Tooth Remineralization: A Comprehensive Reference in Nutrition and Natural Health
Definition and Overview
Tooth remineralization is the natural repair process for non-cavitated tooth lesions, in which calcium, phosphate, and sometimes fluoride ions are deposited into crystal voids in demineralized enamel. Remineralization can contribute towards restoring strength and function within tooth structure.
De- and remineralization are critical to the formation of dental caries and tooth erosion. Both demineralization and remineralization occur on the tooth surface, and thus can be considered as highly dynamic processes, characterized by the flow of calcium and phosphate out of and back into the tooth enamel.
Dental caries is a multifactorial disease caused by the interaction of dietary sugars, dental biofilm, and the dental tissue of the host. It results from repeated cycles of demineralization and remineralization at the interface of the biofilm and the tooth surface. Demineralization is the process of removing mineral ions from hydroxyapatite crystals in hard tissues, such as enamel, which can lead to dental caries if left unchecked. The remineralization process can reverse the lost mineral ions that occur during demineralization. The degree of demineralization and remineralization depends on several variables, including the amount of available calcium and phosphate and salivary pH levels.
How Demineralization Presents: Clinical Signs and Progression
Demineralization is the removal of minerals (mainly calcium) from any of the hard tissues: enamel, dentine, and cementum. It begins at the surface, and may progress into either cavitation (tooth decay) or erosion (tooth wear). Tooth decay demineralization is caused by acids from bacteria in the dental plaque biofilm, whilst tooth wear is caused by acids from non-bacterial sources.
White spot lesions (WSLs) are early stages of caries, characterized by the sub-surface demineralization of enamel caused by the bacteria in plaque. In contrast, enamel erosion starts with the surface dissolution of tooth mineral and is caused by acidic beverages and food.
The outer layer of the tooth, the enamel, is the strongest and most mineralized layer. Enamel is thickest and strongest at the chewing surface of the tooth and gets thinner and more porous (weaker) as it tapers to the root by the gumline. The middle layer of the tooth is dentin, which is less mineralized and more porous, with the porosity getting greater as you get deeper into the dentin. This layer is the more sensitive layer of the tooth. These pores are in direct communication with the pulp, the innermost layer of the tooth. The pulp has no mineral content.
When dental caries (tooth decay) is in the strong enamel outer layer, it is "incipient" and reversible. Maximizing topical remineralization and minimizing demineralization can heal it.
White spot lesions and cavities result when the rate of demineralization exceeds the rate of re-mineralization, typically in a process that requires many months or years.
Body Systems Involved
The Oral and Salivary System
Remineralization occurs on a daily basis after attack by acids from food, through the presence of calcium, phosphate and fluoride found in saliva. Saliva, a bodily fluid important in the maintenance of tooth integrity, acts as a natural buffer to neutralize acid, preventing demineralization in the first place. If there is reduced saliva flow or reduced saliva quality, this will increase the risk of demineralization and create the need for treatment in order to prevent demineralization progression.
Saliva has a significant role in remineralization of dental enamel. It not only has a buffering capacity to neutralize the oral cavity's low pH generated after acidic encounters, but also acts as a carrier of essential ions, such as fluoride, calcium and phosphate, which have a positive role in enamel's remineralization.
Proteins are part of the normal anatomy of human saliva, and some salivary proteins, such as proline-rich proteins, statherin, and histatins, have an affinity for enamel surfaces and thus help remineralization by increasing local calcium concentration.
Acidic proline-rich proteins (PRPs), for example, exhibit high affinity to hydroxyapatite, inhibit crystal growth of calcium phosphate salts from solutions supersaturated with respect to hydroxyapatite, bind calcium ions, and interact with several oral bacteria on adsorption to hydroxyapatite. Statherins, histatins, and cystatins also exhibit affinities to mineral surfaces, inhibit calcium phosphate precipitation, and play a role in maintaining the integrity of teeth.
Acting together with the acidic proline-rich and mucinous proteins, statherin maintains the supersaturated state of saliva with respect to most calcium phosphate salts in the acquired enamel pellicle, a condition needed for the recalcification and stabilization of the tooth enamel and for the inhibition of formation of mineral accretion on tooth surfaces.
