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By J. V. Soames and J. C. Southam

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Fluorapatite crystals may also be formed during enamel development if fluorides have been administered systemically (for example by water fluoridation). Fluorapatite is less soluble in acid than hydroxyapatite. Systemic fluoride also promotes the formation of hydroxyapatite crystals with a more stable crystal lattice. Fluoride ions in plague inhibit bacterial merabolism and this provides an additional mechanism for the prevenrive action of fluoride in enamel caries. Po~­ F- Fig. 2 Ionic exchanges at the saliva-plaque-enamel interface.

Tooth morphology - Deep, narrow pits and fissures favour the retention of plaque and food. Tooth position - Malaligned teeth may predispose to the retention of plaque and food. Factors extrinsic to the tooth Saliva - Flow rate, viscosity, buffering capacity, availability of calcium and phosphate ions for mineralization, and the presence of antimicrobial agents such as immunoglobulins, thiocyanate ion, lactoferrin, and lysozyme may affect caries pattern. Diet - The most important factor is the frequency of intake of sugary foods and drinks.

Shallow, broad concavities with polished surfaces are produced. Fig. 4 Toothbrush abrasion. 2. Occupational (environmental) erosion is now relatively uncommon. It is seen in workers exposed to acids in their workplace and is usually due to atmospheric pollution. The labial surfaces of the maxillary and mandibular incisors are usually involved as these are the surfaces most exposed to the atmosphere. 3. Regurgitation of stomach contents or persistent vomiting causes erosion in which the palatal surfaces of the maxillary teeth are primarily affected - a condition referred to as perimolysis (Fig.

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