Posts Tagged ‘tooth enamel’

Tooth Enamel Erosion and Prevention

Friday, January 13th, 2012

The strongest and hardest tissue in the human body is tooth enamel. Two percent of enamel is comprised of organic material—protein, lipids and citrate. The other 98 percent consist of water and the minerals calcium hydroxylapatite and calcium fluorapatite (1). Enamel completely envelops other components of the tooth structure, including the dentin, cementum and dental pulp. Enamel protects teeth against the daily wear of biting and chewing. It enables the teeth to withstand hot and cold temperatures, acid and other chemicals which have an erosive effect on teeth. (1, 2, 3).

Tooth enamel ranges in thickness from 2.5 to 3.0 millimeters. It appears white, but actually has a semi-translucent color. The enamel receives it white appearance from the dentin underneath. Coffee, tea, wine, and cigarette smoking discolors are some of the main reasons for discolored tooth enamel (3).

Causes of Tooth Enamel Erosion

Enamel has a high mineral content, which makes it vulnerable to “demineralization” from ingested foods, which contain starch and sugar.


Candy, soft drink, fruit juices, and other sweets leave a large amount of sugar coatings on the oral cavity. Sugar may constitute the single largest contributor to enamel erosion. Bacteria flourish on sugar and generate lactic acid, which eats into the enamel.


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Why Did I Chip / Break My Tooth?

Thursday, August 20th, 2009

Why Do Teeth Break and Chip?

Most people have experienced chipping or breaking one of their teeth at one point or another.  However, they may not know why it happened.  An accidental injury, bite discrepancies, grinding (bruxism), clenching, or tooth decay (a tooth that has decayed enough to undermine its surface) can obviously cause breakage.  However, it is not common knowledge that one’s tooth can also break/chip if a tooth filling (either amalgram silver and composite fillings) is not the right size or has any cracks in it. 

What To Do If You Break Your Tooth

Since breaks can range from small chips to major fractures, you could either need a major procedure or no treatment at all.  A tooth has three layers: the enamel (hard outer coating), the dentin (middle layer under the enamel), and the pulp, which is the tooth’s fleshy nerve center.  The most common tooth breakage is just a chip where one’s tooth simply loses some enamel.  Usually, no pain is felt.  If enough tooth enamel is chipped off, the dentin may be exposed.  The tooth may not hurt too much, but it is more sensitive to cold.  The worst breaks expose the pulp, which can cause extreme pain and even bleeding.

If you get a small chip in your tooth and it is feeling sensitive, try a painkiller (if it is safe for you to take it), and make a dental appointment.  For more serious fractures, rinse your mouth out with warm water, and make a dentist appointment as soon as possible.  If you take a painkiller, do not take aspirin as it increases the risk of heavy bleeding.  If your mouth was injured and your soft tissue is swelling, apply an ice pack to it. 

A dental emergency involves your whole tooth being knocked out, roots and all, and this requires immediate treatment to save the tooth. Pharmacies sell tooth savers, which is something people should keep in their medicine cabinets in case of an emergency like this.  The tooth should be carried to the dentist in a container of either your saliva or milk.  Do not touch the root of the tooth, so it does not get damaged.  Handle the tooth gently, do not scrub it, but you can rinse the tooth with milk if you feel the need to.

Broken Tooth Treatment

Even if your tooth only got chipped, the dentist is probably going to take an x-ray of the damaged tooth and recommend being gentle with it for a few days.  Usually a minor chip can be smoothed out/polished, or perhaps filled with a composite material.  If the break is more serious, rapid treatment is needed. 

If dentin is exposed, a dentist can cover it with a material that will provide protection temporarily until a more specific treatment is begun.  A tooth can almost always be completely recovered with a permanent crown if the pulp remains healthy. 

Unfortunately, if the pulp is damaged, the solution will be more complicated.  Endodontists and general dentists perform root canals in order to remove the damaged pulp before putting on a crown.  An immediate follow-up may be requested if the break in your tooth is more than a small chip, in order to make sure it is healing correctly. 

How to Prevent Your Teeth From Chipping/Breaking

People can take various precautions in order to prevent a tooth fracture from happening.  While playing sports, one can use a mouth guard that protects the teeth while allowing the person to breathe and be active without distraction.  One should go on regular dental checkups for preventive treatment and practice proper oral care habits at home.  By doing this, one will prevent the development of tooth decay that could induce breakage. 

If you have large fillings in one or more of your teeth, you should probably get the high-risk teeth crowned because the preventative treatment is less painful and costly than if you wait until they fracture.  It is common for root canals to be needed for teeth cracked from oversized fillings in order to save them.  Sometimes the tooth will need to be removed from your mouth completely if the case is severe enough.  Crowns hold teeth together by surrounding them in a continuous shell. 

Also, if you have an uneven bite or an issue with bruxism or clenching, your dentist can take care of any problems caused by these issues in a comprehensive treatment plan for mouth restoration; with this, uneven and extreme wear is minimized and cracks are much less likely to occur.


