Nano HA is what is found in the saliva,it is what the body uses to maintain the mineralization of the teeth; and the saliva is supersaturated with Nano HA.
Studies have found that HA nano-particles produced consistent enamel remineralization in 10 minutes, formation of a surface of carbonated HA. The nanocrystals are biomimetic.
“The treatment of demineralized enamel only for ten minutes, by synthetic carbonated HA nanocrystals, induces a consistent enamel remineralization through the formation of a surface carbonate-hydroxyapatite coating. This coating is due to the chemical bond of the synthetic CHA nanocrystals biomimetic for composition, structure, size, and morphology on the surface prismatic hydroxyapatite enamel.” (Roveri N, Battistella E, Bianchi CL, et al. Surface enamel remineralization: biomimetic apatite nanocrystals and fluoride ions different effects. Journal of Nanomaterials 2009, article ID 746383, 9 pages)
“This in-vitro study documented the deposition of nanoparticle hydroxyapatite on demineralized enamel surfaces after treatment with an experimental remineralization gel.” (Kutsch VK, Kois JC, Chaiyabutr Y, Milicich GW. Reconsidering remineralization strategies to include nanoparticle hydroxyapatite. Compendium March 2013. 34(3):170-177)
It has also been documented that Nano HA outperforms fluoride in remineralization on initial enamel lesions.
“In terms of restorative and preventive dentistry, nano-hydroxyapatite has significant remineralizing effects on initial enamel lesions, certainly superior to conventional fluoride, and good results on the sensitivity of the teeth.” (Pepla E, Besharat LK, Palaia G, Tenore G, Migliau G. Nano-hydroxyapatite and its applications in preventive, restorative and regenerative dentistry: a review of literature. Ann Stomatol (Roma). 2014 Nov 20;5(3):108-14. Rev.)
It makes sense because nature uses Nano HA to remineralize the teeth, not fluoride!
In this study Nano HA was equally as effective as fluoride.
“Remineralization therapies led to statistically significant increase of enamel SMH value (P < 0.0001). None of the groups reached their original baseline level of SMH following the remineralization therapy.” (Mielczarek A, Michalik J.The effect of nano-hydroxyapatite toothpaste on enamel surface remineralization. An in vitro study. Am J Dent. 2014 Dec;27(6):287-90. 90 human enam. 3wk pH cycle)
“It was concluded that nano-hydroxyapatite and fluoride had the potential to remineralize initial enamel lesions. CPP – ACP can be used as an effective adjunct to fluoride therapy but cannot be used as an alternative to fluoride.” (Vyavhare S, Sharma DS, Kulkarni VK. Effect of three different pastes on remineralization of initial enamel lesion: an in vitro study. J Clin Pediatr Dent. 2015 Winter;39(2):149-60. SMH, SEM, 3,6,9,12 pH cyc)
At the end of the day it is all about keeping the mouth in balance. If the mouth is not in balance, figure out why. Then you can start to address how the patient can get him or herself back in balance using the therapeutic and restorative strategies discussed over the last few weeks.