glycerophosphate - a compound based on two components that are most important for saturating the enamel with minerals - calcium and phosphorus.

Calcium glycerophosphate (GP) is a compound with a high level of bioavailability, since it is a direct substrate for salivary enzymes. It is the ability of GF to integrate into the physiological process of mineralization that allows for the rapid restoration of demineralized tooth enamel. The remineralization process is accelerated by the inclusion of magnesium salt, an activator of salivary enzymes, in the gel. Another basic component - xylitol - performs an anti-carious function. It is included in the ROCS Medical Minerals gel.

The ROCS Medical gel line is represented by the following options

Classic ROCS Medical Minerals , which is a gel for remotherapy and has a wide range of indications for use. The main situations for its use: caries in the white spot stage, hypoplastic processes in tooth enamel, demineralization of enamel after teeth whitening, in a complex scheme with methods of microabrasion and composite infiltration of enamel, complex treatment of dental fluorosis, focal demineralization after removal of braces, stabilizing and therapy that improves the results of clinical teeth whitening, as an alternative to teeth whitening in the case of a number of contraindications to it, and others.

ROCS Medical Sensitive , unlike the classic gel, contains a special component - potassium nitrate, which is a traditional substance for drugs that relieve the sensitivity of hard dental tissues due to impaired conduction of pain impulses. Due to its sensitivity-compensating properties, ROCS Medical Sensitive is recommended as a gel with the same remineralizing properties, but for those clinical situations where there is also an additional factor of tooth sensitivity, which quite often accompanies local loss of minerals in the teeth. In addition, the gel is also recommended as a means to relieve normal tooth sensitivity.

Since remotherapy can and should be done at any age, starting from the moment of teething, a special ROCS Medical minerals with strawberry flavor . Due to the flavoring additive, it is more pleasant for children and adolescents.

For difficult situations, when there is a need for a particularly active remineralizing effect, there are a number of products that can enhance the effect: special mineral rinses, mineral tablets (such as ROCS Medical chewable tablets ).

And, of course, during the days and subsequently after remotherapy, it is extremely important for the patient to use a special toothpaste with special remineralizing activity. ROCS Biocomplex Active Protection toothpaste is ideal for this purpose and contains the proteolytic enzyme bromelain and its peptide components, calcium glycerophosphate, magnesium chloride and xylitol (6%). Each component of the complex, performing its task, increases the efficiency of others. The enzyme, by breaking down plaque proteins, promotes its high-quality removal from the surface of the teeth. Bromelain and peptides are essential factors in plaque control. They provide the prolonged action of toothpaste against plaque. According to the subjective assessment of consumers, teeth remain smooth and clean throughout the day.

Slowing down the formation of plaque provides teeth with almost constant availability of the mineral components contained in toothpaste and saliva. As a result, mineralization occurs of both healthy enamel and the initial foci of carious lesions.

For successful mineralization of teeth, it is desirable to have factors that modulate the permeability of tooth enamel. For this purpose, the active complex of the paste - MINERALIN® - uses xylitol in a concentration of 6%. Research by American and Finnish specialists has found that in this concentration xylitol significantly enhances the mineralization process, which is associated with its ability to form complex compounds with calcium. In the composition of toothpaste, this substance performs several functions: being a sweetener, xylitol improves its taste characteristics; Being a polyhydric alcohol, it functions as a moisture-retaining component. The mechanism of involvement of this substance in the biochemical metabolism of streptococci is characterized as lethal synthesis, and therefore the activity of cariogenic bacteria is reduced. Experiments have established that the effect of xylitol against cariogenic streptococci appears at a concentration of 2–2.5%.

ROCS Biocomplex Active Protection toothpaste with ROCS Medical Minerals , you can achieve the maximum rate of remineralization of tooth enamel.

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Basic recommendations

Be sure to use RemarsGel 1-2 times a day. Both treatment and prevention must be strictly daily! "RemarsGel" can be used both at home and for treatment in a dental clinic.

The course of treatment of tooth enamel consists of 20-28 procedures. In case of visible damage to the teeth, “RemarsGel” should be used every day until the enamel is restored, and then – to consolidate the action of the complex 1-2 times a week.

For preventive effects, 10-14 procedures are sufficient. The prophylactic course of “RemarsGel” is recommended to be carried out 3 times a year.

Prevention of demineralization

To prevent demineralization at home, you should first take care of proper nutrition. The diet should include foods rich in fluoride, calcium and other substances that are beneficial for tooth enamel. These include:

• Legumes;
• Green vegetables;
• Milk and dairy products;
• Nuts.

In addition, it is recommended to reduce consumption or completely eliminate tea, coffee, carbonated drinks, and sugar from the diet.

A course of home remediation involves the use of special products aimed at restoring the mineral composition of tooth enamel. Retherapy gels will help provide this effect. For example, the following are well suited for these purposes:

• GC Tooth Mousse;
• Dental Resources (USA);
• ROCS Medicals Minerals.

To achieve maximum effect, it is better to fill the mouthguards with the listed gels. This way the composition does not come into contact with saliva and adheres to the enamel as tightly as possible. It is better to make custom-made mouthguards so that they accurately replicate the anatomical structure of the teeth.

