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Cariology Group, American Dental Association Health Foundation, Paffenbarger Research Center, National Institute of Standards and Technology, Stop 8546, Gaithersburg, MD 20899-8546, USA jvogel{at}nist.gov

To the Editor:

RE: Shen P, Cai F, Nowicki A, Vincent J, Reynolds EC (2001). Remineralization of enamel subsurface lesions by sugar-free chewing gum containing phosphopeptide-amorphous calcium phosphate. J Dent Res 80:2066–2070.

Recently, Shen et al. published an article on the remineralization of subsurface lesions by chewing gums containing casein phosphopeptide-amorphous calcium phosphate (see above). However, because the enamel samples used in this study were exposed to the oral environment for only 160 min per day (including treatment intervals) during a two-week experiment, it is difficult to draw a conclusion about the clinical remineralization effect of this compound. The study showed that mineral deposition into the enamel specimens from the test gum after 35 hrs of oral exposure was similar to that observed in a study with a control gum in which the enamel samples were kept in the mouth continuously for 504 hrs (21 days). However, this study did not produce information on whether the test gum would produce any additional remineralization, relative to the control gum, under these more realistic continuous-exposure conditions or under the conditions commonly used in in situ remineralization studies ( J Dent Res 71[Spec Iss]:949–952, 1992).

This question is especially relevant because the experimental design limited loss of the casein phosphopeptide-amorphous calcium phosphate test substance from plaque into oral fluids, and because, as shown by the non-linear dose-response reported in this study (Table 3), additional remineralization became more difficult to achieve as the concentration of the additive increased. Although the casein phosphopeptide-amorphous calcium phosphate compound is certainly a promising remineralization agent, its true potential will need to be assessed in studies that reflect clinical conditions.

Journal of Dental Research, Vol. 81, No. 4, 228 (2002)
DOI: 10.1177/154405910208100401

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