Gaithersburg, MD.—Amorphous calcium phosphate is more than a cosmetic benefit for patients—it’s the first nonfluoride therapy to remineralize enamel and dentin.
From healing the early signs of caries to desensitizing teeth to adhering orthodontics, ACP is one of the hottest materials in dentistry.
So what is it? When calcium and phosphate salts are combined in just the right way, they form a solution that precipitates ACP—amorphous because it has no definite shape. The process is quick. Once the ACP dissolves in enamel fluids and is transported into the caries lesion, the calcium and phosphate ions precipitate and recrystallize as apatite to repair the early lesion. Some precipitated apatite remains bound to the tooth’s surface.
“This is the next big thing,” said Clifton M. Carey, Ph.D., director, Independent Research and Grant Administration at PRC. “this is the first big thing that could replace fluoride.
Said Dr. Daniel Meyer, senior vice president, ADA Science/Professional Affairs: “It has the potential of being a major ingredient in products designed for remineralizing hard tissues, including bone, enamel, and dentin. It depends not only on the material, but the way products are designed along with the mechanisms to deliver the material to the appropriate areas.
ACP mainly works by enhancing the natural healing process of saliva. It can also help prevent future caries and secondary cavities. Because traditional restorations merely seal the hole, they cannot cause a tooth to heal itself. By adding ACP to the filling, a tooth can effectively regenerate.
That’s what researchers hope. So far, Dr. Carey says only small cavities can benefit from the remineralizing potential of ACP, but as they continue testing, he hopes that one day advanced caries lesions will benefit as well as root canal therapy or possibly even bone fracture repair.
“Laboratory data show that ACP can reverse early caries,” Dr. Carey said. “However, if a cavity has advanced significantly beyond the early stages, a dentist would still need to perform a traditional filling. Current research is investigating the inclusion of ACP in composites to prevent secondary caries.”
To date, the Food and Drug Administration has approved products containing ACP for cosmetic purposes and in fluoride varnish, dental prophylaxis paste and an oral care gel. It has been successful as a dentin desensitizer and as a desensitizer added to professional bleaching products, said Dr. Gary Shumacher, PRC’s associate director and chief of clinical research.
“Gum recess, dentin exposure, tooth whitening and post root-planing cause dentin sensitivity through the dentin tubules,” he said. “Occluding or filling the dentin tubules will prevent the sensitivity. ACP is the ideal material for this since it has the consistency like the paste which is very effective in fill the holes. ACP also has the same chemical composition as and converts to the tooth mineral.”
Products currently on the market include the Enamel Pro Series from Premier Dental, a prophy paste that debuted in 2006 and a fluoride varnish that debuted in February at the Chicago Midwinter meeting that can be directly applied to the teeth. There also is Enamel Care toothpaste by Church and Dwight, tooth-bleaching products where a clinician can mix drops to make a paste to apply. An orthodontic cement by Bosworth is good for kids having a hard time cleaning their braces.
Future products could include mouthwash and chewing gum. PRC researchers are currently working to get ACP into an inject able paste for root canal sealers, Dr. Schumacher added.
ACP is also helpful for patients who complain about the discomfort that often accompanies whitening. Gels that contain ACP generally reduce that problem. The peroxide found in whitening gels also effectively mixes with the ACP.
Here at Desert Smiles, Dr. Wilcox stays abreast of the latest advances in dentistry. Not all Phoenix dentists or Arizona dentists do that. As we try to provide the finest in Glendale cosmetic dentistry, we have incorporated this technology into our bleaching procedures, hygiene and other preventive services.