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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 is visible.

Because enamel is translucent, you can see light through it. But the main body of the tooth - the dentin - is the part that is responsible for your tooth colour, 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 very hard substance designed to protect 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 permanent. Because enamel has no living cells, the body cannot repair it once it is chipped or cracked.

What causes enamel erosion?

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

  • Excessive fizzy and 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
  • A diet high in sugar and starches
  • Acid reflux disease ( GORD)
  • Gastrointestinal problems
  • Certain 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) can cause erosion of the tooth surface. Other 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 (habitual teeth-grinding), which often occurs involuntarily during sleep.
  • Abrasion. This is physical wear and tear of the tooth surface that happens due to brushing your teeth too hard, improper flossing, biting on hard objects (such as fingernails, bottle caps or pens) or chewing tobacco.
  • Abfraction. This occurs following stress fractures in the tooth, such as cracks from flexing or bending of the tooth.
  • Corrosion. This occurs when acidic content damages the tooth surface, which can be due to the consumption of certain highly acidic foods and medications, or as a result of GORD or frequent vomiting from bulimia, binge drinking or other conditions.

There is increasing evidence that bulimia is a cause of enamel erosion and tooth decay. Bulimia is an eating disorder that is associated with binge eating and vomiting, a source of acid. Frequent vomiting erodes tooth enamel and can lead to cavities due to the stomach acid in the vomit.

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