Chapter 4: Microelements: Part I: Zn, Sn, Cu, Fe and I

Microelements are essential components of the diet. This chapter describes the effect of several such elements: zinc, copper, iron, tin, and iodine, on oral health. As part of normal diets, these elements have limited associations with specific oral conditions. This is partly because of their presence at relatively low concentrations and partly because they are most often present as mixtures where the effect of any one element is confounded by others. Deficiencies in microelements can cause health problems. Hence supplements, often containing one or more microelements, are prescribed to combat such conditions. All these ions exhibit antibacterial properties. Such effects are invariably small at the concentrations found in conventional foods and drinks. However, at higher concentrations, these ions can inhibit acid production by plaque bacteria involved in dental caries. Of more importance, zinc and tin have potentially significant effects on the de- and remineralisation processes involved in dental caries. Indeed, both elements have been included in oral hygiene products such as toothpastes for many years. Zinc, in particular, has demonstrated not only the ability to reduce dissolution rates of enamel and hydroxyapatite but also to inhibit calculus formation. Tin can also markedly reduce the dissolution rates. Both Cu and Fe have demonstrated anti-caries effects in animal models, whilst Fe-containing drinks have been shown to reduce enamel erosion in situ. The broad spectrum antibacterial properties of iodine have been promoted for its potential use against both early childhood caries and chronic periodontitis. However, more convincing clinical research is required to validate efficacy.