How to Remineralize Teeth and What Remineralizing Gum Can Really Do

Remineralizing teeth is the return of calcium and phosphate to enamel that acid has partly dissolved, and it works only while the enamel surface is still unbroken. You can remineralize teeth with fluoride toothpaste, fewer daily acid exposures, and sugar-free gum after meals, but no product closes a cavity, which needs dental fillings or another restoration.

Enamel starts to dissolve below a critical pH that textbooks quote as 5.5, yet the real threshold moves between 5.1 and 6.5 depending on the calcium and phosphate in your saliva. The American Dental Association lists 5% sodium fluoride varnish, 38% silver diamine fluoride, and 5,000 ppm fluoride toothpaste among the most effective professional ways to arrest early decay, and it recommends against 10% CPP-ACP.

Remineralizing teeth at home depends on the strength of the evidence. Fluoride toothpaste rests on 96 studies in a 2019 Cochrane review. Hydroxyapatite toothpaste showed 17% caries protection across 3 randomized trials, and in an 18-month trial of 189 adults, 89.3% of hydroxyapatite users and 87.4% of fluoride users developed no new decay. Visible change is slow: after braces, 421 white spot lesions were tracked and improved only slightly at 6 weeks and 6 months.

Remineralizing gum, sold under brands such as Underbrush, adds nano-hydroxyapatite, xylitol, and mastic to a gum base. Does remineralizing gum work? Sugar-free chewing gum reduced new decay by 28% across 12 studies, mainly by stimulating saliva, while PubMed listed no caries trial of a finished nano-hydroxyapatite gum as of October 2026. This guide also covers sensitive teeth, receding gums, veneers and crowns, and the timing of teeth whitening, from the conservative-first viewpoint Maltepe Dental Clinic applies before recommending any filling, bonding, or veneer.

The information in this article is for educational purposes only and does not constitute medical advice. Consult a qualified dental professional before making any treatment decisions.

What Does Remineralizing Teeth Mean?

Remineralizing teeth means redepositing calcium and phosphate ions from saliva into enamel crystals that acid has partly dissolved. Enamel is built mostly from hydroxyapatite, a calcium phosphate mineral, and it loses some of that mineral each time plaque bacteria turn sugar into acid or an acidic drink touches the tooth.

Saliva reverses that loss between acid attacks. Saliva buffers acid, carries calcium and phosphate back to the tooth surface, and, when fluoride is present, helps form fluorapatite crystals that resist the next acid attack better than the original mineral, as the American Dental Association Library summarizes in its 2023 chewing gum review.

The remineralization of teeth follows a threshold called the critical pH. Dental texts often quote pH 5.5 for enamel, but the critical pH can rise to pH 6.5 in people with low salivary calcium and phosphate and fall to pH 5.1 in fluids richer in those minerals, as University of Manitoba oral biologist Colin Dawes explained in the Journal of the Canadian Dental Association (2003). This moving threshold explains why two people with the same diet lose enamel at different rates, and why remineralization repairs white spots but not acid erosion.

Why Can White Spots Remineralize When Acid Erosion Cannot?

White spots can remineralize because early decay dissolves mineral beneath an intact surface layer, leaving a crystal framework that saliva and fluoride can refill. Acid erosion dissolves enamel from the outside in, so no framework remains and the lost thickness does not return, the same distinction Dawes (2003) draws between white-spot lesions and eroded enamel. Remineralization adds density to enamel that is still present, which sets the point where home care ends and restorative treatment begins.

Which Enamel Damage Can Remineralization Reverse Before Dental Fillings Are Needed?

Remineralization can reverse or arrest noncavitated lesions, the chalky white or light brown spots where the enamel surface is still unbroken. Once the surface breaks into a hole, a dentist arrests the lesion or repairs it with dental fillings, because no toothpaste, gel, or gum rebuilds missing tooth structure.

In this infographic, we compare early enamel lesions, cavities, acid erosion and exposed roots to show what remineralization can improve and when dental treatment may be needed.

