Remineralization of Dentin

Hello!

I have been so excited about your book and your tooth care system since my dad introduced it to me about 6 months ago. I am especially interested in this subject since I have just began a career as a dental assistant. I am already amazed by how much variation I have seen from dentist to dentist on just about every subject. Because of this variance, I had a few questions for you that I can not seem to get consistent answers on.



The first thing I was wondering was whether or not decay can be reversed once it has reached the dentin. The dentists I have asked tell me that dentin cannot be re-mineralized but that enamel can. I have been told that if decay has reached the dentin it must have a filling. So, if someone has decay that has reached the dentin, but not the pulp of the tooth, what do you recommend? Which brings me to my next question: I have no restorations in my mouth, and a dentist recently told me that I have a few tiny “sticky spots” on my back molars. She recommended that I have a fissurotomy done on these and sealants placed. I have read your chapter on sealants, but was wondering if opening the grooves in you molars can be beneficial or not. It was explained to me that the fissurotomy would make these areas easier to clean. However, since I have no other restorations, I am hesitant to do this.


The other thing I was wondering about was that I heard that listerine “deactivated” the effectiveness of ACT and vice a versa. I have read you posts about listerine and believe this person was probably misinformed, but wanted to ask anyways.


Thank you so much for your time and all you are doing for people around the world. My limited experience in the dental world has made me realize just how much of an effect people’s mouth health can have on them. And taking that into account, I believe you are making a direct impact on people’s happiness and well-being globally.
Sincerely,


M

Hi M,

Wow – your message shows me that the way you think is amazing!

I am so impressed by your understanding and interest in oral health. You have asked the most relevant and important questions.

If this is your entry into the dental world – how wonderful – how important – and wow, THE DENTAL WORLD NEEDS YOU!!!
Now to your questions ( in reverse):

The ACT/ Listerine Q- Science and results support my system.

As a pediatric dentist, any fluoride treatments were acidified.

One role of Listerine in my system is to acidify the outer enamel and prepare it to receive the “recrystalization” effect produced by dilute fluoride. Acidity produces a more powerful recrystalization effect than dilute fluoride alone.

Research shows when fluoride is added to Listerine, it increases the effectiveness of the fluoride.

Check the references to low pH use of fluoride on this Listerine Total site ( But PLEASE don’t decide Listerine Total is the answer – read below!!)

http://www.jjdentalprofessional.com/listerine-total-care.html Using acidic Listerine separately from ACT fluoride is FAR MORE effective than mixing these products together, as in Total Care.

( Imagine skin – with Listerine the “skin toner” and ACT the “moisturizer”. Toner “opens” the pores so moisturizer can penetrate and moisturize deeper.

Mixing the lotions together may be better than toner alone, but NOT as effective as toner followed by moisturizer. Agreed?)

Fissurotomy:

Remember that no filling is as perfect as a pristine tooth.

Sealants can contain BPA ( I’m sure you are aware of this new controversy) – Even a BPA-free sealant would need maintenance.

Remineralizing Dentin:

Kiss Your Dentist Goodbye tries to explain why dentists are forced to make decisions based on their personal experience.

With emerging technology this can change – hopefully in the patient’s best interest.

Dentists are trained to be concerned – most are disbelievers about remineralization – and dentists don’t want to run into bigger problems on their “watch”.

With fluoride you get remineralization only in the outer layer of enamel.

Using a wound analogy – only the “skin” heals with fluoride – not the “flesh” of the wound.

Consequently a cavity healed with fluoride alone, will “heal” over the top of the wound – but remain infected in the deeper areas ( the dentin).

Such semi-healed lesions always have a small hole in the enamel – even if this enamel has grown over the top of the cavity. This hole allows bacteria and liquids to travel through the enamel “shell” and feed cavity-forming bacteria hiding inside the deeper dentin layers. (This is why dentists say that caries into dentin does not remineralize. They have probably seen these semi-healed lesions – These lesions don’t look much from the surface ( they usually show up on X ray) but underneath the surface is an active carious mess)

ONLY WITH THE COMBINED USE of antibacterial agents like xylitol ( which is even better when enhanced by Closys and Listerine as suggested in my system) will these deeper dentin bacteria be inactivated. Xylitol has also been shown to remineralize deeper than fluoride. Constant use of xylitol (to inactivate caries bacteria) plus the remineralizing effect of xylitol creates a synergy with the fluoride (that is remineralizing the surface layer).

This is why the “flesh” of the tooth will heal along with the “skin”.

I could tell you multiple stories of complete remineralization of carious lesions for patients who were told this is impossible.

It is important to differentiate out any lesions sufficiently deep to have already infected the pulp.

If a patient only experiences slight, occasional sensitivity or NO SENSITIVITY in a vital tooth, I believe the lesion can be reversed.

If people use my system exactly as I suggest – most lesions ( like your sticky fissures) would disappear within 6 months.

Why not give this a try and report back to me?Ha!! BUT you MUST follow the system exactly – no mix and match with MI paste etc….

I suggest you get a starter kit from our website – so that you will have EXACTLY the right ingredients for this recipe! hen you can purchase all the ingredients from local stores. Closys can be supplied to dentist offices through dental supply companies. You can get the 64 oz jugs (that is what I give to my employees to help limit the cost).

Best Wishes,

Hope this helps!!

Ellie

Ellie Phillips DDS
http://www.zelliescleanwhiteteeth.com/
Solutions for Oral Health!
author, Kiss Your Dentist Goodbye



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  • A says:

    Dear Dr Ellie.

    The enamel on the upper side of both my front teeth is missing (due to have eaten too much fruit and brushed too hard in my earlier years) It is not very noticeable since it shows at the upper side of the front teeth. I don’t really experience any pain or sensitivity either and had until recently some composite covering the dentin for some years. The composite however “fell” when brushing my teeth once.
    Now I just wonder if I should just let the dentin be and see if it re-mineralizes into enamel? Would that be possible (I have heard that it is impossible by dentists)

    I have started using your system, except Closys/Ultradex and Crest toothpaste since it is not possible to find in Sweden where I live so I use Oral b 123/Ultradex toothpaste, and a salt rinse before brushing instead of using Closys)

    Your sincerly,
    A

    • Once a filling has been cut in a tooth or when plastic has been applied to a tooth, the tooth will not heal naturally any more. On the other hand, there is not really any reason to put a filling on areas of de-mineralization /grooves. Fillings almost always fall off and rarely create benefit beyond esthetics.

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