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Enamel degradation: When acids leave their mark
Tooth enamel degradation is a widespread problem today, mainly due to the frequent consumption of acidic foods and beverages.
Enamel degradation widespread
Tooth enamel degradation (also known as “tooth erosion” or “dental erosion”) is one of the most common dental problems today. Even children and adolescents are increasingly affected. For example, initial signs of enamel degradation have been found in more than 35 percent of 11-13 year olds.*
The reason: acidic foods and beverages are particularly damaging to tooth enamel – and this includes cola, sodas and energy drinks, which are particularly popular among young people.
Tip: A tooth-healthy diet and special dental care products for hardening tooth enamel can protect against enamel degradation.
What is enamel decay?
Tooth enamel is normally as hard as steel. In fact, enamel, which surrounds our teeth and is nearly 100 percent mineral substance, is the hardest substance in the body.
But there is a weak point: When acids (e.g., in fruit, fruit juices or soft drinks) regularly act on the enamel, this causes it to soften and eventually break down. Initially, the tooth appears duller or more transparent at this point, and eventually the yellowish dentin shimmers through.
If the dentin is exposed without protection, this can result in increased sensitivity of the teeth to pain.
Enamel degradation: Causes
Acidic foods and beverages are considered the number one risk factor for tooth enamel degradation. The problem: Acids hide far more frequently in our diet than many assume.
Acid-induced enamel degradation
Acid is poison to tooth enamel. This is because frequent consumption of acidic beverages or foods leads to softening of tooth enamel. Softened enamel, in turn, is the first step toward enamel breakdown (or “tooth erosion,” “acid-induced tooth structure loss”). In this process, enamel degradation progresses from the outside to the inside and – if the dentin underneath the enamel is exposed – can lead to pain-sensitive teeth.
The problem is that acid is not only found in fruits such as apples or grapefruits, but is also hidden in a whole variety of foods and beverages. Wine or salad dressings, for example, can also damage tooth enamel. Soft drinks in particular are real “acid traps”, as they often contain citric acid as an acidifying agent. By the way, this also includes so-called “zero products”.
Acidic foods – where does the danger lurk?
Foods or beverages with a pH value of 4.5 or lower are considered particularly critical for our tooth enamel. However, a high calcium content can reduce the “dangerousness” of certain products, as calcium strengthens the teeth. For example, yogurt has a pH of 3.9 – but does not pose a risk to tooth enamel due to its high calcium content.
Some examples of the degree of "erosive effect" of certain foods and beverages can be found here:
Strong erosive effect
Moderate erosive effect
No erosive effect
Incorrect tooth brushing promotes enamel defects
In addition to an acidic diet, incorrect tooth brushing also promotes the development of enamel defects. In particular, vigorous scrubbing with a toothbrush that is too hard can damage the enamel. Experts refer to this as abrasion.
Tip: If you want to strengthen the enamel in your daily oral hygiene, you can use special toothpastes and mouth rinses with fluoride that have been specially developed for this purpose.
Other causes of enamel degradation
In rarer cases, tooth enamel degradation is promoted by certain underlying diseases such as reflux disease or bulimia (binge eating disorder). In both cases, it is the stomach acid that damages the tooth enamel. Last but not least, mechanical influences such as “grinding” can also result in a tooth enamel defect.
Enamel degradation: symptoms
We ourselves can hardly recognize enamel degradation with the naked eye, especially in the early stages. This makes regular check-ups at the dentist all the more important.
Signs of enamel degradation
Enamel degradation is often difficult for the layperson to detect with the naked eye. The dentist has a trained eye here. He or she can judge whether enamel degradation has occurred on the basis of the following criteria, among others:
- Do the teeth appear thinner?
- Do the edges of the teeth appear transparent?
- Have the teeth lost their shine and do they appear dull?
- Do the teeth appear yellowish?
Good to know: Yellow teeth can therefore be a sign of advanced enamel degradation, as the yellowish dentin is already showing through here.
Painful teeth as a result of tooth erosion
Tooth enamel erosion progresses from the outside to the inside. In the worst case, the dentin, i.e. the tooth bone, is exposed – pain-sensitive teeth can then be the result.
For a better understanding: In the area of the dentine run the so-called dentinal tubules, which are traversed by the finest nerve fibers. If these are exposed without protection, the result can be increased sensitivity to hot, sweet or cold foods.
Tooth enamel degradation: treatment
Once the enamel is gone, it cannot be formed anew. However, the progress of enamel degradation can be stopped by taking appropriate measures. Dietary habits and proper oral hygiene are the most important building blocks here.
Tracking down the acid
Once the dentist has diagnosed enamel degradation, the first step is to track down the triggers. The main thing here is to take a close look at dietary habits. After all, it is usually acids in beverages and foods that attack tooth enamel.
A food diary kept over several days can be helpful in detecting hidden acids in the daily diet. Once the “culprits” have been identified, it is important to avoid them in the future or at least to reduce them considerably. Professional nutritional counseling can be helpful in some cases.
Strengthen tooth enamel
To prevent the progress of enamel degradation, the use of fluorides has proven to be effective. This is because they form a protective layer on the surface of the tooth, which protects it from the attack of acids and makes it more resistant. This is especially important because it is almost impossible to completely eliminate acids from our diet.
The following measures can be considered:
- Daily use of fluoride toothpaste to harden the enamel.
- After daily brushing, use a mouth rinse with fluoride to harden the tooth enamel
- In case of already existing pain sensitivity: weekly application of fluoride gel
Extra tip: Scrubbing too hard when brushing your teeth can further damage enamel and should be avoided. Also, make sure to use soft bristles.
