Remineralisation of White Spot Lesions in situ by Tooth Mousse

Objectives: To investigate the potential of a commercially available dental crème containing casein phosphopeptide – amorphous calcium phosphate (CPP-ACP), ["GC Tooth Mousse" (10% w/v CPP-ACP) (GC Corp, Japan)] to remineralize sub-surface white spot lesions of enamel (WSL) in a double blind, randomized, 2-way cross-over in situ study. Methods: Enamel specimens were sectioned from either buccal or lingual surfaces of extracted sound human third molars and WSL windows were created using the Carbopol method. Specimens were divided into test and control half slabs. Healthy volunteers (n=6) wore mid-palatal appliances containing four enamel test slabs with WSL. A slurry (1g crème, 4ml H₂0) of Tooth Mousse (TM_test) or placebo Tooth Mousse (TM_Placebo) was placed intra-orally (60s) after appliance insertion. The appliance was worn (40min) and the process repeated 4 times per day for 10d. Cross-over occurred after a 7d washout. Mineral content of each remineralized half-slab invested in resin with its control half slab was determined by microradiography after sectioning and lapping to 85 ± 5µm. The % mineral profiles of each WSL and adjacent sound enamel were compared and differences between sound and lesion values calculated (ΔZ_d, ΔZ_r). Proportional change in mineralization (%R) was calculated according to the formula: %R = ((ΔZ_d−ΔZ_r)/ΔZ_d) x 100 and data analysed (ANOVA, Tukey's post-hoc, p<0.05). Results: TM_Placebo resulted in a %R of 3.72 ± 2.10%, whereas TM_test produced %R of 24.22 ± 3.31%. Conclusion: A 20% dilution of Tooth Mousse crème containing CPP-ACP produced 551% more WSL mineralisation than a placebo crème in an in situ model. This study was supported by the Cooperative Research Centre for Oral Health Science, School of Dental Science, The University of Melbourne.