Tooth Structure and Mineral Composition
Roughly 97% of tooth enamel and 70% of dentin consists of hydroxyapatite at a nanoparticle scale. At the nanoparticle scale, it supports the role of saliva by supplying mineral to fill and repair microfissures on the enamel surface and to remineralize incipient lesions, i.e., areas below the surface that have become demineralized by the action of acids from sources such as dental plaque, carbonated beverages and food.
The structure of dental enamel is characterized by a constant balance between demineralization and remineralization. An interruption in this process can lead to the development of demineralized lesions. Demineralization is the reversible process of losing mineral ions from hydroxyapatite crystals of tooth structure, including enamel, dentin, or cementum. The demineralized hydroxyapatite crystal can be mineralized if exposed to an oral environment that supports remineralization. This is achieved when the oral plaque and mixed saliva are oversaturated with ions, including calcium, phosphate, sodium, magnesium, chloride, fluoride and hydroxide, that help remineralize dental enamel.
Systemic and Endocrine Connections
Systemic diseases, inherited disorders, a variety of medications, and other medical interventions can all have a detrimental effect on salivary production, buffering capacity, and the amount of calcium and phosphate available for remineralization.
Saliva reflects the physiologic state of the body, including emotional, endocrinal, nutritional, and metabolic variations.
The pH Threshold: A Central Chemical Principle
The caries process can be described as loss of mineral (demineralization) when the pH of plaque drops below the critical pH value of 5.5; the critical value for enamel dissolution is 5–6, and an average pH of 5.5 is the generally accepted value. Redisposition of mineral (remineralization) occurs when the pH of plaque rises. Whether a lesion develops is the outcome of the balance between demineralization and remineralization, in which the latter process is significantly slower than the former.
The pH level of saliva directly affects remineralization through the amount of calcium and phosphate ions available to the enamel via saliva in times of acidic challenge. Saliva can act as a replenishing agent and inhibit tooth demineralization during periods of low pH, while simultaneously promoting tooth remineralization once the pH returns to a neutral state.
Contributing and Associated Factors
Dietary Sugar and Fermentable Carbohydrates
Dietary sugars are the substrate for cariogenic bacteria to flourish and generate enamel-demineralizing acids. There is a strong correlation between the amount and the frequency of free sugar intake and dental caries. Refined foods and fermentable carbohydrates increase the risk of dental disease.
The readily available sugars allows for the repetitive production of acids from the bacterial metabolism keeping the pH low and leading to the imbalance between the demineralization and remineralization of the enamel surface. The demineralization will overcome remineralization, leading to the formation and progression of dental caries, and this is further worsened by the continuous exposure to sugars from the diet.
Higher frequency of sugar consumption means more demineralization and less remineralization. The duration of the decrease in pH after intake of a cariogenic food is an important confounder in this relation.
Oral Microbial Environment
The oral cavity is inhabited by both beneficial and detrimental micro-organisms. Some microorganisms metabolize sugar in the mouth and release acid, which can then damage tooth structure through loss of calcium and phosphate ions from the enamel surface. This process is known as demineralization and is the primary cause of tooth cavities.
Comparison of results from bacteriological and chemical systems has allowed elucidation of the mechanism by which acquired salivary pellicles and fluoride topical solutions decrease the rate of enamel demineralization. The pellicle retards transport of matter across the enamel surface, whereas the fluoride topical solutions decrease the cariogenicity of the colonizing bacteria.
Acid Exposure from Non-Bacterial Sources
Acids can be extrinsic in source, such as carbonated drinks, or intrinsic acids, usually from stomach acid coming into the mouth. Both types of demineralization will progress if the acid attacks continue unless arrested or reversed by remineralization.
Salivary Flow and Quality
The processes of demineralization and remineralization are modulated by modifying factors such as biofilm composition and pH, calcium and phosphate saturation and buffer capacity of saliva, use (frequency and type) of fluoride and other caries-preventive agents, oral hygiene, diet, and tooth anatomy.
Nutrients Studied in Relation to Remineralization
Calcium
Dental caries is a demineralization of an inorganic part of the tooth due to a multifactorial etiology and occurs when demineralization exceeds remineralization. The calcium and phosphorus ions level in the saliva could affect the balance between demineralization and remineralization of enamel, and their deficiency can strongly influence morphology of the tooth.
