New Strategies for Caries Prevention. The Role of Alkali Production in Dental Biofilms

Alkali generation by oral bacteria affects the ecology of dental biofilms and the chemical equilibrium between enamel and dentin minerals by neutralizing the acids produced from carbohydrate metabolism on dental plaque. As a matter of fact, it has been postulated that oral alkali production may be a major endogenous caries-inhibiting factor. Conservative dentistry and minimal invasive therapy belong to the most recent trends in management of dental caries. It has been recognized that new approaches to intervene earlier in the caries process using new technologies should be the most appropriate therapy especially in ‘‘high caries risk’’ children and adults. The protective principle of oral alkali production by the action of oral bacteria was found its application to dental practice via oral care products such as toothpastes containing arginine. However, there is insufficient clinical evidence regarding the caries-preventive effect for the inclusion of arginine in toothpastes. Further clinical studies which will not be dependent on commercial interests are necessary to confirm their effectiveness.