The most effective nonrestorative treatments include 38% silver diamine fluoride, sealants, 5% sodium fluoride varnish, 1.23% acidulated phosphate fluoride gel, and 5,000 ppm fluoride toothpaste or gel. These come from the 2018 clinical practice guideline of a panel convened by the American Dental Association Council on Scientific Affairs, which issued 11 recommendations by lesion type and advised against 10% CPP-ACP (casein phosphopeptide-amorphous calcium phosphate) (Slayton et al., 2018).

Damage type	What it looks or feels like	What can help
Noncavitated enamel lesion	Chalky white or light brown spot, smooth to the touch	Fluoride varnish, sealants, high-fluoride paste, daily home care
Cavitated lesion	Visible hole or rough area that catches floss	Silver diamine fluoride to arrest it, or a filling
Acid erosion	Thinner, glassy, or cupped enamel, often on several teeth	Removing the acid source; restoration once structure is lost
Exposed root surface	Yellowish surface near the gum line	High-fluoride toothpaste prescribed by a dentist

Lesions in the first row respond to daily habits, so home care decides whether a white spot hardens or keeps growing.

How Do You Remineralize Teeth at Home?

To remineralize teeth at home, raise the supply of minerals at the tooth surface and cut the number of daily acid attacks. There are 5 main habits that support remineralization at home:

1. Brush twice a day with fluoride toothpaste. Toothpastes with 1,000 to 1,500 ppm fluoride reduce new decay compared with non-fluoride paste in trials of children and adolescents, based on high- and moderate-certainty evidence (Walsh et al., Cochrane, 2019).
2. Keep sugar and acidic drinks to mealtimes. Each separate snack or sip starts a new acid attack, so frequent sipping keeps enamel below its critical pH longer than a single meal does.
3. Chew sugar-free gum for 20 minutes after meals. Clinical trials found less decay in people who chewed sugar-free gum for 20 minutes after meals (American Dental Association Library, 2023).
4. Clean between your teeth once a day. The ADA positions sugar-free gum as an addition to twice-daily fluoride brushing and daily interdental cleaning, never as a replacement.
5. Ask about prescription-strength fluoride for active lesions. A dentist can apply 5% sodium fluoride varnish or prescribe 5,000 ppm toothpaste when white spots are active.

The toothpaste in the first habit is where most people now choose between fluoride and hydroxyapatite.

Does Fluoride or Hydroxyapatite Toothpaste Remineralize Teeth Better?

Fluoride toothpaste remineralizes teeth with the larger and more independent body of evidence, while hydroxyapatite toothpaste performs comparably in a smaller set of trials. The 2019 Cochrane review of fluoride toothpaste covered 96 studies published between 1955 and 2014 (Walsh et al., 2019).

Hydroxyapatite toothpaste evidence is newer. A 2021 systematic review screened 291 records, found 5 clinical caries trials, and pooled 3 randomized trials to estimate 17% protection against decay (Limeback et al., 2021). An 18-month trial of 189 adults in Poland found no new decay in 89.3% of hydroxyapatite users and 87.4% of users of a 1,450 ppm fluoride paste (Paszynska et al., 2023).

Two details change how to read those results. The 2023 trial tested non-inferiority against a predefined 20% margin, which shows hydroxyapatite was not meaningfully worse than fluoride, a narrower claim than “equal”. Two of the 3 authors of the 2021 review and 3 co-authors of the 2023 trial work for Dr. Kurt Wolff GmbH & Co. KG, the German company that sells Karex hydroxyapatite toothpaste, and a 2022 laboratory study on human enamel found Karex less protective than a 1,400 ppm fluoride paste (Guntermann et al., 2022).

You should stay with fluoride toothpaste unless you have a specific reason to avoid fluoride, and hydroxyapatite paste is the evidence-backed alternative if you do. Trials of this size are missing for most other remineralizing products, which is why a side-by-side view of the evidence helps.

How Strong Is the Evidence Behind Each Way to Remineralize Teeth?

