Calotropis gigantea as a Potential Treatment for Inaccessible Carious Lesion: An In Vitro Study

antimicrobials, 7 but they often require long-term use and may not be cost-effective.Advanced approaches include S. mutans vaccines using proteins, peptides, conjugates, and deoxyribonucleic acid (DNA), 4 but their effectiveness is limited due to bacterial mutations and virulent strains.Casein phosphopeptides (CPP) stabilize amorphous calcium phosphate (ACP) to form CPP-ACP, aiding remineralization and buffering acids, 8 though its effects are transient and may trigger allergic reactions.Hydroxyapatite remineralizes enamel, reduces plaque, and buffers pH.It is biocompatible and comparable to fluoride but expensive, with limited antibacterial action. 9hemoprophylactic agents such as antibiotics, cationic and ionic compounds, and plant-derived compounds are delivered through mouthwashes, toothpastes, gels, or varnishes. 10However, overuse IntroductIonDental caries is a biofilm-induced, diet-influenced, multifactorial, noninfectious, and progressive condition characterized by net demineralization of dental hard tissues. 1 The human oral cavity harbors approximately 700-1,000 microbial species, forming complex biofilm on tooth surfaces.Caries develop when frequent sugar intake shifts this biofilm toward an acidogenic, aciduric, and cariogenic state. 2 Streptococcus mutans contributes significantly through acid production, acid resistance, and extracellular polysaccharide (EPS) formation, with glucosyltransferases (GtfBCD) facilitating matrix formation. 3Risk factors include biofilm composition, gene transfer, EPS production, and behavioral, psychological, and social influences.Conventional preventive strategies such as brushing, flossing, and rinsing are effective but rely heavily on patient compliance and may not reach high-risk areas like pits and fissures.Sealants offer protection in these regions, particularly in children with a high caries index, 4 but require professional application, limiting accessibility in underserved populations.Fluoride remains a cornerstone in caries prevention due to its ability to inhibit demineralization, promote remineralization, and suppress acid production.However, concerns about overexposure include dental and skeletal fluorosis, thyroid dysfunction, and the need for repeated application. 5ylitol, an anticariogenic sweetener, blocks sucrose binding and inhibits S. mutans adhesion, though there is limited evidence of microbial metabolism even after prolonged exposure. 6Probiotics support oral health by disrupting biofilm formation and producing