Dairy products may decrease caries risk. Dairy products contain calcium, which may encourage enamel remineralization. Two longitudinal studies, among 600 Japanese and 432 Danish adults respectively, found an inverse association between milk and caries incidence. These epidemiological associations, while consistent, do not establish causation independently of other dietary factors.
The essence of the remineralization concept of demineralized tooth surfaces might be achieved by simultaneously supplying calcium, phosphate, and fluoride ions to the teeth in order to induce formation of various apatites that remineralize and strengthen the tooth.
Phosphate
Tooth remineralization occurs when minerals such as calcium, phosphate, and fluoride are redeposited into demineralized enamel. In the oral cavity, a dynamic balance is maintained: saliva, supersaturated with minerals, continuously nourishes the enamel. At a neutral and alkaline pH level, ions penetrate the microspaces of hydroxyapatite crystals, reinforcing them.
The study of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), a dairy-derived calcium-phosphate complex, has produced some of the strongest clinical evidence for a nutritionally derived agent. A systematic review registered in the PROSPERO database aims to evaluate the clinical efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP)-based products in the remineralization of WSLs; inclusion criteria comprised randomized clinical trials, prospective cohort studies, and pilot studies conducted on human subjects with WSLs affecting permanent teeth. Fourteen articles met the inclusion criteria and were analyzed. The main findings indicate that CPP-ACP is clinically effective in promoting the remineralization of WSLs, although the results were inconsistent across studies. Comparisons with placebo and resin infiltration treatments revealed greater efficacy for CPP-ACP. The combination of CPP-ACP with fluoride appeared to further enhance the remineralizing effect on WSLs. Additional standardized clinical studies with longer follow-up periods are warranted to confirm these outcomes.
Fluoride
Fluoride promotes remineralization and this has been suggested as the main mechanism by which fluoride protects the teeth. Fluoride and calcium ions are more strongly bound than hydroxyl groups; therefore fluoride can replace hydroxyl to form fluorapatite (FAP), which has high acid resistance and poor solubility. Fluorides can promote remineralization by encouraging calcium ions in saliva to attach to the tooth surface.
The presence of fluoride reduces the critical pH by 0.5 pH units, thus exerting its protective effect. This is among the most robustly established findings in preventive dentistry, supported by multiple systematic reviews.
Vitamin D
Vitamin D3 plays a pivotal role in many biological functions like calcium (Ca) and phosphorous (P) metabolism and hard tissue mineralization and tooth formation.
Deficiency of vitamin D can cause enamel hypoplasia, which is a significant factor for early childhood caries. Studies have shown that adequate vitamin D levels can significantly reduce the incidence of dental caries, particularly in children, by enhancing the remineralization processes in teeth and modulating immune responses to oral pathogens. The relationship between vitamin D and dental caries has been explored through various studies, which indicate that vitamin D deficiency correlates with an increased risk of caries.
A randomized clinical trial at the University of Mosul, Iraq, assessed 40 participants (20 female, 20 male, aged 20–40 years), evaluating the indirect effect of oral vitamin D3 administration on remineralization of early initiated enamel caries lesions in human permanent teeth through evaluation of enamel surface microhardness, and elemental weight percentage of calcium and phosphorus in teeth surface using XRF analysis. This study is a relatively small single-center trial and its results require replication in larger multi-center studies.
Vitamin K2
Studies have shown that osteocalcin is also present in dental tissues, suggesting that vitamin K2 may help remineralize teeth by facilitating calcium deposition in enamel and dentin.
Research on the relationship between vitamin K2 and dental health remains largely theoretical. Rat studies demonstrate MK-4 supplementation increases bone mineral density in jawbone and alveolar bone height. Direct human studies examining vitamin K2's effects on tooth structure are limited. Most evidence derives from periodontal research or bone study extrapolations. Current literature relies heavily on observational studies rather than clinical interventions. Conclusions about vitamin K2's remineralizing capabilities stem from known mechanisms rather than direct clinical evidence.
Vitamin K2 has been shown to have an antioxidant potential in the brain and may prove to be a potent way to preserve the endocrine-controlled centrifugal dentinal fluid flow. This is a preliminary hypothesis published in Medical Hypotheses (ScienceDirect, 2015) and has not been confirmed in clinical trials. The evidence for vitamin K2 in direct tooth remineralization remains weak and largely mechanistic.
