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What Causes Tooth Enamel Damage?

How Enamel Protects Your Teeth

Enamel is kind of like the shell of an egg: it protects the softer, more vulnerable part of the tooth inside.

But unlike an eggshell, the thin layer of enamel is tough. In fact, enamel is the hardest substance in the body. It can withstand decades of biting, chewing and crunching -- with some luck and good dental care.

What Makes Teeth White?

Tooth enamel might seem white, but it's actually the layer underneath -- dentin -- that's makes the tooth appear lighter or darker. Enamel is semi-translucent. At least it starts that way.

Over time, coffee, tea, wine, cigarettes, and other substances can stain your enamel, making it dingy, yellow, or gray.

From Enamel Erosion to Cavities

As tough as tooth enamel is, it's not indestructible. Acids from foods and bacteria can eat away at it, causing erosion and cavities.

In this slide, cavities are forming in the center.

Enamel can also be chipped or cracked. And unlike bone, enamel can't grow back on its own. The damage is permanent.

Tooth Decay and Sensitivity

What happens when tooth enamel is damaged? The exposed part underneath becomes vulnerable to decay. Cavities aren't the only problem.

Teeth with damaged enamel can become sensitive to extreme temperatures. Suddenly, eating ice cream or sipping hot coffee can be painful or unpleasant.

How Bacteria Destroys Enamel

After you eat, certain bacteria in your mouth feast on sugars from sweet foods and starches. This makes acids that can destroy enamel. The green rods in this slide are bacteria that cause gingivitis.

The acids found in sodas, juices, and drinks are harmful, too. Some are more corrosive than battery acid.

Over time, these acids cause erosion, literally shrinking the size of the tooth.

Wine Tasters, Beware

Wine tasters may be at high risk for enamel stain and erosion.

Why? Sipping wine many times a day -- and swishing it in the mouth -- increases the enamel's exposure to damaging acids.

That’s why it's better to drink a glass of wine, soda, or sweet tea with a meal instead of sipping it over several hours.

Eating and Digestive Problems

Conditions that cause vomiting or acid reflux can damage tooth enamel. This slide shows erosion from the eating disorder bulimia.

When stomach acid gets into the mouth, it can have a corrosive effect on the tooth enamel. The same goes for any condition that causes frequent vomiting, from gastrointestinal problems to eating disorders.

The Problem With Dry Mouth

If you have a dry mouth -- caused by a medication side effect or a health condition -- the acids stick around longer, causing greater damage.

Saliva naturally neutralizes acids in the mouth that erode teeth. It also resupplies minerals to strengthen tooth enamel.

Grinding Teeth

Another cause of tooth enamel damage is bruxism -- or teeth-grinding. Over time, the constant clenching and friction can wear down or fracture the enamel. In this slide, teeth grinding has ground down the upper and lower front teeth.

Bruxism is often worst when you sleep -- that's when you can't control it. Reducing stress may help. Some people wear a special mouth guard to bed.

Your Mouth Is Not a Bottle Opener!

Your mother was right: Never open bottles, packages, or other containers with your teeth. You might permanently chip or crack the enamel.

Gnawing on anything else -- like pens or fingernails -- or chomping down on seeds, popcorn kernels, or ice could have the same result.

Kids and Tooth Enamel Erosion

Many experts believe that tooth enamel erosion is on the rise -- especially in children. Why? Some say that kids are drinking too many acidic drinks and sodas.

Drinking less tap water with protective fluoride -- and more bottled water without it -- could also be part of the problem.

Tips to Fight Tooth Enamel Erosion

There are simple ways to reduce tooth erosion. Brush after eating or drinking. Use a soft toothbrush and fluoride toothpaste.

You can also have some milk or a piece of cheese after a meal to help neutralize acids.

Lastly, chewing sugar-free gum with xylitol after eating will stimulate your saliva production. That's another way to counteract the effects of acids.

Improve Your Dental Hygiene

Floss your teeth; don't use toothpicks.

Brush your teeth gently. Scouring teeth with a hard-bristled toothbrush can damage enamel.

Beware when using teeth-whitening products, which can damage enamel if used improperly or too often.

If you need pointers on how to properly care for your teeth, just ask your dentist.

Reviewed by Alfred D. Wyatt Jr., DMD on November 15, 2011

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