Physical model for lesion formation in the presence of low levels of solution fluoride.

A quantitative physical model is presented for the formation of subsurface carious lesions in the presence of low levels of solution fluoride. Calculations using independently determined model parameters are in agreement with mineral density profiles measured in bovine enamel lesions. The proposed mechanism is controlled by fluoride in the following way: as fluoride diffuses into enamel, it is rapidly adsorbed to enamel crystallites, resulting in very low microenvironmental fluoride concentrations, so long as the crystals are not saturated with respect to fluoride adsorption. The result of this saturable adsorption is a widening band of fluoride-saturated crystals near the surface, beneath which the microenvironmental fluoride concentrations are negligible. In the saturated band, the microenvironmental fluoride concentration in the pore solution is high enough to suppress dissolution, while in the deeper, relatively fluoride free region, dissolution can occur. In addition to predicting observed mineral density profiles, the model also predicts the demarcation in solution conditions between the regime where subsurface lesion formation occurs and that where the dissolution pattern is that of surface erosion; and the lack of insensitivity of dissolution rate to hydrodynamics in the presence of low levels of fluoride, as contrasted to the square root of stirring rate dependency observed in the absence of fluoride.