Vitamins and minerals

Why this matters

Fluoride is the single most effective preventive agent in dentistry, and almost everything students are taught about how it works was overturned decades ago. Enamel cannot repair itself, so a nutritional insult in the first years of life is written permanently into a tooth you will see thirty years later. And one molecule you have probably never heard of explains dental calculus, a diagnosis only a dentist can make, and the drug class that most constrains your treatment planning.

The big picture

Minerals in the mouth sit in a permanent tug of war between dissolving and rebuilding, and vitamins are mostly the machinery that governs it. Fluoride shifts that balance from outside the tooth; vitamin D and the calcium-phosphate axis supply the raw material; and pyrophosphate is the brake that stops crystals forming where they should not.

The 14 cards in this lesson

1. 01Solubility decides storage, storage decides poison
2. 02Two organs, two hydroxylations, and the one we measure
3. 03Five bone profiles, and the one that goes the wrong way
4. 04Enamel keeps the receipt
5. 05Reading a dated insult
6. 06Fluoride works in the fluid, not in the crystal
7. 07Critical pH is not a constant, and fluoride cannot work alone
8. 08One number generates every fluoride label in the surgery
9. 09Clinical alert — in the lesson
10. 10Three fluoride numbers, and the answer you owe a parent
11. 11The clotting vitamin is also a bone vitamin
12. 12The molecule that stops crystals, and the drug built to survive it
13. 13Clinical alert — in the lesson
14. 14Six lines that survive the exam

You have got it when

You are ready to continue when you can derive any fluoride product concentration from one number, explain why fluoride works in the fluid rather than in the crystal, and say what a low alkaline phosphatase means in a child who has lost a tooth.