Remineralisation Effect Of Malus Domestica Incorporated Paste For Pedodontic Application
Abstract
Background: Dental caries remains a prevalent oral health issue among children worldwide, necessitating effective preventive strategies. The concept of remineralization, the natural repair process of non-cavitated enamel lesions, has gained significant attention in pediatric dentistry. Malus domestica, commonly known as apple, has been recognized for its potential in enhancing remineralization due to its rich content of bioactive compounds, including polyphenols, fluoride, and various minerals. This study investigates the remineralization potential of a novel toothpaste incorporating Malus domestica extract for pedodontic application.
Objective: To evaluate the efficacy of Malus domestica-incorporated paste in promoting enamel remineralization of primary teeth compared to conventional fluoride toothpaste.
Methods: Fresh Malus domestica fruits were processed to obtain a concentrated extract, which was incorporated into a dental paste base. Thirty sound human primary teeth with non-cavitated enamel lesions were randomly assigned to three groups: Malus domestica-incorporated paste, commercial fluoride toothpaste (positive control), and no treatment (negative control). Teeth underwent standardized brushing protocols twice daily for 4 weeks. Remineralization was assessed using Quantitative Light-Induced Fluorescence, microhardness testing, and Scanning Electron Microscopy at baseline and after treatment.
Results: Teeth treated with Malus domestica-incorporated paste showed significant reduction in lesion size and severity (p < 0.05), with efficacy comparable to commercial fluoride toothpaste. Enamel microhardness significantly increased in the treatment group, and SEM analysis revealed smoother enamel surfaces with evident mineral deposition. No adverse effects were reported.
Conclusion: Malus domestica-incorporated paste demonstrated significant remineralization effects in non-cavitated enamel lesions of primary teeth, supporting its potential as a safe and effective alternative or adjunct to conventional fluoride treatments in pedodontic practice.
References
2. American Academy of Pediatric Dentistry. Policy on early childhood caries (ECC): classifications, consequences, and preventive strategies. Pediatr Dent. 2016;38(6):52-54.
3. Farooq I, Bugshan A. The role of salivary contents and modern technologies in the remineralization of dental enamel: a narrative review. F1000Res. 2020;9:171. doi:10.12688/f1000research.22499.1
4. Mehta V, Gaur A, Chaurasia M, et al. Efficacy of herbal fluoride toothpaste in preventing early childhood caries. J Pharm Bioallied Sci. 2025;17(Suppl 4):S3398-S3400. doi:10.4103/jpbs.jpbs_1437_25
5. Saikia A, Sivasubramanian A, Muthu MS, Ganesh A, Chandrasekaran K, Kirubakaran R. Herbal dentifrices for prevention of dental caries in children and adolescents: a systematic review. Int J Clin Pediatr Dent. 2024;17(2):229-236. doi:10.5005/jp-journals-10005-2780
6. Kharouf N, Haikel Y, Ball V. Polyphenols in dental applications. Bioengineering (Basel). 2020;7(3):72. doi:10.3390/bioengineering7030072
7. Anwar MA, Sayed GA, Hal DM, et al. Herbal remedies for oral and dental health: a comprehensive review of their multifaceted mechanisms including antimicrobial, anti-inflammatory, and antioxidant pathways. Inflammopharmacology. 2025;33(3):1085-1160. doi:10.1007/s10787-024-01631-8
8. Schestakow A, Rasputnis W, Hannig M. Effect of polyphenols on the ultrastructure of the dentin pellicle and subsequent erosion. Caries Res. 2024;58(2):81-89. doi:10.1159/000536199
9. Li JY, Zhan L, Barlow J, Lynch RJM, Zhou XD, Liu TJ. Effect of tea polyphenol on the demineralization and remineralization of enamel in vitro. J Sichuan Univ (Med Sci). 2004;35(3):364-366.
10. Twetman S. Caries prevention with fluoride toothpaste in children: an update. Eur Arch Paediatr Dent. 2009;10(3):162-167. doi:10.1007/BF03262678
11. Wright JT, Hanson N, Ristic H, Whall CW, Estrich CG, Zentz RR. Fluoride toothpaste efficacy and safety in children younger than 6 years: a systematic review. J Am Dent Assoc. 2014;145(2):182-189. doi:10.14219/jada.2013.37
12. Abdolahinia ED, Taher SI, Dehdezi PA, et al. Strategies and challenges in the treatment of dental enamel. Cells Tissues Organs. 2023;212(6):485-498. doi:10.1159/000529968
13. Giacaman RA. Sugars and beyond. The role of sugars and the other nutrients and their potential impact on caries. Oral Dis. 2018;24(7):1185-1197. doi:10.1111/odi.12778
14. Cate JM. Novel anticaries and remineralizing agents: prospects for the future. J Dent Res. 2012;91(9):813-815. doi:10.1177/0022034512455032
15. Janakiram C, Venkitachalam R, Fontelo P, Iafolla TJ, Dye BA. Effectiveness of herbal oral care products in reducing dental plaque & gingivitis - a systematic review and meta-analysis. BMC Complement Med Ther. 2020;20(1):43. doi:10.1186/s12906-020-2812-1
