Recently, there’s been some confusion about tooth enamel. Although it’s the strongest substance in the human body — even stronger than bones — it is susceptible to decay, and gradually wears down with age. It is also established fact that tooth enamel does not contain living cells, so it cannot repair itself or grow back. Once it’s gone, it’s gone.
Or is it?
Herein lies the confusion. Although tooth enamel can’t regenerate, it can be strengthened and repaired through remineralization, a process where minerals are added back to the teeth. While this is encouraging news, remineralization isn’t a treatment for advanced enamel erosion. It’s most effective when erosion is detected in its earliest stage.
The Causes of Enamel Erosion
Acids in foods and beverages are the main culprits when it comes to enamel erosion. Saliva works to neutralize these acids in your mouth, but certain types of diets, oral hygiene habits and medical conditions can make it hard for your saliva to keep up. The following types of foods and beverages are the most likely to cause damage:
- Sugary foods (like candy or fruit juice).
- Starchy foods (like bread or potatoes).
- Acidic foods (like soda or citrus fruits).
Combined with poor oral hygiene, a diet that’s high in these foods can put your enamel at risk. Other causes for enamel erosion include:
- Teeth grinding (bruxism).
- Chronic acid reflux.
- Dry mouth (xerostomia).
- Medications (like aspirin).
- Eating disorders (like bulimia).
Because enamel plays an essential role in protecting the inner, living parts of your teeth, erosion can lead to cavities, sensitivity and infection. Eroded teeth often appear discolored, cracked, chipped, or indented. Teeth may also appear more translucent — particularly around their biting edges — and develop rounded or uneven surfaces as the enamel wears away. They also become more sensitive to tastes and temperatures.
Moreover, enamel gradually wears down from daily activities like eating, grinding and clenching teeth. This is a natural, cumulative process that intensifies with age. So while age itself doesn’t directly cause enamel erosion, it is a factor.
How the Remineralization Process Works
As mentioned earlier, tooth enamel can’t be restored, but it is possible to strengthen your remaining enamel. Colgate recommends the following steps to assist the process:
Maintain a proper saliva pH — Because saliva plays a vital role in maintaining your mouth’s pH, it’s important to make sure you’re producing enough. An easy way to do this is to swish water in your mouth after eating and drinking. Chewing sugar-free gum and sucking on sugar-free candies can also promote saliva production. However, those with xerostomia may need additional treatments as recommended by their dentist. Our blog post — “What Causes Dry Mouth?” — covers this topic in detail.
Use fluoride toothpaste — Fluoride is one of the most common and effective methods in preventing demineralization. Brush at least twice a day, but preferably after every meal. If your teeth are especially susceptible to cavities, your dentist may recommend a prescription-strength fluoride toothpaste, which contains a higher concentration of fluoride (5000 parts per million) than over-the-counter options (typically 1000-1500 ppm). This increased fluoride level enhances the remineralization process, making teeth more resistant to acid attacks from bacteria and sugars, thus reducing the risk of cavities.
Floss every day — Flossing helps eliminate hard-to-reach food in your mouth, which can be a cause of bacteria that weakens your enamel — which leads to tooth decay.
Make probiotics part of your diet — Probiotics, or “good bacteria” like Lactobacillus and Bifidobacterium, are typically present in dairy products like yogurt and can also be taken as supplements. Probiotics have been shown to reduce bacteria in your mouth — thereby aiding in cavity prevention and other oral diseases — as well as preventing enamel demineralization.
Avoid foods high in sugar and carbohydrates, as well as acidic foods —Sugary foods and drinks (both diet and regular) can attack your enamel — which, of course, also leads to tooth decay.
Drink water — Staying hydrated by drinking water can help prevent dry mouth and acidity in the body, both of which can contribute to tooth decay. Drinking water also helps prevent plaque from building up and can wash away food particles and debris. Water may increase saliva production, and saliva contains minerals that can help remineralize teeth. Some medications and treatments can contribute to dry mouth. Be sure to check with your doctor if you are experiencing this.
Can Remineralization Reverse a Cavity?
The short answer is yes —with conditions. Remineralization can reverse a cavity, but only in the earliest stage of decay. When demineralization is detected before a cavity forms, remineralization can help restore the enamel. This early stage is when the decay is limited to the enamel, appearing as white spots or chalky patches. At this point, the enamel has softened, but a hole hasn’t yet formed. However, once a cavity has penetrated the enamel and reached the dentin, remineralization alone is not sufficient, and a filling or other restorative treatment is needed.
The Take-Home Message
We hope we’ve cleared up any confusion or misconceptions you may have had about enamel remineralization. Although it is possible, prevention of enamel erosion is preferable to treatment. Following our steps about how the remineralization process works will also help you keep it strong in the first place!
Of course, consulting with your dentist about ways to protect your enamel is essential. Based upon your oral health history, he or she may recommend a prescription fluoride toothpaste, or application of a dental sealant to prevent tooth decay. Our blog post — “Advantages of Dental Sealants for Children and Adults” — covers this procedure in detail.
At NK Family Dental, it is our mission to provide the highest quality and most compassionate oral care to our Chicago patients, including both dental and periodontal services. Our practice is trusted for advanced oral surgery procedures and comfortable root canal treatment.
Our team of experienced, dedicated dental professionals will help address your oral health concerns, and determine the best solution for you based on your individual situation. We strive to identify treatment options that fit your needs.
Our dental specialists include our general dentist, Dr. Nilofer Khan, our endodontist, Dr. Sabek, and our periodontist, Dr. Amir Danesh. Dr. Danesh is a board-certified periodontist and Diplomat of the American Board of Periodontology. He has contributed to the publication of two books, as well as published over 20 papers in prestigious dental research journals.
We serve the neighborhoods of Logan Square, Bucktown, Humboldt Park, and Wicker Park with the dedication that’s earned us the reputation as the Best Dentist in Chicago!
We understand that the main concern you may have is cost, which is why we accept all major PPO plans for dental insurance and also offer our in-house dental plan. Please see our financing page for more information.
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