Sports Drinks May Erode Tooth Enamel

Monday, April 27th, 2009

Research has shown that the citric acid in sports drinks can damage teeth.

Researchers at the New York University College of Denstistry used cow teeth to come to this conclusion. They cut the teeth in half and put them in the top-selling sports drinks, and after they soaked up to 90 minutes (similar to a human sipping on drinks throughout the day), they found that the enamel of the teeth was partially eaten away. If the enamel coating is weakened, the sports drinks are more likely to leak into the bonelike material underneath the enamel, which causes teeth to soften and weaken. This condition is called erosive tooth wear, and it can lead to severe tooth damage or the loss of teeth if it is not treated.

Surprisingly enough, Dr. Mark Wolff, chairman of cariology and comprehensive care at the NYU College of Dentistry, said brushing immediately after drinking a sports beverage is likely to cause more damage than waiting a bit. This is because the softened tooth enamel is more vulnerable to the toothpaste’s abrasiveness.

Experts recommend that people should consume sports beverages in moderation, and wait at least 30 minutes before brushing their teeth, so the softened enamel has time to re-harden. It may also be a good idea for someone who consumes a lot of sports drinks to find an acid-neutralizing, re-mineralizing toothpaste to help re-harden soft tooth enamel.

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Is The Acid In Your Mouthwash Eroding Your Tooth Enamel?

Tuesday, March 31st, 2009

Mouthwash That Erodes Your Tooth Enamel is Very AcidicRecent research has uncovered a startling new discovery about the mouthwash you are probably using. Did you know that over 90% of the mouthwash that is commercially available contains an acid level comparable to that of household vinegar?

Can you imagine rinsing and gargling with vinegar? I don’t even have to tell you what that would taste like, but think for a second what it can do to your teeth!

The enamel on your teeth is one of the hardest substances that your body can produce.  However, acid is one of the most corrosive substances in nature. The study shown below discovered that rinsing your mouth with a mouthwash that contains a high concentration of acid causes a drastic increase in enamel loss.

Also, enamel loss has a direct correlation to sensitivity in teeth – people with less enamel complained of much greater sensitivity in their teeth to hot and cold.

As you can see from the chart below – almost all commercially available mouthwashes have a highly ‘acidic’ environment.

Moral of the Story: Use a non-acidic mouthwash.

Various Commercial Mouthwashes pH Acid Level
The ‘Natural’ Dentist 3.2
More Acidic







Less Acidic

Peroxyl 3.7
Listerine 4.3
Breath-Rx 4.7
Scope 5.4
TriOral – 2 phase 5.7
Rembrandt 6.5
Water (Neutral) 7.0
TheraBreath 8.2 An “Antacid” Mouthwash!

“Acid in your mouthwash dissolves your tooth enamel, potentially creating serious problems for the person using it…”

The Journal of Clinical Periodontology, The erosive effects of some mouthrinses on enamel. A study in situ.

by Pontefract H, Hughes J, Kemp K, Yates R, Newcombe RG, Addy M.

Division of Restorative Dentistry, Dental School, Bristol, UK.

BACKGROUND: There are both anecdotal clinical and laboratory experimental data suggesting that low pH mouthrinses cause dental erosion. This evidence is particularly relevant to acidified sodium chlorite (ASC) formulations since they have plaque inhibitory properties comparable to chlorhexidine but without the well known local side effects.

AIM: Studies in situ and in vitro were planned to measure enamel erosion by low pH mouthrinses. The study in situ measured enamel erosion by ASC, essential oil and hexetidine mouthrinses over 15-day study periods. The study was a 5 treatment, single blind cross over design involving 15 healthy subjects using orange juice, as a drink, and water, as a rinse, as positive and negative controls respectively. Two enamel specimens from unerupted human third molar teeth were placed in the palatal area of upper removable acrylic appliances which were worn from 9 a.m. to 5 p.m., Monday to Friday for three weeks. Rinses were used 2x daily and 250 ml volumes of orange juice were imbibed 4x daily. Enamel loss was determined by profilometry on days 5, 10 and 15. The study in vitro involved immersing specimens in the 4 test solutions together with a reduced acid ASC formulation for a period of 4 h under constant stirring; Enamel loss was measured by profilometry every hour.

RESULTS: Enamel loss was in situ progressive over time with the 3 rinses and orange juice but negligible with water. ASC produced similar erosion to orange juice and significantly more than the two proprietary rinses and water. The essential oil and hexetidine rinses produced similar erosion and significantly more than water. Enamel loss in vitro was progressive over time, and the order from low to high erosion was reduced acid ASC, essential oil, and hexetidine mouthrinses and orange juice.

CONCLUSION: Based on the study in situ, it is recommended that low pH mouthrinses should not be considered for long term or continuous use and never as pre-brushing rinses. In view of the plaque inhibitory efficacy of ASC, short- to medium-term applications similar to those of chlorhexidine would be envisaged.

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