High risk caries protocol header image

We can help you get optimal and more predictable clinical outcomes for the treatment of high risk caries

picture of doctor Fortin


Developed by Dr. Christian Fortin
Dr. Christian Fortin received his Doctorate in Dental Medicine (DMD) from the University of Montreal in 1979. He practiced as a General Dentist until 1993 when he entered into the public health arena. Furthermore, he then received a certificate in Geriatric Dentistry from the University of McGill in 1994 and a Master Degree in Community Health from the Laval University in 1999.

As a Consulting Dentist for the Direction of Public Health of Chaudière-Appalaches since 1993, Dr. Fortin contributed to the writing of the Publication on Water Fluoridation: Analysis of Benefits and Risks to Health, published in 2007 by the National Public Health Institute of Quebec and dental public health action plan 2005-2012 of the Quebec Ministry of Health and Social Services (MSSS)

Dr. Fortin has been an administrator of the Order of Dentists of Quebec from 2006 to 2010 and is presently a member of the Association of Dental Public Health of Quebec. He also acts as a Dental Consultant for the MSSS.

graph showing the pH of consumables


The pH is one of the most important factor in maintaining healthy teeth. Oral microorganisms are sensitive to change in pH. A pH below 5.9 quickly leads to lesions, and often cavital lesions. Fortunately, our evidence-based products will help increase the pH and keep it to a level where the saliva is able to play its protective role and help the remineralization process.

pH scale comparison

Pure water has a neutral pH of 7.00
• A pH of 6.00 is 10x more acidic
• A pH of 5.00 is 100x more acidic
• A pH of 4.00 is 1000x more acidic
• A pH of 3.00 is 10000x more acidic
• A pH of 2.00 is 100000x more acidic

graph showing ph drops when eating an apple

Frequent intake + ⇩ pH of plaque
⇧ Lactobacillus + ⇧ S.Mutan

Frequent sugar intake reduces dental plaque pH and favours bacteria growth. Lactobacillus levels goes from 1,000/ml to 1,000,000/ml. This growth also favors caries development.

From M. Larmae. Simple tests for caries susceptibility. International Dental Journal (1985), vol 35, no 2, 109-117.

graph showing frequent sugar intake favours bacterial growth


Protection Factors / Absence of Caries
• Quantity and quality of saliva
• Fluoride
• Use of antibacterial agents: chlorhexidine & xylitol

Risk Factors / Presence of Caries
• High levels of bacteria
• Sugar habits
• Abnormal saliva

scales with risk factors on one side and protection factors on the other
graph showing when caries can be remineralized

...and process

Majority of enamel caries and 60% of caries that extend beyond the dentinal half (histological section) & that are not cavitated can be remineralized.

Medicinal Ingredients

The main substance of our teeth is hydroxyapatite (97 % of enamel and 70 % of dentin), a calcium phosphate compound. Nano medical hydroxyapatite (<mHAP>) particles penetrate below the surface of the enamel, providing replacement calcium and phosphate ions to areas from which minerals have dissolved, thereby remineralizing the demineralized enamel and restoring its integrity and translucent gloss.

Xylitol is a 100% natural sweetener derived from vegetable sources. Twenty years of research shows Xylitol efficacy treating dry mouth and reducing tooth decay.