Magnesium
Magnesium is present in the hard tissues of the body. In enamel, the content of Mg2+ ranges from 0.2 to 0.5 wt%. Mg2+ is present near the grain boundaries as an intergranular phase of Mg-substituted amorphous calcium phosphate (Mg-ACP). Such amorphous phases have been proved to make a significant impact on the mechanical characteristics and wear resistance of enamel.
When the remineralized layer forms, calcium phosphates (CaPs) provide exogenous ions to compensate minerals lost by enamel, while fluoride and magnesium ions can exchange with calcium ions in HA, changing the solubility and mechanical properties of ion-doped HA. Magnesium prevents biofilm formation, thereby decreasing the risk of dental caries. However, these findings are primarily from in vitro or materials-science contexts; robust human clinical trials on dietary magnesium supplementation and remineralization are lacking.
Zinc
Zinc reduces bacterial and tartar formation on tooth surfaces. Therapeutic elements such as strontium, zinc, magnesium, or silver introduced into bioactive glass networks confer additional properties such as antibacterial effects, promotion of dentin and bone mineralization, or modulation of cellular responses. As with magnesium, zinc's role in remineralization has been studied primarily at the materials and in vitro level; dedicated human clinical trial evidence for zinc as a dietary supplement supporting remineralization is limited.
Natural and Plant-Derived Ingredients Studied in Relation to Remineralization
Xylitol
Traditional use: Xylitol is a naturally occurring five-carbon sugar alcohol found in many fruits, vegetables, and hardwoods. Its use as a sugar substitute in gums and candies for dental purposes became widespread in Scandinavia in the 1970s and 1980s following the landmark Turku Sugar Studies, which compared dietary sucrose with fructose and xylitol for their effects on caries incidence.
Scientific evidence: Xylitol is a naturally occurring non-fermentable polyol used as a sugar substitute and is therefore considered a non-cariogenic sweetener. Xylitol promotes remineralization by increasing salivary flow and inhibits bacterial growth and metabolism in the plaque biofilm.
Xylitol decreases the incidence of dental caries by increasing salivary flow and pH and reducing the number of cariogenic (mutans streptococci) and periodontopathic (Helicobacter pylori) bacteria, plaque levels, xerostomia, gingival inflammation, and erosion of teeth. Optimal inhibition of S. mutans growth by xylitol occurs with a total daily consumption of 5–6 g at a frequency of three or more times per day.
Remineralization of enamel lesions was observed to be twice more with xylitol gum than without the gum. An anticaries effect of xylitol and sorbitol usage has been demonstrated; the xylitol group had 27% fewer caries than the sorbitol group.
A 2013 multicenter, placebo-controlled, double-blind randomized clinical trial of 691 adults in the United States compared peppermint xylitol lozenges with control (non-sugar) lozenges over 33 months. Participants in the xylitol arm developed 40% fewer root caries lesions than those in the placebo arm.
A 2021 in vitro and in situ study published in PubMed evaluated xylitol varnishes on enamel remineralization. The percentage surface hardness recovery (%SHR) in both studies was significantly increased by xylitol and Duraphat™ varnishes when compared to placebo. Considering subsurface remineralization, only the xylitol varnishes were able to significantly reduce the enamel lesion. Xylitol varnishes can be promising alternatives to promote enamel remineralization of newly erupted permanent and deciduous teeth.
A meta-analysis published in PMC drew on a literature search through the Cochrane Library, Medline, PubMed, SCOPUS, and Web of Science for publications from 1966 to March 2020. Evidence-based results showed that the most effective xylitol product in caries prevention was 100% xylitol, chewed or consumed three to five times per day, after meals, with a total dose of 5–10 g of xylitol per day. Despite these favorable anti-cariogenic properties, the evidence for the clinical effectiveness of xylitol as a caries-preventive agent is controversial. The overall evidence strength for xylitol in remineralization is moderate: it is well supported in reducing cariogenic bacteria and increasing salivary flow, but some systematic reviews flag high risk of bias in the supporting literature.
Green Tea Polyphenols
Traditional use: Green tea (Camellia sinensis) has been consumed for over 4,000 years in East and Southeast Asia, where its use in maintaining oral health has been part of traditional practice in Chinese and Japanese medicine. Folk practices including using green tea as a mouth rinse have been documented in these traditions.
