Demineralization of teeth

Demineralization of teeth (Lat. demineralisatio) is the process of leaching inorganic substances (calcium, phosphorus) from the hard tissues of the tooth under the action of acids. This process is the initial stage of enamel destruction and caries lesion formation.

Etiology and Pathophysiology

At neutral pH levels (≈7), the processes of demineralization (dissolution of mineral component crystals) and remineralization (partial or complete restoration of mineral component crystals) of enamel and dentin are in balance.

The process of demineralization predominates when the pH at the tooth surface drops below a critical level (pH=5.2–5.5). Acids produced by biofilm bacteria or ingested with food dissolve hydroxyapatite crystals. Micropores form in the enamel structure, which alters its optical properties and leads to a loss of hardness.

Clinical significance

Initial demineralization appears as a white matte spot on the tooth surface, visible when dried. At this stage, the process is considered reversible: with timely elimination of the acid factor and remineralizing therapy, the enamel can restore its density without surgical treatment.