Nutrition, diet and dental health — de- and remineralisation of teeth

Abstract

There is little if any evidence that nutrition during the time of tooth formation has any clinically significant effect on caries susceptibility of erupted teeth in man. Caries, erosion and demastication are not nutritional diseases. They are, however, diet-related diseases because erupted teeth are subject to local chemical and mechanical effects of the diet contacting the teeth. Caries is the result of a chronic undermining demineralisation of the teeth by organic acids that are produced by the bacteria of the dental biofilm while fermenting carbohydrates from the human diet. Dental erosion is the result of a chronic localised loss of dental hard tissue etched away from the surface by acids derived from the diet or from gastric reflux. The physicochemical grounds of de- and remineralisation of teeth are explained using detailed diagrams. Initial caries lesions without cavitation of the surface can remineralise (heal) under conditions of low cariogenic diet and good oral hygiene. However, once the surface has broken and cavitation occurred, there is no alternative to restorative dental therapy because remineralisation is no more possible.