This is an interesting question that researchers are still working on. The answer to this question is very important because it may lead to a better way to deal with cavities. Currently, an area is drilled, cleaned and prepared to accept an ‘inert’ material that serves as a replacement to the decayed tooth.
The first step in the decay process is the breach of the enamel. But if there were a way to prevent that enamel breach in the first place, this could theoretically be a preventive measure or process to take against cavities.
Disclaimer: I am not a doctor nor am I a dental professional.  And there are likely to be those who disagree with me.
One problem that will be encountered in this process is the established industry itself. There is a relatively rigid system in place that works on ‘current’ theories and it is a business model that has worked for a long time.  However, if you were to suddenly introduce a proven method to prevent cavities and repair enamel in the vast majority of cases, there might be some resistance from the current ‘establishment’.
This is nothing new and happens in all industries and sciences. Generally, we call this ‘politics’. And it can stifle true progress. But I digress.
As I just mentioned, how tooth enamel forms, the exact process is still being researched but I came across this very interesting article at ScienceDaily.com Entitled: Connecting the Dots: Dental Medicine Team Describes How Enamel Forms.Â
Here is a relevant excerpt from the article:
“Â Â “Enamel starts out as an organic gel that has tiny mineral crystals suspended in it,”…
…Â Dr. Beniash and his team found that amelogenin molecules self-assemble in stepwise fashion via small oligomeric building blocks into higher-order structures. Just like connecting a series of dots, amelogenin assemblies stabilize tiny particles of calcium phosphate, which is the main mineral phase in enamel and bone, and organize them into parallel arrays. Once arranged, the nanoparticles fuse and crystallize to build the highly mineralized enamel structure.Â
“The relationship isn’t clear to us yet, but it seems that amelogenin’s ability to self-assemble is critical to its role in guiding the dots, called prenucleation clusters, into this complex, highly organized structure,” Dr. Beniash said.   “
As mentioned in the article, they do not yet understand exactly how this works. However, it is clear that the understanding is improving greatly. Based on this, I would theorize that there should be a better way to remove tooth decay and restore natural enamel some time in the future.
This is one of the areas the dentist cannot help people with today. They cannot help enamel to regrow. They do have artificial substances to install if a tooth is chipped, but wouldn’t it be SO much better if they one day had a simple gel they could ‘paint’ onto the tooth that would help the enamel repair in a natural way.
I would very much like to see this happen. The trauma of cavity drilling and filling is very destructive to our teeth. In addition, that work may very well need to be redone at some point in the future.
With current technology, there is not choice but to create a ‘bigger hole’ each time they ‘redo’ the filling. This can lead to too much destruction of the tooth enamel at some point, causing the need for a root canal and crown.
Of course, the cost of all of this maintenance is also a burden to patients as well. But again, there will be resistance. But if the path is clear, it is possible that this will be available to us one day.
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