Importance of high pKA acids in cariogenic potential of plaque.

Through the use of computer simulation, it is shown that anions of high pKA acids (e.g., acetic, propionic, butyric), present in resting plaque fluid, act as effective buffers during the production of stronger acids (e.g., lactic) by oral micro-organisms. Using reported organic acid compositions for plaque, obtained from caries-resistant and caries-susceptible individuals, analyzed at various times following sucrose exposure, it is shown that the calculated pH values of the aqueous phase of plaque describe typical Stephan curves. Furthermore, it is shown that for higher acid anion contents in resting plaque, a higher degree of saturation of the aqueous plaque phase with respect to enamel is maintained during acid production, resulting in a lower demineralization potential of plaque. Enamel demineralization experiments conducted in vitro confirmed the significance of the results of the computer simulations, thus providing evidence for a correlation between the known metabolic activity of plaque (organic acid composition), physical chemistry of plaque, and caries susceptibility.