The evidence behind each way to remineralize teeth ranges from 96 trials for fluoride toothpaste to no clinical trial for bentonite clay. Read the table from top to bottom: the higher a method sits, the more weight it deserves in a daily routine.

Method	Best human evidence	Main finding	How to use it
Fluoride toothpaste (1,000 to 1,500 ppm)	Cochrane review, 96 studies (Walsh et al., 2019)	Less new decay than non-fluoride paste	Daily foundation
Professional fluoride varnish or 5,000 ppm paste	ADA guideline, GRADE-rated (Slayton et al., 2018)	Among the most effective for arresting early lesions	For active white spots
Sugar-free chewing gum (any brand)	Meta-analysis, 12 studies (Newton et al., 2020)	28% less new decay; moderate-quality trials	After meals, as an extra
Hydroxyapatite toothpaste	Meta-analysis of 3 RCTs (Limeback et al., 2021) plus an 18-month RCT of 189 adults	17% protection; non-inferior to 1,450 ppm fluoride	Fluoride-free alternative
CPP-ACP chewing gum	One 24-month RCT, 2,720 adolescents (Morgan et al., 2008)	18% lower odds of lesion progression than plain sugar-free gum	Promising, one large trial
Xylitol products outside toothpaste	Cochrane review, 10 studies (Riley et al., 2015)	Low to very low quality; no proven benefit in adults	A sweetener, not a treatment
Hydroxyapatite chewing gum	One 2-week trial, 100 participants, on sensitivity (Porciani et al., 2014)	Less dentin sensitivity than placebo gum; no caries trial	Unproven for decay
Mastic gum	One short-term trial in orthodontic patients (Aksoy et al., 2007)	Fewer saliva bacteria for up to 135 minutes	Antibacterial, not a mineral source
Plant extracts such as aloe vera and cacao	Scoping review of 20 articles, largely lab and animal work (Irmaleny et al., 2024)	Lab-level remineralization signals	Not ready for daily reliance
Bentonite clay	No clinical remineralization trial in PubMed (searched October 2026)	No measured effect on human enamel	Skip as a remineralizer

In this infographic, we compare the scientific evidence behind ten ways to remineralize teeth, from well-established fluoride treatments to options with limited or no clinical proof.

Time is the one variable this table leaves out, and it decides when any of these methods show a visible result.

How Long Does It Take to Remineralize Teeth?

Remineralizing teeth takes weeks to months, and the visible change is usually smaller than before-and-after photos online suggest. Researchers at the Academic Center for Dentistry Amsterdam measured 421 lesions in 58 patients with quantitative light-induced fluorescence after their braces came off, and found a small improvement at 6 weeks and a further improvement at 6 months (van der Veen et al., 2007).

The smallest white spots improved least, by an average relative 2%, while larger lesions improved by 12%, and the authors described the overall regression as small. A remineralized spot often becomes harder while staying visible, because an arrested lesion is not the same as a vanished one. Slow results push many people toward a daily shortcut, and remineralizing gum is the product that promises one.

What Is Remineralizing Gum, and Does It Work?

Remineralizing gum is a sugar-free chewing gum that adds mineral or antibacterial ingredients, most often nano-hydroxyapatite, xylitol, calcium carbonate, and mastic resin, to a gum base. Remineralizing gum works through 2 separate routes: chewing stimulates saliva, which is well supported, and the added minerals touch enamel, which has little direct evidence in gum form.

Does Remineralizing Gum Work for Cavities and White Spots?

Remineralizing gum can lower the risk of new decay the way any sugar-free gum does, but no published trial shows a nano-hydroxyapatite gum reversing white spots or cavities. Sugar-free gum reduced new decay by 28% across 12 trials and by 33% in the 8 trials that used xylitol gum, though the King’s College London authors rated the trials as generally moderate quality with high variability (Newton et al., 2020).

The only added mineral with a long-term caries trial in gum form is CPP-ACP, not hydroxyapatite. Adolescents who chewed a 54 mg CPP-ACP gum 3 times a day for 24 months had 18% lower odds of lesion progression than those chewing the same gum without it (Morgan et al., 2008), a different format from the 10% CPP-ACP product the ADA advises against. That gap between ingredient and finished product matters most for the best-known brand in the category.

