A caries band-aid: Sequential anti-biofilm and remineralization therapy for functional and aesthetic restoration of enamel caries

Both functional and aesthetic restoration are essential for effective early caries treatment. Among current strategies, caries in-situ remineralization therapy (CIRT) has been widely studied for early intervention. While CIRT effectively restores enamel hardness, it remains limited in aesthetic improvement—particularly the elimination of white spot lesions. This is largely due to persistent dental biofilms, which create a low-pH, low-permeability microenvironment that disrupts mineral ion transport and inhibits the ordered regeneration of enamel crystals, thereby limiting aesthetic recovery such as the resolution of white spot lesions. To address this, we developed a caries band-aid with integrated anti-biofilm and remineralization layers, enabling spontaneous, sequential treatment—first removing biofilms to create a clean surface, then initiating enamel remineralization. In vitro and in vivo studies showed that enamel hardness recovered to near-normal levels within 7 days. Mineral loss was reduced by ∼40 % compared to the non-sequential group. White spot lesions were eliminated after 16 days, while the non-sequential group showed only partial improvement. This study is the first to report a remineralization strategy capable of simultaneously restoring both functional and aesthetic defects of early caries. The sequential strategy offers a promising solution to overcome CIRT limitations and guide effective caries management.