A Guide to Maintaining the Enamel on Your Teeth

For the job it’s asked to do, there’s no man-made substance on the planet that can compare with tooth enamel created by the human body. If it’s taken care of properly, it will last a lifetime, protecting teeth from decay. It’s the hardest substance in the human body, with the highest percentage of minerals of any bodily tissue. The protein-rich fluid present in enamel even has some self-healing properties. When enamel breaks down because of trauma or decay, dentists use ceramic caps, gold crowns, or composites in its place, but these substitutes pale in comparison to the real deal. Enamel is integrally attached to the dentin layer below, unlike gold or composites.

Unlike ceramics, enamel rarely cracks all the way through. That’s because structurally, enamel is similar to woven fiber. When cracks do form, there is no obvious path they follow. Thanks to enamel, teeth do not avoid damage, but instead, they contain it. The structural integrity of enamel is especially evident in sufferers of the rare disorder amelogenesis imperfecta, which leaves permanent and baby teeth virtually enamel-free. Those afflicted with the disorder have smaller, hypersensitive teeth prone to extensive damage. But enamel does have one major flaw: It contains no living cells, and so the body cannot naturally restore it. This means it is susceptible to decay.

What causes healthy tooth enamel to decay? The simple answer is acid. Bacteria that live in the mouth interact with sugars left on the teeth. This produces acid that mixes with saliva to form plaque that sticks to teeth. The acid eats away at tooth enamel, causing cavities to form. Cavities are essentially evidence that the mineral structure of the tooth has been dissolved, or demineralized. Things get worse without regular brushing and flossing, which disturb the bacteria. If left undisturbed, the damage gets worse every time sugar is consumed. In early stages, the surface layers of the teeth are eroded, until finally, the soft pulp of the tooth is exposed.

There are several ways to avoid this decay, including avoiding certain foods. Sugary drinks and starchy foods can really do a number on tooth enamel. In particular, candies and sweets such as lollipops and caramels get stuck on the teeth and can cause long-term damage. Potato chips and soft breads can also easily get stuck in teeth, coming into contact with plaque and causing harmful acids to form. Carbonated soft drinks contain acids that wear away tooth enamel as well as sugar that can create additional acids. With every sip, acid attacks the teeth for up to 20 minutes. The damage soda can do to teeth is even worse if it is sipped slowly over a long period of time. Even sugar-free soda still has harmful acids that can cause decay. The natural sugars in fruit juice can also cause dental problems. In fact, any drink containing citric acid or phosphoric acid can be problematic because these acids alter the pH balance in the mouth and can cause tooth erosion. It is best to rinse the mouth with tap water instead of brushing after drinking such beverages because they can weaken tooth enamel and brushing can then remove the enamel. Diet isn’t the only factor in tooth decay: Enamel can also be eroded by frequent use of public swimming pools with incorrect pH levels, and studies have shown that certain at-home whitening products can weaken enamel as well.

There are several ways to limit the damage done by certain food and drinks. When eating sugary food, eat it with a regular meal so the body can make more saliva. This helps to reduce the damaging effects of the acid production. It also rinses pieces of the sugary food out of the mouth. After the meal, chewing on a piece of sugarless gum can help wash out the food and acid. Drinking more fluoridated water can also help prevent damage to tooth enamel. To protect enamel, eat foods high in calcium. Calcium counters the acids that cause decay. Milk, cheese, and other dairy products are high in calcium. Regular brushing and flossing, especially after meals, can help ward off decay. But over-brushing could potentially wear down the enamel, especially if the brushing is too fast or hard. Supplementing with fluoridated mouthwash or tablets will also help fight cavities and strengthen enamel in addition to the use of regular fluoridated toothpaste. Communities with fluoride added to the water system can improve dental health of their residents. For younger residents, fluoride unites with the surface of the teeth, making them less likely to decay.

Methods of preventing tooth decay change as teeth develop from childhood and adolescence through adulthood. Parents should start brushing children’s teeth with fluoride-free toothpaste as soon as the first tooth appears. Fluoride comes into the picture when kids reach the age of two. Toddlers need to have their teeth brushed after breakfast and before bed for about 30 seconds. Parents should floss for their kids as soon as two teeth emerge that touch. When the full set of 20 baby or milk teeth emerge, school-age kids should brush for two minutes twice a day, and they should begin to floss around age seven. Chewing gum with xylitol at this age can also help prevent decay. And parents should avoid sharing toothbrushes or spoons with their kids because this can cause cavity-causing bacteria to be passed on.

What about adults facing issues with tooth enamel? How can they enhance or strengthen it? In combination with consistent, high-quality oral care, using “restoring” toothpastes and mouthwashes can help prevent decay. These products introduce minerals and calcium that patch weak spots in the enamel. Products that contain calcium phosphate or stannous fluoride are beneficial in restoring or strengthening enamel. If necessary, dentists can prescribe stronger toothpaste and mouthwash than those purchased over the counter.

The following resources can help people who want to know more about tooth enamel:

• Cracked on Impact: The Secrets of Tooth Enamel
• Tooth Decay Is Easily Preventable
• Tooth Decay (Caries or Cavities) in Children
• The Best and Worst Foods for Your Teeth
• Tooth Development
• How to Keep Your Tooth Enamel Strong
• Dental Erosion and Severe Tooth Decay Related to Soft Drinks
• Fluoride Facts
• Erosion of Dental Enamel Among Competitive Swimmers
• Soft Drinks and Oral Health
• Something To Smile About
• The Surprising Truth About Cavities
• Are “Restoring” Toothpastes and Mouthwashes Marketing or Medicine?
• Cavities Are Contagious
• When Teeth Get Damaged
• Researchers Discover Key Player in Enamel Regeneration
• Think Before You Drink: Erosion of Tooth Enamel From Soda Is Permanent
• Teeth and Nerves
• Common Habits That Harm Your Teeth
• Sugar-Free Drinks Can Still Damage Teeth
• Tooth Enamel: Nature’s Crowning Achievement
• Detroit Dental Services
• Detroit Cosmetic Dentists
• Detroit General Dentistry