Demineralization of teeth

Demineralization of teeth (Latin demineralisatio) is the process of leaching of 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 carious defect formation.

Etiology and pathophysiology

At neutral pH values (≈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 equilibrium.

The demineralization process prevails when the pH at the tooth surface decreases below the critical level (pH=5.2-5.5). Acids produced by plaque bacteria or ingested from food dissolve hydroxyapatite crystals. Micro-pores form in the enamel structure, which changes its optical properties and leads to a loss of hardness.

Clinical significance

Initial demineralization appears as a white matte stain 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 regain its density without surgical treatment.