Is Underbrush Gum Legit?

Underbrush gum is a real, sugar-free product whose ingredients each have some research behind them, but PubMed listed no clinical trial of the finished gum on decay or white spots as of October 2026. Underbrush is made by Nathan & Sons, and its product page (checked October 2, 2026) lists xylitol, a chicle gum base, erythritol, mastic gum, spruce gum, nano and micro hydroxyapatite, calcium carbonate, calcium bentonite clay, magnesium carbonate, and zinc gluconate.

The label suggests chewing 1 to 2 pieces after meals for at least 30 minutes, longer than the 20 minutes the ADA uses for sugar-free gum. A dentist’s reading of the formula splits it into 3 parts:

• Evidence-backed parts: sugar-free chewing and xylitol, which stimulate saliva and replace sugar.
• Plausible but untested parts: nano and micro hydroxyapatite, which have toothpaste trials but only one short sensitivity trial in gum form.
• Unsupported parts: calcium bentonite clay, which has no clinical remineralization trial in PubMed.

For someone who already chews gum, a sugar-free gum like Underbrush is a reasonable swap; as a replacement for fluoride toothpaste or a dental exam, it is not. Maltepe Dental Clinic has no commercial relationship with Nathan & Sons or any gum brand. The same caution applies to every remineralizing gum label.

How Should You Read a Remineralizing Gum Label?

To read a remineralizing gum label, check 5 details before you buy:

1. Confirm the sweeteners are sugar-free, such as xylitol, erythritol, or sorbitol, with no sucrose or glucose syrup.
2. Compare the chewing instructions with the 20-minute standard the ADA uses for sugar-free gum after meals.
3. Look for disclosed amounts, such as grams of xylitol per piece and the type and percentage of hydroxyapatite.
4. Search each cited study on PubMed to confirm the author, the journal, the conclusion, and whether the study tested gum or toothpaste.
5. Check the pack for the ADA Seal of Acceptance, which the ADA considers only for sugar-free gum.

Point 4 matters because a study on a xylitol toothpaste or a mastic extract says nothing direct about a finished gum. Mastic, one ingredient on many of these labels, shows that gap clearly.

Is Mastic Gum Good for Your Teeth?

Mastic gum can lower mouth bacteria for a short time, but it does not supply minerals to enamel. Mastic is the resin of the Pistacia lentiscus shrub, chewed as a natural gum across the Eastern Mediterranean, including Turkey.

Orthodontic patients at Süleyman Demirel University in Isparta, Turkey, who chewed mastic gum for 15 minutes had significantly fewer Streptococcus mutans, lactobacilli, and total bacteria in saliva up to 135 minutes later than after chewing paraffin (Aksoy et al., 2007). The trial measured bacteria in saliva, not enamel or decay, so mastic belongs in the antibacterial column rather than the remineralizing one. Sensitivity is the one outcome where a mineral-containing gum has been tested directly.

Can Remineralizing Gum Ease Sensitive Teeth?

A hydroxyapatite gum may ease sensitive teeth within 2 weeks, based on one controlled trial. Our guide to sensitive teeth covers the wider causes and treatments that a gum cannot address.

In that trial, 100 adults chewed 2 pieces 3 times a day; air-blast sensitivity fell by 66% with the calcium hydroxyapatite gum versus 25% with placebo gum, and cold-water sensitivity fell by 49% versus 31% (Porciani et al., 2014). The placebo gum also helped, which shows how much of the effect comes from chewing and saliva alone. Persistent sensitivity still calls for an exam, because decay and exposed roots produce the same symptom, and many people try natural fixes first.

Can You Remineralize Teeth Naturally With Clay, Xylitol, or Plant Extracts?

You can remineralize teeth naturally by protecting saliva flow and limiting sugar, but most natural remineralization products lack clinical proof. A 2024 scoping review in the European Journal of Dentistry found 20 articles on aloe vera, bilimbi, Galla chinensis, siwak, and cacao; all reported some potential, yet the evidence was largely laboratory and animal work with designs the authors called heterogeneous (Irmaleny et al., 2024).

