Tooth enamel erosion is a wearing and breakdown of the thin outer layer covering the teeth called enamel. This outer layer is the hardest tissue in our bodies. The main part of your tooth is the layer under the enamel and that is called the dentin layer.
The outer layer of enamel helps protect your teeth from its everyday use. This can encompass things such as chewing, biting, crunching, and even bruxism (tooth grinding). Even though tooth enamel is very strong it can break, chip and crack over time from daily use. Tooth enamel also acts to insulate the tooth from possibly painful changes in termperature or even chemicals (acids) that can cause a similar painful reaction.
Tooth enamel is unable to repair itself like a broken bone can. The damage from a chip or break to tooth enamel is forever. The explanation for this is that there are no living cells in the tooth enamel, unlike the second layer (dentin), which does. So the body does not have the ability to fix tooth enamel like it might a broken bone.
The erosion of enamel happens when acids eat away at the tooth enamel. Tooth enamel erosion is just one of the many reasons for tooth discomfort or pain. The erosion occurs when excessive acids in the mouth wears away the tooth enamel. Normally the calcium present in saliva will work to neutralize the acids in the foods or liquids we eat. But if you eat or drink a high amount of highly acidic foods, alcohol, soda, citrus juice (lemons, oranges), the calcium in your saliva will not be able to keep up to neutralize the acid. This will cause a change in the balance from a neutral environment to one that leans more acidic. Pure fruit juices and Carbonated drinks are highly acidic. If you drink large quantities of these drinks you are increasing your risk for tooth enamel erosion.
Other Reasons for the Erosion of Tooth Enamel
-Dry Mouth (also called Xerostomia). This occurs when salivary flow is decreased and that can be due to many factors. These factors can include systemic disease or even prescription medications.
-Acid reflux disease - also referred to as GERD (gastroesophageal reflux disease)
-Medications. For example aspirin or antihistamines. Penicillin is also known to cause dry mouth
-Genetics. A person's genetics are involved in what acidic level your mouth is naturally kept at. Your mouth may naturally lean towards an acidic state anyway and your lifestyle will just make the issue of tooth enamel erosion even worse.
-Environmental factors. Brusxism (Teeth Grinding) and stress can and will increase the amount of tooth enamel erosion by causing damage to the teeth in a physical manner. This will ultimately thin out the enamel giving the acids in your diet an even easier time of causing tooth enamel erosion.
-Bulimia. This disease has been shown over and over again to cause tooth enamel erosion. Bulimics are known for binge eating and quickly vomiting after. The release of acids from the stomach into the oral cavity will cause tooth enamel erosion over time.
Tooth Enamel Erosion - Signs and Symptoms
Tooth Pain. When tooth enamel erosion occurs, you may experience tooth pain from hot and cold foods and drinks. Remember, the tooth enamel serves as a protective insulating layer. As it thins out you are more susceptible to these changes.
Changes in color. You may begin to notice a yellowing of teeth during tooth enamel erosion. This is because the dentin (naturally yellow in color ) is becoming exposed as the enamel wears thin and translucent and allows the dentin color to show through.
Transparency. As the tooth enamel erodes and this layer becomes thinner light may be able to shine thru and give the appearance that the tooth is transparent.
Cracking and Cupping. Cracks and small indentations may develop from tooth enamel erosion.
Severe and Painful Tooth Sensitivity. Certain foods (sweets) and temperatures of foods (hot or cold) may cause a twinge of pain and discomfort in the early stage of tooth enamel erosion.
-Smooth, shiny surfaces on the teeth. Tooth enamel erosion causes mineral loss on these areas which gives the teeth a glazed look to them.
When tooth enamel erosion occurs, the tooth is more prone to cavities or tooth decay. When the tooth decay enters the hard enamel, it has an easier entry to the inner parts of the tooth.
-Maintain proper dental hygiene. This includes visiting your dentist regularly for dental examinations and cleanings. As well as brushing after every meal and flossing at least once a day.
Eliminate highly acidic foods and drinks. These include carbonated sodas, lemons, and other citrus fruits and juices. An important tip is to rinse your mouth immediately with water after ingesting these liquids. This will wash the acids from your mouth as well as bring your mouth back to a neutral pH state. If you do decide to continue to drink citrus or fruit juices choose ones that are low acidic in content. Wait for a minimum of 1 hour to brush teeth after it has been exposed to acids in food or drinks. Acid leaves the enamel softened and more prone to tooth enamel erosion during brushing.
-Use a straw. When drinking acidic drinks use a straw. This pushes the acidic liquid to the back of your mouth bypassing the teeth.
-Keep track of snacks. Snacking during the day with out brushing increases the risk for tooth decay. Following snacking the mouth will be acidic for a few hours until you are able to brush and rinse your mouth. Try to avoid snacking unless you are able to rinse your mouth and brush your teeth afterwards.
-Sugar free gum. Chewing gum stimulates salivary flow. Studies have shown it can increase up to 10X normal when chewing gum. Try to choose xylitol gum as it has been shown to reduce the acids in the mouth.
-Drink more water throughout your day if you have low saliva volume or dry mouth. This will keep your mouth in a more neutral range.
-Fluoride toothpaste Use. Fluoride strengthens teeth so use a commercially available fluoride toothpaste.
-Talk to your dentist about daily fluoride mouthwash rinses, like ACT anti cavity rinse, if you have a history of tooth decay.
Your dentist has a few ways to restore the damages to your teeth caused by erosion. Your dentist will be able to evaluate the treatment plan for your case. In some instances, dental bonding can be used to protect the tooth (act as an artificial insulator) as well as increase the cosmetics. If the tooth enamel erosion is more significant, a crown may be needed to restore and protect the tooth before any more damage might occur.
Tooth enamel erosion can be a very serious problem for patients as it develops and gets worse. Routine dental examinations will show the problem before it becomes too far along. If you have any concerns about tooth enamel erosion ask your dentist at your next dental visit.
By Marielaina Perrone DDS
Dentist in Henderson Nevada
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