Further measures in case of enamel degradation
Anyone who wants to do something to protect tooth enamel in addition should consider the following tips:
- Drink water after consuming acidic foods or beverages to dilute the acids.
- Chewing gum can also benefit dilution of acids
- Do not brush your teeth immediately after eating acidic foods or drinks, but wait about 30 minutes
Depending on the severity and cause of the enamel defect, other treatment measures may be considered.
For example, bulimic patients should rinse their mouth with water after an “acid attack” (i.e., after vomiting).
In the case of very pronounced tooth structure defects, “restorative measures” may also be considered. For example, the tooth surface can be coated with so-called dentin adhesives.
Ask your dentist for advice on this.
Tooth enamel decay: prevention
Don’t give enamel degradation a chance! You can do a lot to protect or harden tooth enamel, especially when it comes to diet and oral hygiene. Read here what is important.
Strengthen tooth enamel with toothpaste Anyone who wants to harden the enamel and thus make it more robust against the influence of acidic foods should start with daily oral hygiene.
A special toothpaste for enamel with fluoride can help to specifically strengthen the softened enamel with minerals.
In addition, the use of a fluoride-containing mouth rinse can be helpful to protect the teeth even more comprehensively against acid attacks. In the case of already defective enamel and resulting pain sensitivity, the additional use of a fluoride gel once a week is sometimes useful. Ask your dentist for advice on this.
Extra tip: Brush your teeth gently and not with too much pressure. Use a toothbrush with soft bristles.
Protect tooth enamel: Focus on nutrition
In order to prevent enamel degradation, the diet should also be specifically checked and adjusted if necessary. Acidic foods and beverages are particularly damaging to tooth enamel. Caution is therefore advisable here.
Therefore, it is recommended:
- Avoid soft drinks and energy drinks as much as possible.
- Drink water more often, because fruit juices and nectars also have a high acid content.
- Caution is also advised with wine!
- Suck acidic sweets less often
Fruit also naturally contains a lot of acid. However, fruit is part of a balanced and healthy diet. In addition, chewing fresh fruit stimulates saliva production, which neutralizes the acidity to some extent. Therefore, the following applies: Do not eliminate fruit from your diet, but if necessary reduce the consumption of particularly acidic types of fruit such as apples, oranges or kiwis.
Tip: Do not brush your teeth immediately after consuming acidic foods and drinks, as the tooth enamel is already weakened by then and can thus be “abraded” more easily. It is better to wait 30 minutes to an hour. Until then, you can rinse or dilute the acids in your mouth with a few sips of water.
Regular check-ups at the dentist
Tooth enamel decay is a lengthy process that is barely visible to the naked eye in the early stages. It is therefore all the more important to have the enamel checked by the dentist as part of regular examinations.
Protect tooth enamel: Tips
Reduce acidic drinks and foods
Does sour make you happy? When it comes to tooth enamel erosion, that’s not the case at all. This is because acids soften tooth enamel and thus promote tooth erosion. In this respect, acidic foods and beverages should be avoided as much as possible. This means:
- Above all, avoid sodas and soft drinks (even “zero” products!).
- Reduce fruit juices (e.g. apple juice) and nectars.
- Reach for water or herbal tea more often
- Do not keep acidic sweets in your mouth for too long
Acidic fruit does not necessarily have to be eliminated from the diet, as chewing stimulates saliva production and neutralizes acids to a certain extent. However, reduce especially real “acid boosters” such as apples or kiwis. In addition, brush your teeth after eating them. However, wait about 30 minutes to an hour before doing so, so that the tooth enamel can recover from the acid attack during this time. Until then, you can rinse away or dilute the acids in your mouth with a few sips of water.
Important to know: Salad dressings are also usually acidic.
Oral hygiene: strengthening tooth enamel
Since acids are contained in numerous foods and beverages – including healthy foods such as fruit – it is almost impossible to completely eliminate the intake of acids. This makes proper oral hygiene all the more important for strengthening tooth enamel and thus making it more resistant to external influences.
Thus, special toothpastes have been developed that can harden the enamel with fluoride. Mouthwash containing fluoride can also be useful as a supplement.
In addition, when brushing your teeth, be careful not to scrub too hard – otherwise the enamel will be worn away (“abrasion”). Use a toothbrush with soft bristles. Extra Tip:Toothbrushes with soft bristles have proven effective for sensitive or irritated gums. To ensure good hygiene, toothbrushes should always be replaced every two months.
Improve calcium intake
While acids attack tooth enamel, calcium has positive effects. This is because the mineral strengthens the teeth. Calcium-containing foods such as milk or dairy products (cheese, quark, yogurt) should therefore ideally be on the menu every day.
Ingenious: If you eat fruit together with yogurt, you can reduce the tooth enamel-damaging effect of fruit acids due to the high calcium content.
Another good tip: Eat a piece of cheese after a glass of wine (high acid content). This not only tastes delicious, but also protects tooth enamel. Good to know: Sugar is not only found in sweets. Fruit and fruit juices also contain sugar in addition to tooth-damaging fruit acids.
Regular checkup at the dentist
Tooth enamel degradation is hardly visible to the layman with the naked eye. The dentist has a trained eye here and is better able to assess the teeth for signs of enamel degradation.
This makes regular check-ups all the more important. Good to know: Sensitivity to pain and/or yellowish discolored teeth can indicate enamel degradation. If in doubt, talk to your dentist about this.