Scientific evidence: Fluoride boosters like calcium phosphates, polyphosphates, and certain natural products—including plant polyphenols—can also play an important role in enamel remineralization.
Researchers at the Dental School of the University of Illinois have investigated oral care strategies with the aim of diminishing cariogenic bacteria that cause root caries, neutralizing acidic conditions, preventing collagen scaffold breakdown, and allowing calcium and phosphate remineralization. The conceptual approach used xylitol, green tea extract polyphenols, and amorphous calcium phosphate in combination. This research represents an investigational direction rather than a clinically validated protocol.
The evidence base for green tea polyphenols in direct remineralization in humans is preliminary. Studies largely establish antibacterial activity against Streptococcus mutans and antioxidant properties relevant to gingival health; direct evidence for enamel mineral deposition by tea polyphenols remains limited to in vitro and animal studies.
Nano-Hydroxyapatite (nHAp)
Traditional/historical use: Nano-hydroxyapatite was first developed for use in toothpastes in Japan in the 1980s. It was approved as an anti-decay agent by the Japanese government in 1993 on the basis of laboratory testing and field trials in Japanese schools.
Scientific evidence: Promising biomimetic substances for oral care applications are calcium phosphates, because their chemical composition is very similar to that of the mineral phase in human teeth, especially of natural enamel. Examples for their application include the remineralization of early caries lesions and repair of small enamel defects.
Nano-hydroxyapatite was reported to have prominent remineralization roles in many in vitro studies and human clinical trials. A scoping review of publications from 2010 to 2021 (PMC, 2022) found that the majority of clinical trials (nine) were RCTs, whereas two were in situ investigations. The patient population ranged from 28 to 105 patients. These investigations were all conducted on adults aged 18 or older. Currently, there is insufficient evidence to support the efficacy of nHAp dentifrices in primary teeth.
A 2022 systematic review and meta-analysis (PMC) screened three databases (Cochrane, PubMed-MEDLINE, Ovid EMBASE). Five in vivo (and 5 in situ) studies with at least 633 teeth assessed in more than 420 patients were included. No meta-analysis could be performed for in vivo studies due to the high heterogeneity of the study designs and the variety of outcomes.
A one-year randomized clinical trial in pre- and school-age children (610 children aged 4–7 years) published in PMC (2022) compared hydroxyapatite-fluoride toothpastes with monofluoride toothpastes. The results of this one-year randomized clinical trial suggest that HAP is as efficacious as fluoridated toothpaste in treating dental caries in young children. The study controlled for baseline differences in caries experience and followed the children at six time points. After the 1-year follow-up period, 72.2% of children in the hydroxyapatite toothpaste group demonstrated development or progression of initial caries, compared to 74.2% of children in the fluoridated control group.
The nano-sized particles of fluoridated hydroxyapatite can penetrate the enamel's micropores and defects, facilitating the remineralization process at a deeper level. The overall evidence for nano-hydroxyapatite is moderate and growing, with converging in vitro, in situ, and early clinical evidence supporting remineralization efficacy broadly comparable to fluoride for early lesions; however, heterogeneity across studies prevents definitive meta-analytic conclusions.
Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP)
CPP-ACP is derived from the milk protein casein. It is not an herb or traditional remedy but has been extensively studied as a natural dairy-derived agent. One technology for remineralization is casein phosphopeptide stabilized amorphous calcium phosphate (CPP-ACP; RECALDENT™).
As noted above, a 2025 systematic review (14 RCTs and prospective studies on human subjects with WSLs in permanent teeth) found that CPP-ACP is clinically effective in promoting the remineralization of WSLs, although the results were inconsistent across studies. Comparisons with placebo and resin infiltration treatments revealed greater efficacy for CPP-ACP. The combination of CPP-ACP with fluoride appeared to further enhance the remineralizing effect on WSLs. Evidence strength is moderate; inconsistency across trials means firm conclusions require further standardized research.
Calcium Glycerophosphate (CGP)
At low pH values caused by a high concentration of S. mutans in the plaque, the addition of calcium and phosphate ions from calcium glycerophosphate (CGP) provides a buffer that shifts the hydroxyapatite equilibrium towards remineralization. Further benefits of CGP include the ability to initiate remineralization at pH levels as low as 5 and the ability to bind directly to the enamel surface.
