An article published in the July 1, 2020 issue of Nature details findings from researchers at Northwestern University that shed light on the structure of dental enamel and the decay process.
According to the article “Chemical gradients in human enamel crystallites (Nature, volume 583, pages 66–71(2020)), the researchers used “atomic-scale quantitative imaging and correlative spectroscopies” to examine the structure and composition of dental enamel on a nanometric scale.
Lead researcher Derk Joester, who led the study, said, "Enamel has evolved to be hard and wear-resistant enough to withstand the forces associated with chewing for decades. However, enamel has very limited potential to regenerate. Our fundamental research helps us understand how enamel may form, which should aid in the development of new interventions and materials to prevent and treat caries. The knowledge also might help prevent or ameliorate the suffering of patients with congenital enamel defects."
The study found that “...the nanoscale crystallites of hydroxylapatite (Ca5(PO4)3(OH)), which are the fundamental building blocks of enamel, comprise two nanometric layers enriched in magnesium flanking a core rich in sodium, fluoride and carbonate ions; this sandwich core is surrounded by a shell with lower concentration of substitutional defects.”
The Longer-Term View
These findings won’t immediately change how the issue of dental caries is approached. Prevention remains the emphasis, so continuing to encourage patients to brush twice and floss once daily, and have regular cleanings and examinations, is key.
However, the study also notes:
“A mechanical model based on density functional theory calculations and X-ray diffraction data predicts that residual stresses arise because of the chemical gradients, in agreement with preferential dissolution of the crystallite core in acidic media. Furthermore, stresses may affect the mechanical resilience of enamel. The two additional layers of hierarchy suggest a possible new model for biological control over crystal growth during amelogenesis, and hint at implications for the preservation of biomarkers during tooth development.”
This research opens the door to the possibility of finding and eliminating the “defects” that render tooth enamel susceptible to decay processes. The jury is still out on how effective that approach might be. But with people living longer than ever before, retaining as much enamel as possible is the key to retaining permanent teeth.
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