CC BY-NC-ND 4.0 · Journal of Health and Allied Sciences NU 2023; 13(01): 107-113
DOI: 10.1055/s-0042-1744441
Original Research

Remineralizing Potential of Milk and GC Tooth Mousse on Demineralized Human Enamel: An In Vitro Comparative Evaluation

1   Department of Pediatric and Preventive Dentistry, AB Shetty Memorial Institute of Dental Sciences (ABSMIDS), Nitte (Deemed to be university), Deralakatte, Mangalore, Karnataka, India
Srikala Bhandary
1   Department of Pediatric and Preventive Dentistry, AB Shetty Memorial Institute of Dental Sciences (ABSMIDS), Nitte (Deemed to be university), Deralakatte, Mangalore, Karnataka, India
Ishani Vakil
2   Dr. K. K. Vakil Dental Clinic, Surat, Gujarat, India
› Author Affiliations
Funding Nil.


Introduction Caries initiation is associated with demineralization of the subsurface tooth enamel. Today, bioactive agents based on milk products have been developed to enhance remineralization under cariogenic conditions. However, there is limited information on the remineralization potential of milk.

Materials and Methods Fifty enamel specimens were prepared from sound human premolars. All enamel specimens were then placed in demineralizing solution for 4 days at 37°C to produce artificial carious lesion. Baseline surface microhardness (SMH) was evaluated using Vickers indenter. Enamel specimens were then randomly divided into three groups. Group 1 specimens were kept in artificial saliva, whereas group 2 and 3 enamel specimens were treated with milk and GC tooth mousse, respectively, for 5 minutes twice daily for 21 days. Post-treatment SMH measurements of all specimens were evaluated on the 7th, 14th, and 21st day. Data was statistically analyzed using one-way analysis of variance test and Tukey honest significant difference post-hoc test.

Results There were no significant differences in the SMH values in the control group at any time interval. There were statistically significant increases in the post-SMH values in milk and GC tooth mousse (p < 0.001) at the end of 21st day of remineralization.

Conclusion Milk showed remineralization potential comparable to that of GC tooth mousse.

Clinical Significance

Milk, being a natural product, can be recommended not only for its nutritional benefits but also for its protective effect on oral health.

Publication History

Article published online:
04 May 2022

© 2022. Nitte (Deemed to be University). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

