Thank you very much for your letter. The placebo paste used in this trial did not contain fluoride. However, it would be difficult to extrapolate from the data that the positive results seen in the MI Paste Plus group were a direct result from either the casein phosphopeptide-amorphous calcium phosphate, the fluoride content in the paste, or both.

The pictures you mentioned are from a series that we collect on every patient. The reproduction of these clinical pictures in print and the actual images that we observed on the monitor screen are very different and do not do justice to the trial. We also acknowledge that clinical judgment in the evaluation of the data can be subjective. However, we made every effort to calibrate the investigators and to control the lighting environment. We would also be happy to send you further data sets if you wish.

Finally, as with all procedures carried out in orthodontics, patient compliance is always an issue. Under these trial conditions, the results seem to indicate the benefits of the use of MI Paste Plus containing both casein phosphopeptide-amorphous calcium phosphate and fluoride. However, the real “antidote to the poison” is the effective use of the product by the patient.