A controlled study at PMC evaluated a dentifrice gel (ROCS Medical Minerals) containing calcium glycerophosphate, magnesium chloride, and xylitol in 57 subjects aged 10–30 years with various enamel lesions. The application of the gel containing the mineral complex of magnesium and calcium resulted in a positive remineralizing effect in patients with early stages of caries as well as those with non-caries lesions. White spots (early stage of caries) completely disappeared in 80% of cases after 15 applications of the dentifrice. This is a small, non-blinded study; results are preliminary.
Dietary and Lifestyle Factors
Sugar Quantity and Frequency
Sucrose is the most common dietary sugar and is considered the most cariogenic carbohydrate. Frequent consumption of carbohydrates in the form of simple sugars increases the risk of dental caries. The consumption frequency is more critical than the total quantity, as it affects how often the oral pH falls into the demineralization range. Sticky, retentive foods such as candies, dried fruits, and starchy snacks promote caries by prolonging the exposure time of carbohydrates on the tooth surface.
Dairy and Calcium-Rich Foods
A diet lower in added sugars and fermentable carbohydrates and high in calcium-rich cheese may favor remineralization. Frequent consumption of fermentable carbohydrates, particularly sticky and retentive foods, significantly increases caries risk. Conversely, dairy products (especially cheese), sugar alcohols (xylitol), and fibrous foods stimulate saliva and promote remineralization.
Fibrous Foods and Salivary Stimulation
Dietary choices that stimulate salivary flow, such as fibrous fruits and vegetables, and those rich in calcium and phosphate, can contribute to remineralization and neutralizing acids. The presence and flow rate of saliva are fundamental in modulating caries development.
Oral Hygiene Practices
Regular tooth brushing results in the removal of the bacterial plaque that causes caries and periodontal diseases and makes fluoride (contained in every advanced toothpaste) available for maintenance of the hard dental tissues and for remineralization wherever demineralization has occurred. This explains why in most highly developed countries caries prevalence has decreased markedly during the past 20 years although consumption of sugars remained high.
Systemic Factors Affecting Remineralization Capacity
Other factors, including poor oral hygiene, salivary gland hypofunction, socioeconomic status, parenting practices, and genetics, also play a significant role in dental caries development.
Many modifying factors have been recognized in the modern model of caries, resulting in a complex model that includes saliva, the immune system, time, socioeconomic status, level of education, lifestyle behaviors, and the use of fluorides.
Conditions for demineralization-remineralization dynamics can be affected by specific ecological factors that characterize different tooth surfaces.
Water Fluoridation
Fluoride is primarily ingested through drinking water (75%). Fluoridation of home water is a typical measure to prevent dental caries in many countries, and it can successfully reduce the incidence of dental caries.
Evidence Summary by Agent
- Calcium and phosphate (dietary and topical): Core substrates of remineralization; evidence is foundational and mechanistic, supported by extensive basic science and epidemiological data. Strength: strong.
- Fluoride (topical): Best-supported intervention for promoting remineralization; supported by multiple systematic reviews and decades of clinical research. Strength: strong.
- CPP-ACP (casein phosphopeptide): Systematic review evidence (14 RCTs) supports efficacy for white spot lesions; inconsistency across trials. Strength: moderate.
- Nano-hydroxyapatite: Growing body of RCTs and in situ studies; heterogeneity prevents meta-analysis for clinical outcomes; evidence for adults is moderate, evidence for primary teeth is insufficient.
- Xylitol: Supported by multiple RCTs for reducing cariogenic bacteria and stimulating saliva; some systematic reviews flag risk of bias. Strength: moderate.
- Vitamin D: Observational evidence associates deficiency with increased caries risk; small RCT data supports effect on enamel microhardness; needs larger trials. Strength: moderate but preliminary.
- Green tea polyphenols: Primarily antibacterial in vitro and animal data; human remineralization evidence is weak and preliminary.
- Vitamin K2: Mechanistic hypothesis; direct human clinical evidence for remineralization is absent; largely theoretical and extrapolated from bone research.
- Magnesium and zinc: Structural roles in enamel established; evidence for dietary supplementation improving remineralization in humans is weak and indirect.
References
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