Three popular natural options fall short for different reasons:

• Bentonite clay: PubMed lists no clinical trial testing it for enamel remineralization (searched October 2026).
• Xylitol on its own: Cochrane reviewers rated the evidence for xylitol products outside toothpaste as low to very low quality, with only one adult study (Riley et al., 2015).
• Online cavity-healing regimens: Threads on Reddit’s r/Biohackers combine calcium sodium phosphosilicate (NovaMin) toothpaste, tea tree oil, and raw cacao, yet none of these steps rebuilds a cavitated surface.

The natural habits that do help are plain ones: water instead of sweet drinks, meals instead of grazing, and steady saliva flow. Saliva and minerals act on teeth, which raises the question of whether the gums can rebuild themselves too.

Can Receding Gums Remineralize or Grow Back?

Receding gums cannot remineralize or grow back on their own, because gum tissue is soft tissue with no mineral crystal to rebuild. Our guide to receding gums explains the stages of recession and the treatment options available.

Recession exposes the root surface, which carries less mineral than enamel and dissolves more easily in acid. The ADA guideline lists 5,000 ppm fluoride toothpaste or gel among its effective options, and a dentist decides whether exposed roots need it (Slayton et al., 2018). Root surfaces also sit at the edges of many crowns and veneers, where remineralization still matters.

Does Remineralization Protect Teeth With Veneers, Crowns, or Implants?

Remineralization protects only the natural tooth structure around veneers, crowns, and fillings, because porcelain, zirconia, composite resin, and titanium contain no enamel crystals to rebuild. The weak line of any restoration is its margin, where the restoration meets natural enamel or root, and decay that starts there cannot be remineralized away once it cavitates.

Porcelain veneers at Maltepe Dental Clinic are E-max (lithium disilicate) restorations, which do not decay, but the enamel and root next to them follow the same rules as any natural tooth. Fluoride toothpaste, cleaning between teeth, and sugar-free gum after meals protect those margins. Dental implants have no enamel at all, so their long-term care centers on the gum and bone around them rather than on remineralization.

For patients from the US treated in Istanbul, MDC keeps synchronized digital records and runs remote follow-up after the trip, so a home dentist can check margins against the original treatment records. Enamel condition and margins matter before any cosmetic step, starting with teeth whitening.

Should You Remineralize Enamel Before Teeth Whitening?

You should have white spots and decay assessed before teeth whitening, because peroxide gel lightens tooth color but does not treat demineralized enamel or close a cavity. A dental exam before teeth whitening identifies lesions that need fluoride, sealing, or a filling first.

If you buy a remineralizing gel for teeth whitening, check its active ingredient and concentration, the same test this guide applies to toothpaste and gum. White spots that remain after remineralization raise one final question.

Do White Spots Go Away After Remineralization?

White spots often harden but stay visible after remineralization, and resin infiltration can mask them without drilling. An umbrella review of 13 systematic reviews found that resin infiltration gave acceptable esthetic results and lowered the risk of lesion progression, with a pooled risk ratio of 0.32, or about 68% lower risk (Lin et al., 2022).

A conservative-first plan rules out remineralization and resin infiltration before composite bonding or veneers. If cosmetic treatment is still the right step, Digital Smile Design at Maltepe Dental Clinic shows the planned result before any enamel is prepared, so the decision rests on a preview rather than on a white spot alone.

Sources

All citations below were checked against PubMed records and doi.org on October 2, 2026.

