I refer to the ‘Myth Debunked’ article in last week’s Science page (The Sunday Times of Malta, October 28). It is a feature which I regularly read and appreciate and in this instance I wish to clarify some statements.

It is true that saliva breaks down starches but it does not break down the monosaccharides responsible for acid formation. In the mouth this action is carried out by some of the bacteria found in dental plaque.

No amount of sugars will cause caries in a bacteria-free mouth, a naturally non-existent condition found only in research experiments. This explains the value of good tooth brushing to lessen the amount of plaque (bacteria) present. 

The acid produced will cause the demineralisation of the surface enamel which usually will fully remineralise when the buffering action of the saliva raises the pH to above 5.5. This immediate loss of minerals from the enamel is not caries. The presence of fluoride ions during this phase will result in a remineralised enamel which is in fact more resistant to caries and is one of the beneficial effects of the fluoride ion. 

It is the frequency rather than the quantity of the sugar intake which is a prime factor in the failure to completely remineralise with loss of the organic structure leading to naturally irreparable damage (cavity formation or caries).

The advice to delay tooth brushing is supported although one could recommend tooth brushing just before a meal to lower bacterial content.

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