Karex – caries prevention with hydroxyapatite

Caries – a widespread dental disease

Caries still remains the most widespread type of dental disease. 1 The risk factors are, in particular, sugary foodstuffs and inadequate plaque removal. 2, 3 There are, however, other factors that can significantly increase the risk of caries. Demographic changes have resulted in an aging population. As we age, the amount of medication we take also increases. Many medications that are taken on a day-to-day basis and other factors, such as stress and certain illnesses, can result in a reduction of saliva. 4-6 When saliva is reduced, the natural remineralisation process from saliva is restricted and the risk of caries is increased. There is too little calcium phosphate from the saliva. 3

Karex with hydroxyapatite

Hydroxyapatite is the natural building block of dental enamel and is therefore of particular interest in dentistry as a biomimetic agent. 7

Karex with hydroxyapatite as well as zinc and xylitol protects the teeth using an anti-caries complex:

  • Regeneration and protection of the dental enamel 8-15
  • Biofilm management 16
  • Plaque removal 17


Karex contains hydroxyapatite and is therefore effective even when saliva is reduced. This is because the active ingredient is already present in mineral form and does not have to be formed from the saliva through remineralisation processes. 10 Moreover, Karex with hydroxyapatite repairs microfine defects in the enamel and forms a protective film against caries. Thus, Karex protects the teeth from caries just as effectively as fluoride toothpaste.

Karex with hydroxyapatite - for modern caries protection


  1. Listl, S., Galloway, J., Mossey, P. A. & Marcenes, W. Global economic impact of dental diseases. J. Dent. Res. 94, 1355-1361 (2015).
  2. Meyer-Lückel, H., Paris, S. & Ekstrand, K. Karies: Wissenschaft und Klinische Praxis. (Thieme, 2012).
  3. Fejerskov, O. & Kidd, E. Dental Caries: The Disease and its Clinical Management. (Wiley, 2009).
  4. Sreebny, L. M. & Schwartz, S. S. A reference guide to drugs and dry mouth - 2nd edition. Gerodontology 14, 33-47 (1997).
  5. Guggenheimer, J. & Moore, P. A. Xerostomia: etiology, recognition and treatment. J. Am. Dent. Assoc. 134, 61-69 (2003).
  6. Villa, A., Connell, C. L. & Abati, S. Diagnosis and management of xerostomia and hyposalivation. Ther. Clin. Risk Manag. 11, 45-51 (2015).
  7. Enax, J. & Epple, M. Synthetic hydroxyapatite as a biomimetic oral care agent. Oral Health Prev. Dent. (accepted).
  8. Kani, K. et al. Effect of apatite-containing dentifrices on dental caries in school children. J. Dent. Health 19, 104-109 (1989).
  9. Lelli, M. et al. Remineralization and repair of enamel surface by biomimetic Zn-carbonate hydroxyapatite containing toothpaste: a comparative in vivo study. Front. Physiol. 5, 333 (2014).
  10. Najibfard, K., Ramalingam, K., Chedjieu, I. & Amaechi, B. T. Remineralization of early caries by a nano-hydroxyapatite dentifrice. J. Clin. Dent. 22, 139-143 (2011).
  11. Tschoppe, P., Zandim, D. L., Martus, P. & Kielbassa, A. M. Enamel and dentine remineralization by nano-hydroxyapatite toothpastes. J. Dent. 39, 430-437 (2011).
  12. Loveren, C. v. Toothpastes. Vol. 23 (Karger, 2013).
  13. Roveri, N. et al. Synthetic biomimetic carbonate-hydroxyapatite nanocrystals for enamel remineralization. Adv. Mater. Res. 47-50, 821-824 (2008).
  14. Yamagishi, K. et al. Materials chemistry: a synthetic enamel for rapid tooth repair. Nature 433, 819 (2005).
  15. Hegazy, S. A. & Salama, I. R. Antiplaque and remineralizing effects of Biorepair mouthwash: A comparative clinical trial. Pediatr. Dent. J. 26, 89-94 (2016).
  16. Hannig, C., Basche, S., Burghardt, T., Al-Ahmad, A. & Hannig, M. Influence of a mouthwash containing hydroxyapatite microclusters on bacterial adherence in situ. Clin. Oral Investig. 17, 805-814 (2013).
  17. Harks, I. et al. Impact of the daily use of a microcrystal hydroxyapatite dentifrice on de novo plaque formation and clinical/microbiological parameters of periodontal health. A randomized trial. PloS one 11, e0160142 (2016).

A detailed overview of literature can be found here.