Nanobacteria's potential involvement in enamel repair in caries

Dental caries is the accumulation of numerous episodes of demineralization and remineralization, rather than a unidirectional demineralization process. Demineralization and remineralization occur constantly either simultaneously or alternately and whether a lesion will progress or be repaired depends upon the predominant process over periods. Even if fluoride has demonstrated the anti-caries effect by shifting the demineralization/remineralization balance favorably, little is known about non-fluoride action in favor of the balance and the effect of fluoride could not fully explain enamel repair in caries. Recently, in vitro experiments demonstrated enamel repair by synthetic apatite nanocrystals which showed the strong affinity, excellent biocompatibility, mechanical improvement, and a higher resistance to acids than apatite from teeth. This reminds us of a controversial microorganism called nanobacteria (NB) which form nanocrystalline apatite around themselves. Although NB have been detected in some pathological calcifications, epidemiologic literature suggests that they are widespread present in the healthy people blood. Considering the similarity of synthetic nanocrystalline apatite to that of NB and blood circulation communicating with saliva, we put forward a hypothesis that NB may act in enamel surface just like what the synthetic nanocrystalline apatite does in vitro to repair enamel in caries.