title: The clinical application of surface pH measurements to longitudinally assess white spot enamel lesions.
abstract: OBJECTIVE
  Means of objectively assessing white spot enamel lesions (WSEL) are critical for determining their potential activity and monitoring the success of preventive treatments. The aim of this study was to determine whether surface pH measurements of WSEL changed during a preventive course of care designed to remineralize the lesions.
  
  
  METHODS
  Eight healthy subjects (1 male and 7 females) with at least one WSEL were recruited (19-64 years). Each subject was placed on a preventive treatment program including the daily application of a CPP-ACP paste (MI paste, GC Corp., Japan) with custom fitted trays for more than 6 months. The surface pH values of sound enamel and WSEL were monitored for up to 2 years using a micro-pH sensor. The visual appearance of the WSEL was monitored via digital photography, and images were analyzed qualitatively on a 5-point scale to assess the success of the remineralization preventive program. The relationship between the qualitative assessment of WSEL appearance and the WSEL pH was investigated using a Spearman's rho non-parametric correlation.
  
  
  RESULTS
  The surface pH of the WSEL was different to that of the sound enamel surrounding it in all patients at all times. All lesions showed visual improvement as the treatment period progressed. The pH of the WSEL increased towards that of sound enamel over the course of treatment significantly correlating with the visual improvement of the lesion (rho=0.63, p<0.0001).
  
  
  CONCLUSIONS
  The clinical assessment of WSEL surface pH changes with time may have utility as an additional objective measure for the assessment of WSEL activity.
authors.affiliation: Cariology and Operative Dentistry, Department of Restorative Sciences, Graduate School, Tokyo Medical and Dental University, 5-45 Yushima 1-chome, Bunkyo-ku, Tokyo 113-8549, Japan. kitasako.ope@tmd.ac.jp
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kitasako
authors.forename: Nathan J
authors.initials: NJ
authors.lastname: Cochrane
authors.forename: Matin
authors.initials: M
authors.lastname: Khairul
authors.forename: Kanako
authors.initials: K
authors.lastname: Shida
authors.forename: Geoffrey G
authors.initials: GG
authors.lastname: Adams
authors.forename: Michael F
authors.initials: MF
authors.lastname: Burrow
authors.forename: Eric C
authors.initials: EC
authors.lastname: Reynolds
authors.forename: Junji
authors.initials: J
authors.lastname: Tagami
mesh_terms: D000287:Administration, Topical; D000328:Adult; D015374:Biosensing Techniques; D002021:Buffers; D002327:Cariostatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002364:Caseins / Q000008:administration & dosage / Q000627:therapeutic use*; D003731:Dental Caries / Q000473:pathology / Q000503:physiopathology* / Q000517:prevention & control; D003743:Dental Enamel / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008137:Longitudinal Studies; D008297:Male; D008832:Microchemistry / Q000295:instrumentation; D008875:Middle Aged; D023861:Photography, Dental / Q000379:methods; D012463:Saliva / Q000187:drug effects / Q000378:metabolism / Q000502:physiology; D012636:Secretory Rate / Q000502:physiology; D014089:Tooth Remineralization / Q000379:methods*; D055815:Young Adult
chemical_list: D002021:Buffers; D002327:Cariostatic Agents; D002364:Caseins; C447032:casein phosphopeptide-amorphous calcium phosphate nanocomplex