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

Tooth enamel is considered the strongest substance in the body. It covers the visible part of the tooth called the crown, and unlike other parts of the mouth, it does not have blood vessels or nerves. 

How Does Enamel Develop?

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

What Does 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.

Enamel Wear

Your enamel is the outer layer of the teeth. It serves as the first defense against oral attackers and shields the teeth from everyday use, acid from oral bacteria, and the impact from your regular biting habits.

Enamel wear occurs when the enamel is damaged due to exposure to different chemicals from food, fluids, and even smoking. Although the saliva neutralizes the acids in the mouth and maintains 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 erode the enamel of the tooth, which can be caused by the following:

  • Low salivary flow or dry mouth
  • Acid reflux
  • A 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 happens when the tooth cracks from being bent or flexed too far.
  • Attrition describes tooth friction, usually when people grind their teeth.
  • Abrasion is when the surface of the tooth emerges. It's common in people who use their teeth for things other than eating (opening packages, bottles, etc.). 

In some instances, the lack of enamel arises from developmental problems during the critical developmental stages or inherited conditions. Currently, two general conditions cause a lack of enamel on one's teeth:

Enamel hypoplasia: When someone has enamel hypoplasia, their teeth tend to have depressions in the form of pits and groves. They may also have white or yellowish spots on the teeth and be especially sensitive to the temperature. Factors that can increase this risk include congenital issues and hereditary factors.

Hypomineralization: Another factor that can contribute to a lack of enamel. Like enamel hypoplasia, risk factors include congenital issues, but one can also contract this from childhood illnesses. Those afflicted with enamel hypomineralization tend to have a chalky tooth surface. Their teeth may also appear translucent. 

While disease-associated factors partially cause a lack of enamel, it's not the only thing that causes it. Most cases of enamel loss do not involve hereditary causes. Instead, enamel erosion is the most significant contributor to this reduction, be it in those who are predisposed or not. 

For the most part, two factors typically contribute to erosion:

Physical. When enamel erosion is physical, it is physically taken off over time. The causes include sustained frictional or blunt damage your teeth get over time, due to external abrasive forces, or improper oral habits. Repeat occurrences usually take off more enamel. Intervention for this type of erosion often involves pinpointing practices that contribute to it and correcting them, either by oral appliances or lifestyle changes. 

Chemical. When enamel erosion is chemical, it usually comes from substances you eat. One obvious offender is acid, found in most carbonated or sour drinks. Other sources include chlorine from pools or certain medications. In this case, you can limit erosion by regulating your intake of abrasive substances in your diet or otherwise.

Signs of Enamel Wear

Tooth sensitivity is a sign of an early enamel erosion stage wherein the teeth become 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.

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 about 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

Like most dental problems, enamel erosion is preventable with proper oral hygiene such as brushing, flossing, and rinsing with mouthwashFluoride 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 a 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.

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