Resistance of the Enamel to Dental Caries

¹ Dental School, University of Bristol, England

Enamel structures were divided into susceptible and resistant structures on the evidence of microradiography. It was argued that the difference between these two types of structures is most probably in the nature of their organic matrix, the soluble structures having a soluble matrix and the insoluble structures an insoluble matrix. Supporting evidence was advanced. An examination of the amount and size of spaces produced by tissue loss in the carious process before cavitation shows two distinct stages, the first occurring in the translucent zone and the second in the dark zone and the body of the lesion. The second stage is related to demineralization, but the first stage is caused by the removal of soluble organic material; supporting evidence for this was advanced. Similar translucent zones are produced by the chemical removal of soluble organic material. Teeth in gross fluorosis and amelogenesis imperfecta are both relatively caries-immune, yet both have hypocalcified enamel. A common factor was found in their abnormal organic enamel matrices. Taken together, the evidence provides strong support for the view that the attack of caries causes a primary loss of soluble organic matrix, which facilitates the demineralization of the soluble structures, while those with an insoluble matrix remain relatively unaffected.

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