  • References

  • 1 Featherstone JD. The science and practice of caries prevention. J Am Dent Assoc 2000; 131 (07) 887-899
  • 2 Featherstone JD. The continuum of dental caries–evidence for a dynamic disease process. J Dent Res 2004; 83 Spec No C C39-C42 [Spec Iss C]
  • 3 Reynold EC. Remineralization of enamel subsurface lesions by casein phospfopeptide stabilized calcium phosphate solutions. J Dent Res 1997; 76 (09) 1587-1595
  • 4 Roberts AJ. Role of models in assessing new agents for caries prevention–non-fluoride systems. Adv Dent Res 1995; 9 (03) 304-311 , discussion 312–314
  • 5 Gandhy M, Damle G. Relation of salivary inorganic phosphorous and alkaline phosphatase to the dental caries status in children. J Indian Soc Pedod Prev Dent 2003; 21: 135-8
  • 6 Rahiotis C, Vougiouklakis G. Effect of a CPP-ACP agent on the demineralization and remineralization of dentine in vitro. J Dent 2007; 35 (08) 695-698
  • 7 Llena C, Forner L, Baca P. Anticariogenicity of casein phosphopeptide-amorphous calcium phosphate: a review of the literature. J Contemp Dent Pract 2009; 10 (03) 1-9
  • 8 Robertson MA, Kau CH, English JD, Lee RP, Powers J, Nguyen JT. MI Paste Plus to prevent demineralization in orthodontic patients: a prospective randomized controlled trial. Am J Orthod Dentofacial Orthop 2011; 140 (05) 660-668
  • 9 Shen P, Manton DJ, Cochrane NJ. et al. Effect of added calcium phosphate on enamel remineralization by fluoride in a randomized controlled in situ trial. J Dent 2011; 39 (07) 518-525
  • 10 Oshiro M, Yamaguchi K, Takamizawa T. et al. Effect of CPP-ACP paste on tooth mineralization: an FE-SEM study. J Oral Sci 2007; 49 (02) 115-120
  • 11 Harper DS, Osborn JC, Hefferren JJ, Clayton R. Cariostatic evaluation of cheeses with diverse physical and compositional characteristics. Caries Res 1986; 20 (02) 123-130
  • 12 Reynolds EC. Remineralization of enamel subsurface lesions by casein phosphopeptide-stabilized calcium phosphate solutions. J Dent Res 1997; 76 (09) 1587-1595
  • 13 Bryans J. Dairy products and dental health. Dent Dig 2006; 7: 2
  • 14 Bowen WH, Pearson SK. Effect of milk on cariogenesis. Caries Res 1993; 27 (06) 461-466
  • 15 Hegde AM, Naik N, Kumari S. Comparison of salivary calcium, phosphate and alkaline phosphatase levels in children with early childhood caries after administration of milk, cheese and GC tooth mousse: an in vivo study. J Clin Pediatr Dent 2014; 38 (04) 318-325
  • 16 Vakil I, Shetty V, Hegde AM. Remineralizing and anticariogenic benefits of pure milk—a review. Nitte Univer J Health 2016; 6 (02) 57-62
  • 17 Kohn WG, Collins AS, Cleveland JL, Harte JA, Eklund KJ, Malvitz DM. Guidelines for Infection Control in Dental Health Care Settings. MMWR Recomm Rep 2003; 19 ;52(RR-17): 1-61
  • 18 Yamaguchi K, Miyazaki M, Takamizawa T, Inage H, Moore BK. Effect of CPP-ACP paste on mechanical properties of bovine enamel as determined by an ultrasonic device. J Dent 2006; 34 (03) 230-236
  • 19 Chuenarrom C, Benjakul P, Daosodsai P. Microhardness tests for enamel and dentine. Mater Res 2009; 12: 473-476
  • 20 Ivancakova R, Hogan MM, Harless JD, Wefel JS. Effect of fluoridated milk on progression of root surface lesions in vitro under pH cycling conditions. Caries Res 2003; 37 (03) 166-171
  • 21 Devlin H, Bassiouny MA, Boston D. Hardness of enamel exposed to Coca-Cola and artificial saliva. J Oral Rehabil 2006; 33 (01) 26-30
  • 22 Aimutis WR. Bioactive properties of milk proteins with particular focus on anticariogenesis. J Nutr 2004; 134 (04) 989S-995S
  • 23 Featherstone JD, Shariati M, Brugler S, Fu J, White DJ. Effect of an anticalculus dentifrice on lesion progression under pH cycling conditions in vitro. Caries Res 1988; 22 (06) 337-341
  • 24 Hegde MN, Moany A. Remineralization of enamel subsurface lesions with casein phosphopeptide-amorphous calcium phosphate: a quantitative energy dispersive X-ray analysis using scanning electron microscopy: an in vitro study. J Conserv Dent 2012; 15 (01) 61-67
  • 25 Divyapriya GK, Yavagal PC, Veeresh DJ. Casein phosphopeptide-amorphous calcium phosphate in dentistry: an update. Int J Oral Health Sci 2016; 6 (01) 18
  • 26 Lata S, Varghese NO, Varughese JM. Remineralization potential of fluoride and amorphous calcium phosphate-casein phosphopeptide on enamel lesions: An in vitro comparative evaluation. J Conserv Dent 2010; 13 (01) 42-46
  • 27 Ryge G, Foley DE, Fairhurst CW. Micro-indentation hardness. J Dent Res 1961; 40 (06) 1116-1126
  • 28 Maupome G, Aguilar-Avila M, Medrano-Ugalde H, Borges Yaez A. In vitro quantitative micro hardness assessment of enamel with early salivary pellicles after exposure to an eroding cold drink. Caries Res 1999; 33: 140-147
  • 29 Yendriwati, Sinaga RM, Dennis D. Increase of enamel hardness score after cow milk immersion of demineralized tooth: an in vitro study. World J Dent 2018; 9 (06) 439-443
  • 30 Silverstone LM, Hicks MJ, Featherstone MJ. Dynamic factors affecting lesion initiation and progression in human dental enamel. II. Surface morphology of sound enamel and carieslike lesions of enamel. Quintessence Int 1988; 19 (11) 773-785
  • 31 Marsh PD. The oral microflora and biofilm on the teeth. Microb Ecol Health Dis 2009; •••: 130-137
  • 32 Larsen MJ. Dissolution of enamel. Scand J Dent Res 1973; 81 (07) 518-522
  • 33 Al-Ani SA. Evaluation of the effect of casein phosphopeptide–amorphous calcium phosphate mousse versus natural raw fresh milk on enamel surface roughness after a pH challenge. Al-Rafidain Dental Journal. 2020; 20 (02) 183-194
  • 34 Petti S, Simonetti R, Simonetti D'Arca A. The effect of milk and sucrose consumption on caries in 6-to-11-year-old Italian schoolchildren. Eur J Epidemiol 1997; 13 (06) 659-664
  • 35 Petridou E, Athanassouli T, Panagopoulos H, Revinthi K. Sociodemographic and dietary factors in relation to dental health among Greek adolescents. Community Dent Oral Epidemiol 1996; 24 (05) 307-311
  • 36 Moynihan P. Foods and factors that protect against dental caries. Nutr Bull 2000; 25 (04) 281-286
  • 37 Kashket S, DePaola DP. Cheese consumption and the development and progression of dental caries. Nutr Rev 2002; 60 (04) 97-103
  • 38 Johansson I. Milk and dairy products: possible effects on dental health. Scand J Nutr 2002; 46 (03) 119-122
  • 39 El Deeb M, Abdel Moneim RA. Remineralization potential of lactose-free and plant based milk on enamel surface of human teeth subjected to energy drinks. Egypt Dent J 2018; 64: 3439-52