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Tooth Enamel: Functions, Problems & Proper Care | Hawaii Family Dental

What is tooth enamel?

The tooth enamel, which is considered the strongest substance in the body, is one of the four major tissues that comprises the tooth along with dentin, cementum, and the dental pulp.

It covers the visible part of the tooth called the crown. Unlike other parts of the mouth, it does not have blood vessels or nerves. Still, it is highly mineralized with 96 percent of its composition being water and the rest being organic materials. Hydroxyapatite, a naturally occurring mineral which is a crystalline calcium phosphate, is the primary mineral of the tooth enamel.

How does the enamel develop?

A part of the tooth development process, enamel begin to form in the crown stage through the process called amelogenesis or enamel formation. The process starts following the first establishment of the dentin through ameloblast cells.

The enamel formation is further divided into two stages called the secretory stage where proteins and an organic matrix  form a partially mineralized enamel, and the maturation stage which completes the mineralization of the enamel.

What does the enamel do?

As the outer layer of the tooth, enamel serves as a protective barrier against harmful bacteria and acids that can attack the teeth and cause dental problems. It also protects the teeth from the pressure and stress of the teeth's daily use including in chewing, biting, and grinding. Moreover, it works as an insulator of the teeth for temperatures and chemicals that may be potentially harmful to the teeth.

What are the problems associated with the enamel?

Remineralization of the enamel can take place and repair it to a certain degree. However, the body cannot repair severe damage to the enamel. Unlike the bones, enamel contains no living cells which can possibly help in the repair.

Enamel Wear

Enamel wear occurs when the enamel is damaged due to its exposure to different chemicals from food, fluids, and even smoking. Although the saliva works to neutralize the acids in the mouth and maintain its balance, too much exposure can lead to enamel erosion as the saliva cannot keep up with the acids.

Causes of Enamel Wear

Enamel wear or erosion can occur when acids corrode the enamel of the tooth which can be cause by the following:

  • Low salivary flow or dry mouth
  • Acid reflux
  • High amount of starch and sugar in the diet
  • Medications such as antihistamine and aspirin
  • Highly acidic drinks or food such as the excessive consumption of soda
  • Gastrointestinal problems
  • Genetics

Environmental Causes of Enamel Wear

Any combination of stress, wear and tear, corrosion and friction can cause the tooth surface to erode. These terms are also known as:

  • Abfraction. This takes place following stress fractures in the tooth like bending of the tooth or cracks from flexing of the tooth.
  • Attrition. This is described as a natural tooth to tooth friction which takes place when a person gnashes his or her teeth like bruxism. This usually happens involuntarily when a person is sleeping.
  • Corrosion. This takes place when the acidic content impairs the surface of the tooth. This can be because of excessive consumption of acidic foods, beverages, and medications. Likewise, this may be due to frequent gagging from bulimia, as a result of GORD, binge drinking, and other conditions.
  • Abrasion. This pertains to the erosion of the surface of the tooth which emerges because of improper flossing, brushing the teeth too hard, chewing tobacco or biting on hard or solid objects like pens, bottle caps, and fingernails.

Signs of Enamel Wear

  • Tooth sensitivity is a sign of an early stage of enamel erosion wherein the teeth becomes sensitive to some foods and drinks especially sweets and those with high temperatures.
  • Tooth discoloration is a condition wherein the tooth appears yellow. The discoloration is caused by the exposure of the dentin due to enamel erosion.
  • Cracked and chipped tooth as it becomes more jagged, irregular, and rough due to the erosion.
  • Indentations on the tooth's surface

Treatment

There are different types of treatments available for enamel wear. Depending on the degree or extent of the problem, the recommended treatment may include bonding, veneer, or crown. Talk to your dentist to know more of your options.

Additionally, you can also get treatments to reduce the effects of the symptoms of enamel wear such as tooth sensitivity, tooth discoloration, cracked or chipped tooth, and indentations on the tooth's surface.

Prevention

Enamel erosion, like most dental problems, is preventable with proper oral hygiene such as brushing, flossing, and rinsing with mouthwash. Fluoride treatments can also help strengthen the tooth's enamel.

Moreover, it is advisable to refrain from food and drinks that can potentially harm the enamel particularly those rich in sugar and acids. If you intend to drink acidic beverages, it is recommended to use straw to avoid contact with the teeth. Also, decrease the frequency of snacking as it subjects the teeth to more probability of tooth decay.

Additionally, accompany your food consumption with water to ensure the adequate amount of saliva and prevent the occurrence of dry mouth. Try chewing sugar-free gums to boost saliva production.


References:

  • https://www.webmd.com/oral-health/guide/tooth-enamel-erosion-restoration#1
  • https://www.everydayhealth.com/hs/healthy-teeth-guide/enamel-erosion/
  • https://www.healthline.com/health/enamel-erosion#treatment-and-prevention
  • https://www.colgate.com/en-us/oral-health/basics/mouth-and-teeth-anatomy/what-is-tooth-enamel-0113
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