Non-fluoride remineralising agents

There are a number of topical applications claiming to lead to remineralisation of a decalcified tooth surface. However, most international guidelines acknowledge that further research is required before recommending widespread use of other remineralising agents in dental caries management plans—fluoride remains first-line therapy for the primary prevention and treatment of dental caries.

Emerging evidence suggests casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) in combination with fluoride can reverse dental caries in the early stages of the disease (noncavitated lesions). CPP-ACP products should not replace fluoride interventions, but may be discussed as an additional treatment in motivated patients (see here for more information). Use clinical judgment to determine if CPP-ACP is an appropriate option in patients at elevated risk of dental caries.