Tooth Enamel Erosion and Restoration

What is tooth enamel?

Enamel is the thin outer covering of the tooth. This tough shell is the hardest tissue in the human body. Enamel covers the crown or the part of the tooth that’s visible.

Because enamel is translucent, you can see light through it. But the main body of the tooth, the dentin, is the part that’s responsible for your tooth color - whether white, off white, grey, or yellowish.

Sometimes coffee, tea, cola, red wine, fruit juices, and cigarettes stain the enamel on your teeth. Regular visits to your dentist for routine cleaning and polishing can help remove most surface stains and make sure your teeth stay healthy.

What does tooth enamel do?

Enamel helps protect your teeth from daily use such as chewing, biting, crunching, and grinding. Although enamel is a hard protector of teeth, it can chip and crack. Enamel also insulates the teeth from potentially painful temperatures and chemicals.

Unlike a broken bone that can be repaired by the body, once a tooth chips or breaks, the damage is done forever. Because enamel has no living cells, the body cannot repair chipped or cracked enamel.

What causes enamel erosion?

Tooth erosion happens when acids wear away the enamel on teeth. Enamel erosion can be caused by the following:

• Excessive soft drink consumption (high levels of phosphoric and citric acids)
• Fruit drinks (some acids in fruit drinks are more erosive than battery acid)
• Dry mouth or low salivary flow
• Diet (high in sugar and starches)
• Acid reflux disease ( GERD)
• Gastrointestinal problems
• Medications ( aspirin, antihistamines)
• Genetics (inherited conditions)
• Environmental factors (friction, wear and tear, stress, and corrosion)

What are environmental causes of tooth surface erosion?

Friction, wear and tear, stress, and corrosion (or any combination of these actions) can cause erosion of the tooth surface. More clinical terms used to describe these mechanisms include:

• Attrition. This is natural tooth-to-tooth friction that happens when you clench or grind your teeth such as with bruxism, which often occurs involuntary during sleep.
• Abrasion. This is physical wear and tear of the tooth surface that happens with brushing your teeth too hard, improper flossing, biting on hard objects (such as fingernails, bottle caps, or pens), or chewing tobacco.
• Abfraction. This occurs from stress fractures in the tooth such as cracks from flexing or bending of the tooth.
• Corrosion. This occurs when acidic content hits the tooth surface such as with certain medications like aspirin or vitamin C tablets, highly acidic foods, GERD, and frequent vomiting from bulimia or alcoholism.

More findings show bulimia as a cause of enamel erosion and tooth decay. Bulimia is an eating disorder that’s associated with binge eating and vomiting, a source of acid. Frequent vomiting erodes tooth enamel and can lead to cavities.