• Walsh, T., Worthington, H.V., Glenny, A.M., Marinho, V.C., & Jeroncic, A. (2019). Fluoride toothpastes of different concentrations for preventing dental caries. Cochrane Database of Systematic Reviews, 3(3), CD007868. https://doi.org/10.1002/14651858.CD007868.pub3
• Aksoy, A., Duran, N., Toroglu, S., & Koksal, F. (2007). Short-term effect of mastic gum on salivary concentrations of cariogenic bacteria in orthodontic patients. The Angle Orthodontist, 77(1), 124–128. https://doi.org/10.2319/122205-455R.1
• American Dental Association. (2023). Chewing gum. ADA Library & Archives, Oral Health Topics. https://www.ada.org/resources/ada-library/oral-health-topics/chewing-gum
• Dawes, C. (2003). What is the critical pH and why does a tooth dissolve in acid? Journal of the Canadian Dental Association, 69(11), 722–724. https://pubmed.ncbi.nlm.nih.gov/14653937/
• Guntermann, L., Rohrbach, A., Schäfer, E., & Dammaschke, T. (2022). Remineralization and protection from demineralization: effects of a hydroxyapatite-containing, a fluoride-containing and a fluoride- and hydroxyapatite-free toothpaste on human enamel in vitro. Head & Face Medicine, 18(1), 26. https://doi.org/10.1186/s13005-022-00330-5
• Irmaleny, I., Fatriadi, F., & Christovher, C. (2024). Natural materials’ potential as alternative teeth remineralization agents: a scoping review. European Journal of Dentistry, 18(2), 468–476. https://doi.org/10.1055/s-0043-1776122
• Limeback, H., Enax, J., & Meyer, F. (2021). Biomimetic hydroxyapatite and caries prevention: a systematic review and meta-analysis. Canadian Journal of Dental Hygiene, 55(3), 148–159. https://pubmed.ncbi.nlm.nih.gov/34925515/
• Lin, G.S.S., Chan, D.Z.K., Lee, H.Y., et al. (2022). Effectiveness of resin infiltration in caries inhibition and aesthetic appearance improvement of white-spot lesions: an umbrella review. Journal of Evidence-Based Dental Practice, 22(3), 101723. https://doi.org/10.1016/j.jebdp.2022.101723
• Morgan, M.V., Adams, G.G., Bailey, D.L., et al. (2008). The anticariogenic effect of sugar-free gum containing CPP-ACP nanocomplexes on approximal caries determined using digital bitewing radiography. Caries Research, 42(3), 171–184. https://doi.org/10.1159/000128561
• Newton, J.T., Awojobi, O., Nasseripour, M., et al. (2020). A systematic review and meta-analysis of the role of sugar-free chewing gum in dental caries. JDR Clinical & Translational Research, 5(3), 214–223. https://doi.org/10.1177/2380084419887178
• Paszynska, E., Pawinska, M., Enax, J., et al. (2023). Caries-preventing effect of a hydroxyapatite-toothpaste in adults: a 18-month double-blinded randomized clinical trial. Frontiers in Public Health, 11, 1199728. https://doi.org/10.3389/fpubh.2023.1199728
• Porciani, P.F., Chazine, M., & Grandini, S. (2014). A clinical study of the efficacy of a new chewing gum containing calcium hydroxyapatite in reducing dentin hypersensitivity. Journal of Clinical Dentistry, 25(2), 32–36. https://pubmed.ncbi.nlm.nih.gov/25122980/
• Riley, P., Moore, D., Ahmed, F., Sharif, M.O., & Worthington, H.V. (2015). Xylitol-containing products for preventing dental caries in children and adults. Cochrane Database of Systematic Reviews, 2015(3), CD010743. https://doi.org/10.1002/14651858.CD010743.pub2
• Slayton, R.L., Urquhart, O., Araujo, M.W.B., et al. (2018). Evidence-based clinical practice guideline on nonrestorative treatments for carious lesions: a report from the American Dental Association. Journal of the American Dental Association, 149(10), 837–849.e19. https://doi.org/10.1016/j.adaj.2018.07.002
• van der Veen, M.H., Mattousch, T., & Boersma, J.G. (2007). Longitudinal development of caries lesions after orthodontic treatment evaluated by quantitative light-induced fluorescence. American Journal of Orthodontics and Dentofacial Orthopedics, 131(2), 223–228. https://doi.org/10.1016/j.ajodo.2005.07.017