M Beerens

DISCUSSION 6 109 not already been remineralised. Applying high doses of fluoride at this stage will only remineralise the outer layer and will preserve the porosities (and whiteness) of the lesion, increasing the risk of staining. Unfortunately, minimal invasive treatment strategies to promote remineralisation of existing WSL have not been proven in vivo until now. Further research should focus on this specific tool in caries management. Future research may look into ways to positively influence biofilm factors (a healthy microbial ecology of dental plaque) and to restore lesions with calcium and phosphate ions forming structures that simulate unaffected enamel. Novel materials that aim to remineralise lesions or affect the biofilm should be tested in their commercially available form. For this, in vitro and in situ models provide the potential effectiveness of a product available to patients, but confirmation should be obtained from in vivo studies. Looking into the application method of a product, in-office use is preferred, as compliance might have an influence during in vivo research. To overcome this significant problem, future product evaluation should focus on in-office application forms so that the true effect of the product can be measured without the detrimental effects of non-compliance.