Enamel is the hard, protective outer layer of the tooth. It is the hardest substance in the human body and serves to protect the sensitive dentin layer underneath. While enamel is very durable, it is still susceptible to damage and wear over time. Many factors can contribute to enamel erosion and decay. Understanding what causes enamel to break down is important in order to protect your pearly whites.
Acids
Acidic foods and beverages are a major culprit when it comes to enamel erosion. Acids essentially dissolve or “eat away” at the mineral composition of enamel. Frequent consumption of acidic foods and drinks can soften and progressively damage enamel over time.
Some examples of acidic foods and beverages include:
- Citrus fruits and juices – lemons, limes, grapefruit, oranges
- Tomatoes and tomato juice
- Sodas and carbonated beverages
- Wine and alcoholic beverages
- Pickles
- Vinegar
Sugary foods can also contribute to enamel erosion. Bacteria in the mouth feed on sugar and produce acids as a byproduct, which can demineralize enamel.
Grinding and Clenching
Grinding or clenching your teeth, also known as bruxism, can wear down tooth enamel over time. The pressure and friction generated from these actions can rub away at the enamel layer. This type of wear usually occurs on the biting surfaces of the teeth.
Toothbrush Abrasion
Believe it or not, your toothbrush can be a factor in enamel erosion. Brushing too hard or using a stiff-bristled brush can actually wear away enamel over time. Brushing vigorously from side-to-side can also scrape and scratch the enamel surface. Avoid aggressive scrubbing motions and opt for a soft-bristled brush to minimize enamel wear.
Bulimia and GERD
Certain health conditions, like bulimia and acid reflux, can cause enamel erosion due to repeated exposure to stomach acids. Bulimia involves recurrent episodes of binge eating followed by self-induced vomiting. The high acidity of vomit can severely damage enamel with repeated occurrences. Gastroesophageal reflux disease (GERD) causes frequent heartburn and regurgitation of stomach acids up into the mouth, which bathes the teeth in acid.
Tooth Whitening Products
Tooth whitening products utilize chemicals to brighten and remove stains from tooth enamel. However, excessive or improper use of whitening agents can demineralize and weaken enamel over time. Only use whitening products as recommended and consult your dentist if you notice any sensitivity or changes in your enamel.
Fluoride Deficiency
Fluoride helps strengthen and remineralize tooth enamel to prevent cavities and decay. A fluoride deficiency during childhood can make the enamel more prone to erosion. Most communities add fluoride to their municipal water supplies to help prevent tooth decay and promote enamel health.
Genetic Factors
Some individuals may have enamel that is thinner or more brittle in composition, making them more susceptible to erosion. Developmental disorders affecting enamel can also impair its mineral content and protective capabilities. Consulting with your dentist can help identify if genetics may be a factor.
Aging
As we get older, enamel naturally becomes thinner and more worn from many years of use. Older individuals may have weaker enamel that is more vulnerable to chipping, cracking or decaying. Be extra diligent with oral hygiene as you age to help preserve your enamel.
Amelogenesis Imperfecta
Amelogenesis imperfecta is a genetic condition that causes enamel defects present from birth. It affects the development, hardness, and amount of enamel produced. Those with this disorder often have discolored, sensitive, or crooked teeth prone to rapid wear, decay, and breakage.
Celiac Disease
People with celiac disease or a sensitivity to gluten may experience enamel defects and erosion. An immune reaction to gliadin, a gluten protein, can disrupt the formation of enamel and make it more likely to wear away.
Cancer Treatments
Cancer patients undergoing chemotherapy and radiation treatment are at risk for enamel erosion. These cancer therapies reduce saliva production, resulting in a dry mouth environment. Saliva helps buffer acids and wash away food debris to protect enamel. A lack of saliva allows more acidic conditions to demineralize enamel.
Medications
Certain prescription medications can indirectly affect enamel. Drugs like antihistamines, anti-depressants, pain relievers, and diuretics can all reduce saliva flow as a side effect. Again, less saliva means less protection for enamel against acidic insults.
Poor Oral Hygiene
Failing to properly care for your teeth is a surefire way to promote enamel erosion. Skimping on brushing allows plaque bacteria to thrive in the mouth. These bacteria metabolize sugar into enamel-eroding acid. Not flossing also allows caries-causing plaque to linger between teeth. Make sure to brush for 2 minutes twice daily and floss once per day.
Dry Mouth
A condition called xerostomia leaves the mouth chronically dry due to reduced saliva flow. Certain medications, autoimmune disorders like Sjogren’s syndrome, radiation treatment, and nerve damage can cause a persistent dry mouth. Lacking sufficient saliva allows acids from food and drinks to more readily damage enamel.
Teeth Grinding
Grinding or clenching your teeth can wear down tooth enamel over time. This habit generates excess force against the teeth, frictioning away at the enamel layer. Wearing a nightguard minimizes grinding and prevents enamel loss during sleep.
Frequent Snacking
Constant snacking throughout the day produces an acidic environment in the mouth that erodes enamel. Frequent exposure to sugars and acids without reprieve taxes your enamel. Limit snacking to avoid repeated acid attacks on your teeth.
Sugary Foods and Beverages
Excess sugar consumption is a huge contributor to enamel erosion. Bacteria feed on the sugars and release enamel-demineralizing acid as a byproduct. Sticky candies also adhere to teeth surfaces allowing prolonged acid contact. Limit sugary foods and opt for sugar-free gum to stimulate saliva flow after meals.
Prevention Tips
While enamel loss is inevitable to some degree over time, there are things you can do to minimize erosion:
- Brush with a soft-bristled toothbrush and avoid abrasive scrubbing
- Floss daily
- Rinse with water after consuming acidic foods and drinks
- Avoid excessive whitening or bleaching of teeth
- Get enough fluoride through water, toothpaste, and dental treatments
- Chew sugar-free gum to increase saliva flow
- Don’t brush immediately after consuming acidic foods
- Limit acidic and sugary snack and drink frequency
Professional Treatments
Your dentist also offers treatments to help protect and strengthen enamel:
- Fluoride varnish – Contains a high concentration of fluoride to remineralize enamel.
- Sealants – Resin coatings applied to grooves on chewing surfaces to prevent decay.
- Calcium phosphate rinse – Helps rebuild minerals lost in enamel.
- Bonding – Repairs cracked or damaged enamel.
Conclusion
Enamel is susceptible to damage from dietary acids, oral habits like bruxism, and improper hygiene. Limiting acidic and sugary food intake, practicing gentle daily brushing and flossing, and getting regular dental cleanings and fluoride treatments can help maintain strong, healthy enamel.
| Factor | How it Erodes Enamel |
|---|---|
| Acidic Foods and Drinks | Dissolve enamel minerals |
| Grinding and Clenching | Generates friction that wears down enamel |
| Aggressive Brushing | Over-scrubbing can abrade enamel |
| Bulimia and GERD | Repeated exposure to stomach acids |
| Whitening Products | Chemicals can demineralize enamel |
| Fluoride Deficiency | Enamel is weaker without fluoride’s strengthening effects |
| Genetic Factors | Can cause thin, brittle, or poorly formed enamel |
| Aging | Enamel naturally becomes thinner and weaker |
| Poor Oral Hygiene | Allows acidic plaque bacteria to build up |
| Dry Mouth | Reduced cleansing and buffering effects of saliva |
| Frequent Snacking | Promotes repeated acid attacks |
| Sugary Foods and Drinks | Bacteria produce acid when they metabolize sugar |
