Your daily habits — from what you eat and drink to how you brush — may be harming your teeth.
If your dentist has brought up enamel erosion, it’s worth listening. “Enamel is the hard, calcified tissue that covers the crown of the teeth,” says Ana Ferraz-Dougherty, DMD, a dentist in San Antonio, Texas, and a spokesperson for the American Dental Association. “It’s basically the shield against anything we eat and drink to protect against cavities.”
It’s also the white part of your teeth, so when it wears away, you’ll begin to see more of the underlying dentin, which is more yellow. And that’s something that whitening treatments, which work primarily on removing stains caused by foods and drinks, can’t fix.
How Enamel Is Worn Away
Dental enamel provides an incredibly hard shield for your teeth, but it has one major weakness: its pH. Made of carbonated calcium hydroxyapatite, it has an estimated pH of 5.5. Your saliva works to neutralize acids and maintain that balance, as well as to help replace phosphate and calcium ions that are lost to keep the enamel strong. But when saliva can’t keep up with the acids, enamel erosion can happen.
While enamel is incredibly strong, once it wears away, there’s no going back. Since there are no living cells in the enamel of your teeth, it can’t regenerate or heal itself. And if the protective covering wears away, it can expose the nerves in the center of your teeth, making them sensitive to hot and cold. If left untreated, eventually it can even lead to the loss of your teeth.
However, some enamel erosion is simply a natural part of aging. “We use our teeth for eating, drinking, and chewing. As a result, the enamel wears away over time,” says Dr. Ferraz-Dougherty.
Enamel Erosion and Your Diet
Oftentimes, enamel erosion is due to your diet. “If you’re eating a healthy, balanced diet, it shouldn’t be too damaging. But if you’re drinking sodas all day, every day, that’s going to cause really fast damage to your enamel,” says Ferraz-Dougherty.
Some of the biggest culprits are drinks: sodas, sports drinks, and especially sweet tea, which is more acidic than soda and packs a lot of sugar. “The acids wear down the enamel, and the sugar starts in on developing cavities,” says Ferraz-Dougherty. “It’s a double whammy.” But “sugar-free” doesn’t necessarily mean your drink is in the clear either. Seltzers are very acidic too.
Talking to your dentist about your diet habits can help you determine what types of lifestyle modifications you should make to help prevent enamel erosion.
Medical Problems That Contribute to Enamel Erosion
For some people, erosion of tooth enamel is caused by frequent vomiting or acid reflux, which repeatedly exposes the teeth to stomach acid and can cause pitting in the enamel. The risk is magnified during sleep, when you produce less saliva to protect the teeth.
“A lot of people don’t even know it’s happening,” says Ferraz-Dougherty. But a dentist can tell by looking at the specific patterns of wear in your mouth. For example, with acid reflux that happens at night, a dentist might see it on just the side of the mouth that you predominantly sleep on. Or somebody who is bulimic might have enamel loss on the inside surfaces of the upper teeth.
Grinding your teeth can also physically wear down the enamel, so it’s important to talk to your dentist to figure out the root cause of grinding — from stress to tooth position — and find a solution.
When Brushing Can Harm Enamel
It may seem tempting to grab your toothbrush every time you eat or drink something acidic to help prevent enamel erosion — and banish bad breath. But it’s best to wait about half an hour after eating or drinking to prevent further erosion. Right after you expose your teeth to acid from food or drink, the enamel is more delicate. But the saliva in your mouth quickly goes to work to wash away the acids, remineralize your teeth, and fortify the enamel.
That’s why people who struggle with dry mouth, often as a side effect of medication, can have a tendency to get more cavities, according to Ferraz-Dougherty. They’re missing the protective effect of saliva. Chewing sugar-free gum with xylitol can help to both stimulate saliva production and diminish the acids in your mouth.
And that same gum can also help as a stopgap to prevent bad breath while you wait to brush. When you do brush, consider skipping toothpastes with baking soda, which is naturally very abrasive to your teeth, suggests Ferraz-Dougherty.
Treatment Options for Enamel Erosion
If you experience symptoms of enamel erosion, like discolored teeth or sensitivity to hot or cold foods or drinks, it’s important to see your dentist, who can help you to evaluate your options and choose a course of action. Nothing will replace the enamel, but in addition to making certain lifestyle modifications, there are dental products and procedures that can help.
For starters, your dentist may recommend brushing with a toothpaste that contains fluoride or rinsing with a fluoride-containing mouthwash.
If enamel erosion is causing sensitivity or if you are interested in cosmetic changes, veneers and crowns can give the look of healthy white teeth.
For people who have lost enamel at the gumline, putting fillings in those areas may help, says Ferraz-Dougherty.