What is enamel?
Enamel is the hard, outer layer of the teeth. It is the hardest substance in the human body and protects the sensitive dentin underneath. Enamel is made up of hydroxyapatite crystals that provide strength and protect teeth from decay. Once enamel is formed, it cannot be regenerated if damaged or worn away. This makes enamel preservation extremely important for dental health.
What causes enamel loss?
There are several factors that can lead to enamel loss:
Tooth decay
Tooth decay, also known as dental caries or cavities, is the breakdown of teeth due to acids made by bacteria. The bacteria feed on sugars and starches left on teeth after eating and release acids as a byproduct. These acids weaken and dissolve the mineral structure of enamel over time, leading to holes or cavities in teeth.
Acidic foods and drinks
Frequent consumption of acidic foods and drinks can erode and thin enamel. Examples include citrus fruits, tomatoes, carbonated beverages, wine, and fruit juices. The acidic pH softens and slowly dissolves enamel over time.
Gastroesophageal reflux disease (GERD)
GERD causes stomach acid to flow back into the mouth. Repeated exposure to stomach acid can dissolve enamel and cause tooth erosion.
Eating disorders
Eating disorders like bulimia nervosa that involve recurrent vomiting can expose teeth to high amounts of stomach acid, eroding tooth enamel.
Grinding and clenching
Grinding teeth (bruxism) and frequent clenching can wear down tooth enamel from too much pressure and friction over time. This can flatten and fracture enamel.
Abrasion
Using abrasive substances like hard toothbrushes or aggressive brushing can wear away enamel. Abrasion can also occur from habits like nail biting, chewing on pens/pencils, opening hair pins with teeth, and using teeth to cut thread or rip open packages.
How to check for enamel loss
Here are some signs and methods to determine if your tooth enamel has eroded or worn away:
Appearance changes
Thinning or disappearing enamel will change the shape and color of teeth:
– Teeth look smaller or thinner
– Edges and cusp tips become rounded, flat or transparent
– Yellowish tone appears as thicker underlying dentin shows through
– Dark spots or streaks on certain areas
– Increased staining and discoloration
Increased sensitivity
Loss of protective enamel exposes the softer dentin underneath. This can cause teeth to become very sensitive to hot, cold, sweet, or acidic foods and drinks. Pain may linger after the stimulus is removed.
Rough spots
Run your tongue over your teeth to feel for holes, pits, or scratches in enamel. Advanced erosion may leave teeth feeling rough.
Chips and cracks
Inspect teeth closely in the mirror for any chips, fractures, or breaks in the enamel. Damage is easier to see along the gumline and biting edges.
Dental exam
Dentists can check for early signs of enamel loss using diagnostic tools:
– Visual exam – Looks for enamel defects and tooth appearance changes
– Dental X-rays – Helps find problems between teeth
– Tactile exam – Uses a dental probe to check tooth surfaces for roughness
– Air test – Sensitive teeth react to a gentle stream of air
Treatment options
Several treatments are available to help protect, repair, or replace eroded enamel:
Fluoride
Fluoride strengthens enamel and makes it more resistant to decay. Fluoride toothpaste, mouth rinses, gels, and professional fluoride treatments help prevent further enamel loss.
Over-the-counter toothpastes
Some toothpastes contain ingredients to help relieve sensitivity or fill minor enamel defects. Look for brands listing potassium nitrate for sensitivity or compounds like hydroxyapatite, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and bioglass to help remineralize enamel.
Dental bonding
Dentists apply a tooth-colored resin material to fill chips or cracks for a seamless appearance. The bonded resin protects exposed dentin and prevents further enamel loss in the area.
Dental crowns
Crowns completely encase and cover teeth to protect remaining structure. Crowns are custom-fitted caps usually made from ceramic, porcelain fused to metal, or resin materials. They help strengthen compromised teeth.
Enamel microabrasion
This minimally invasive technique uses an acidic compound to selectively dissolve tiny imperfections and stains in enamel. It polishes teeth to restore smoothness.
Teeth whitening
Whitening strips away deep stains to give teeth a brighter, more even appearance. Whitening also helps mask discoloration from enamel loss.
Preventing further enamel loss
Practicing good oral hygiene and limiting enamel-damaging habits can help prevent excessive wear. Tips include:
– Brush teeth twice daily with a soft-bristled brush and fluoride toothpaste
– Avoid brushing too forcefully, abrasives, or firm bristled brushes
– Floss daily to clear food debris and plaque from teeth
– Use non-abrasive mouthwash
– Drink acidic drinks quickly through a straw to minimize contact with teeth
– Wait 30-60 minutes before brushing after consuming acidic foods or drinks
– Avoid grinding and clenching by managing stress, getting a night guard, and Botox
– Get regular dental cleanings and exams to catch problems early
Conclusion
Tooth enamel is susceptible to damage from tooth decay, erosion, abrasion, and other factors. Being aware of signs like sensitivity, discoloration, chips, cracks, and roughness can help detect enamel loss early. Treatments aim to halt disease progression and restore form and function. Preventive measures like proper hygiene, diet modifications, and habits correction help maintain enamel and dental health. Seeking regular professional care allows dentists to monitor enamel status and intervene with appropriate therapies as needed. Addressing enamel loss right away is key to preventing more severe tooth structure damage.