Effectiveness of Natural Remineralizing Agents on Initial Enamel Caries: In Vitro Study

Purpose: The objective of this in vitro study is to evaluate the effectiveness of natural remineralizing agents (Ginger and Rosemary extracts) on initial enamel caries compared to sodium fluoride.
Materials and methods: Thirty human extracted intact maxillary central incisors were used in this study. The teeth were divided into 3 groups of 10 teeth according to the remineralizing protocol used. Two Intervention groups and control group. Group 1 (n=10) teeth were treated with Rosemary remineralizing agent, Group 2 (n=10) teeth were treated with Ginger remineralizing agent and Group 3 (n=10) teeth were treated with sodium fluoride varnish. Laser fluorescence testing was done to all samples using (DIAGNOdent). Then artificial initial enamel caries was created by subjecting all samples to demineralizing solution for 4 days without stirring. Laser fluorescence was tested again after creation of the initial enamel caries. Then each group of samples were treated with one of the remineralizing agents. The agents were brushed to the labial surface. In between treatments the samples were stored in artificial saliva at 37 ^c to resemble the oral conditions.  And finally, Laser fluorescence was assessed once again.
Results: The comparison of Diagnodent values between groups shows that the highest mean value was recorded in ginger group (7.51±1.42). The comparison of difference and percent change in Diagnodent values between groups shows that the greatest increase was recorded in Ginger group (median =2.16), followed by Rosemary (median= 0.84), then sodium fluoride (median= -0.7). The difference between Ginger and Sodium fluoride groups was statistically significant (p=0.014), Regarding the percent change from baseline to D2, the greatest percent increase was recorded in Ginger group (median =61.85), followed by Rosemary (median= 19.3), then sodium fluoride (median= -14). The difference between Ginger and Sodium fluoride groups was statistically significant (p=0.017).
Conclusion: Fluoride varnish, ginger and rosemary can decrease early enamel lesions. The herbals ginger and rosemary may be preferable for prevention purposes on initial remineralization of enamel lesions as more natural products are preferred today.