Virgin coconut oil, coconut milk, and coconut water potential in the remineralization of tooth enamel surface

Abstract

Remineralization is an oral natural repair process, reversing the demineralization effect that causes loss of minerals from the tooth enamel. Previous studies have proven that fluoride, xylitol, and CPP-ACP are efficient against caries and effective remineralization agents. Yet, many studies believe that to allow remineralization to work well, abundant of free available Ca and phosphorus (P) in the saliva are required. Milk was known as an effective remineralization agent due to its high content of CPP-ACP but to individual with lactose intolerance and Cow’s milk allergy, which could give them adverse effects after consumption. Hence, plant-based milk was opted as milk substitute. Limited studies acknowledged some plant-based milk able to promote enamel remineralization due to their high amount of Ca. However, abundance sugar content in some commercial drinks proven otherwise. The current study generally aims to investigate the potential of virgin coconut oil (VCO), coconut milk (CM), and coconut water (CW) as the new alternatives for this matter. To fulfil the general aims, the study aims to evaluate the Ca and P content of VCO, CM, and CW. Furthermore, the study also sought to understand the elemental content changes of the tooth enamel subsurface as well as the morphology changes of the tooth enamel subsurface. The study starts by analysing the elemental content of VCO, CM, and CW using ICP-MS. The samples were taken for acid digestion (Method 3051A) using Teflon vessels for 4h at 170°C, before analysed by ICP-MS. Proceeded with remineralization evaluation of the enamel, the specimens were observed under scanning electron microscope with energy dispersive X-ray (SEM/EDX). The specimens were demineralized using demineralization solution at pH 4.01 for 7 days and then were treated with VCO, CM, and CW as the remineralization solution for 14 days. Distilled water was used as control throughout the study. Observation using SEM/EDX were done before demineralization of the specimens and after every completion of the stages. The overall comparison of EDX data using one-way ANOVA. A direct analysis data acquired from ICP-MS showing the Ca concentration in VCO (0.47±0.15), CW (0.45±0.05) and CM (0.44±0.15), while P concentration showed CM (0.25±0.05), CW (0.09±0.05), and VCO (0.05±0.06). The overall comparison of EDX data using one-way ANOVA showed significant difference of elemental content changes among the samples with p < 0.05. Compared to control (81.35 ± 4.92 Ca wt %), VCO (73.65 ± 4.25 Ca wt %) showed the highest Ca content after remineralization followed by CM (72.08 ± 3.60 Ca wt %) and CW (68.40 ± 2.42 Ca wt %) while contradictory to P wt % which CW (31.94 ± 2.83 P wt %) showed the highest P wt % content followed by CM (27.92 ± 3.60 P wt %), VCO (26.35 ± 4.25 P wt %), and control (18.65 ± 4.92 P wt %). Meanwhile, the enamel subsurface do not show progressive morphology changes but CW which found to cause severe damage to the specimens enamel subsurface. Both VCO and CM left protective layer over the enamel subsurface while control do not show any changes on the enamel surface morphology. In conclusion, only VCO and CM are able to provide aid for remineralization whereas CW unable to promote remineralization on tooth enamel subsurface.