Don't forget about proper oral care. In this case, irrigators will be indispensable. These are effective tools that remove food particles using a targeted jet of water. As a result, the mechanical impact on tooth enamel is reduced, so even people with hypersensitive teeth can use irrigators.

At the same time, we should not forget that preventive care products for demineralization of teeth should be selected by the attending physician. You should also contact your dentist if you experience any discomfort that occurs during tooth enamel retherapy.

Author of the article

Clinical study

RemarsGel is a product that has the unique ability to restore damaged or weakened tooth enamel that is ready for damage; it was originally called Remogel. Research on this drug took place at the Department of Pediatric Therapeutic Dentistry of the Moscow State Medical and Dental University. The purpose of the test was to determine the compliance of the Remogel gel with the possibility and feasibility of its use in dental institutions of the Russian Federation.

During the test, the simplicity and accessibility of the method of using the gel was revealed, and a pronounced remineralizing effect of the gel on foci of demineralization in caries was established. The study showed that Remogel successfully passed medical tests and can be recommended for widespread use in medical practice.

Dissertation of Doctor of Medical Sciences Volkov Evgeniy Alekseevich:

“Pathological changes in the hard tissues of teeth often begin with focal demineralization, leading to dental caries and its complications, as well as non-carious lesions, accompanied by dentin exposure and hyperesthesia. Therefore, mineralization of enamel and dentin, elimination of focal demineralization and hyperesthesia of teeth are a measure for the prevention of more severe pathological processes... A new generation of domestic dental materials and new methods of mineralizing therapy for the pathology of hard dental tissues with the material “BV” (for clinical use - approx. “Gekom”) and a set of gels “Remogel” (now “RemarsGel” - note by “Gekom”) were introduced into practical healthcare at the industry level (included in the State Register).”

Causes of tooth demineralization

Tooth enamel is destroyed for a number of reasons. Most often, a violation of the mineral composition is provoked by the following factors:

1. Excessive consumption of sugar and sweets;
2. Alcohol abuse, addiction to coffee and tea;
3. Failure to adhere to proper nutrition;
4. Drinking unfiltered or low-quality water;
5. Lack of vitamins in the body;
6. Constant stress.

The listed factors change the pH of saliva, which provokes demineralization. It is no secret that saliva is the main source of minerals for tooth enamel. Therefore, any imbalance in this environment leads to negative consequences. A lack of calcium, fluoride and other nutrients appears as white spots on the enamel. This is the first sign of demineralization.

Types and purpose

Gum inflammation is a widespread problem. There are many reasons for it, but the results are always the same: they turn red and bleed, and there is an unpleasant odor from the mouth. Periodontists practice complex treatment: antibacterial medications for oral administration, physical therapy and local therapy.

For local therapeutic effects, antiseptics and analgesics are used in powders and rinsing solutions, but ointments and gels that act in a targeted, effective and long-lasting manner are more convenient. They are quickly absorbed, therefore they actively influence the affected tissues, shorten the healing time and alleviate the patient’s condition. Their peculiarity is the almost complete absence of contraindications, except for individual intolerance and a minimum of adverse reactions compared to other dosage forms.

All such preparations, spread and rubbed into the oral cavity, are usually classified into groups that differ in the basis that binds the active components:

• gels are water-soluble, they are light and have good absorption, so the active components immediately reach the diseased organ in full, in addition, the film formed on the surface acts as an additional protection for the mucous membrane:
• ointments are oily, have a dense and heavy consistency, which is poorly absorbed and washed off with saliva.

Only a doctor will be able to select the right type of medicine, based on the clinical picture of the disease and taking into account the individual characteristics of the patient.

Comprehensive periodontal treatment

Therapy for periodontal diseases is long and complex. The process of destruction of the tissues surrounding the tooth has already begun, and ointment for strengthening the gums or preparations with a gel structure are effective to strengthen them. Depending on the condition of the oral cavity, ointments are prescribed:

1. Heparin. Slows down blood clotting, normalizing microcirculation. The benzocaine it contains provides pain relief. Apply by appliqué.
2. Levomekol. Heals wounds, relieves inflammation. It is also applied as applications, as it is poorly absorbed by the mucous membrane.
3. Troxevasin/Troxerutin. A gel-based anti-inflammatory medication with venotonic, angioprotective (improves blood flow and metabolism) and anti-edema effects. Strengthens the walls of capillaries and increases their elasticity.
4. Asepta. Antiseptic ointment with propolis containing chlorhexidine and metronidazole to fight infections. Contains coenzyme Q10, so it adheres well to the gums without being washed off by saliva. Antimicrobial, antipruritic, analgesic agent accelerates epithelial regeneration and improves metabolic processes.
5. Cryogel. Also, for strengthening, with an antimicrobial and drainage effect, it is placed in the periodontal pocket.

Most of them are dispensed from pharmacies without a prescription and have no special contraindications or adverse reactions. But they must be prescribed by a dentist, in accordance with the clinical picture.