<div class="description">
<p>Fluoride varnish as a caries remineralization and preventive agent<br>Lieutenant Commander Jonathan Stahl, DC, USN, Captain Kim E. Diefenderfer, DC, USN, and Captain N. Blaine Cook, DC, USN<br><br>Rationale for remineralization<br>Dental caries is a dynamic disease process involving the cyclic demineralization and remineralization of tooth structure. A state of health exists when net mineral loss (demineralization) and net mineral gain (remineralization) remain in equilibrium. Fluoride plays a key role in the remineralization of both enamel and dentin caries lesions. Remineralization occurs when calcium and phosphate from saliva, together with fluo-ride, enter the subsurface region of the lesion and form a new veneer on the existing crystalline remnants in the lesion. The remineralized surface is more stable and more resistant to fur-ther acidic attack. Subsequent acid challenges must be quite strong and prolonged to dissolve the remineralized enamel.<br><br>Because initial demineralization occurs below the enamel surface, the outer layer of enamel generally remains intact during the early stages of caries development. In fact, a substantial amount of subsurface demineralization can occur without destroying the outer enamel structural integrity. Using both radiographic and direct visual examination, Pitts and Rimmer assessed the caries status of 1468 permanent posterior approximal surfaces in 211 children. For caries lesions located radiographically in the outer half of enamel, none of the enamel surfaces exhibited cavitation; for lesions in the inner half of enamel, only 10.5% were cavitated; for lesions in the outer half of dentin, 40.9% were cavitated. Only when caries extended radiographically to the inner half of dentin was cavitation evident in all affected enamel surfaces. Similarly, other studies have reported that only an approximate 50% of caries lesions in the outer half of dentin exhibited clinical enamel cavitation.
</p>
<br>Subjects: Dental Caries; Dental Enamel; Dentin;  Fluorides</div>
<div class="fn value">
U.S. Navy. Naval Postgraduate Dental School</div>
<dl><dd><a rel="nofollow" class="external free" href="https://archive.org/details/06002FluorideVarnishAsACariesRemin.AndPrevAgent">https://archive.org/details/06002FluorideVarnishAsACariesRemin.AndPrevAgent</a></dd>
<dd><a rel="nofollow" class="external free" href="https://archive.org/download/06002FluorideVarnishAsACariesRemin.AndPrevAgent/06_-_002%20Fluoride%20varnish%20as%20a%20caries%20remin.%20and%20prev%20agent.pdf">https://archive.org/download/06002FluorideVarnishAsACariesRemin.AndPrevAgent/06_-_002%20Fluoride%20varnish%20as%20a%20caries%20remin.%20and%20prev%20agent.pdf</a></dd></dl>