Introduction

Your teeth are complex structures that are a lot more intricate than you might see on the surface. But the surface level of your teeth is one of the most important parts of the tooth itself.

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The outer layer of your teeth is something called enamel, which acts as a protective layer that shields the underlying structures from harm. Below is (almost) everything you need to know about your enamel, as well as what you can do to keep it from wearing away.

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What Is Enamel?

Enamel is a protective layer over every single one of your teeth. It’s a hard substance that also gives teeth their white color. It’s one of the hardest substances in the human body (even harder than bones) because it has a 96% mineral density.

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Despite the fact that enamel is super strong, it is still at risk for decay when exposed to acids and bacterial buildup in your mouth. This tooth decay is what leads to cavities and other dental issues.

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Enamel is meant to protect the inner structures of your teeth from damage. The layer underneath your enamel is called dentin, which contains microscopic tubules (hollow holes or canals). These tubules send signals to the nerves in the pulp that lies underneath.

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When the enamel is removed, these tubules allow heat, cold, or acid to stimulate the nerves inside the tooth. This causes sensitivity and discomfort.

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But keeping your enamel in check does much more than protect your teeth from feeling sensitive. It also works to prevent diseases and other problems.

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How Does Enamel Become Damaged?

Damaged enamel can form into a cavity, a permanently damaged area on the tooth that develops into tiny holes or openings. Often called caries, these are caused by a combination of factors that stem from bacteria in your mouth.

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First, plaque forms on the enamel. Plaque is a clear, sticky film that coats your teeth from eating too many sugars and starches without proper oral hygiene. Sugars on your teeth are fuel and food for bacteria, which quickly begin to feed on these substances to form plaque. When plaque stays on your teeth without being cleaned, it then hardens into tartar.

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Tartar is much more challenging to clean than plaque and basically creates a shield for bacteria to continue feeding. This erosion forms openings in the enamel, causing the first stage of a cavity by revealing the dentin underneath. 

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If erosion continues past this point, it can move to the inner tooth material called pulp. Pulp contains nerves and blood vessels that can become irritated and swollen when irritated by bacteria. When this happens, there is no place for the pulp to move inside the tooth, which presses down on the nerves and can feel extremely painful.

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What Causes Enamel To Be Damaged?

There are certain risk factors that can cause enamel to wear away quicker than it might otherwise.

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Risk factors include:

Health Conditions

• Heartburn: Heartburn can cause acids from your stomach to flow back into your mouth, which wears away enamel by causing damage to your teeth. 
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• Dry mouth: Saliva can help prevent tooth decay by washing away plaque and countering the acids formed by bacteria. If you suffer from chronic dry mouth, you are at a greater risk of damaged enamel and cavities.
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• Eating disorders: Eating disorders marked by purging (vomiting) can damage enamel because stomach acids can wear away the outer layers of your teeth.
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• Age: Cavities are more common in young adults because of lifestyle habits that might cause tooth decay, as well as in older adults because enamel can wear away naturally with time. Older adults might also use more medications which reduce saliva production and enhance cavity risk.
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• Location of the tooth: Decay is more common in teeth at the back of your mouth (molars and premolars). This is because these teeth have more grooves and pits that latch onto sugars and are more difficult to fully clean. 

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Oral Care Practices

• Poor oral hygiene: If you don’t clean your teeth properly after eating or drinking foods that can cause erosion, plaque will stick around. It’s vital to brush away plaque with a soft-bristled toothbrush and floss twice a day.
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• Brushing too hard: Using a toothbrush with hard bristles, or pressing down too hard when you brush, can strip away your enamel. Instead, use a soft-bristled brush and gently apply pressure to prevent damage.
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• Not enough fluoride: Fluoride is a mineral that occurs naturally to help prevent cavities and even reverse the early stages of tooth damage. Fluoride is usually added to public water supplies, but you can get fluoride-enhanced toothpaste and mouthwash to enhance its benefits.

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Lifestyle

• Frequent snacking: Steadily snacking or sipping sugary drinks is an easy way to give bacteria more time to produce acids. When drinking things like coffee or soda, try to be mindful of how often you consume them each day.
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• Certain foods and drinks: Foods that cling to your teeth and are acidic, like ice cream, sugar, sodas, honey, hard candies, and chips, are more likely to cause decay because they are not easily washed away by saliva compared to other foods.
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• Smoking and vaping: Smoking and vaping can cause dry mouth, which means you’re not producing enough saliva to wash away bacteria that forms from plaque. Not to mention, smoking and vaping can increase your risk of oral cancer.

Importance of Enamel

Enamel is necessary to protect your teeth from becoming too sensitive. But there are some other reasons why protecting it is essential. For one, the enamel is what gives teeth their white appearance, so keeping enamel in check can help you keep a pearly white smile for longer.

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Moreover, if you let your enamel get even more damaged to the point where it forms a cavity, it can get so severe that your quality of life is diminished. Cavities, if left untreated, can cause a lot of pain and discomfort.

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In rare cases, you might even get a tooth abscess that’s caused by a bacterial infection. This can lead to life-threatening complications (like sepsis) if you do not get it checked out in a timely manner.

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How To Protect Enamel

Once enamel is removed, it cannot grow back. This means you want to take extra good care of your teeth to prevent cavities and decay.

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There are ways to protect your enamel, like:

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• Oral hygiene: Your best defense against cavities and gum disease is practicing proper oral hygiene, which is as simple as properly brushing and flossing your teeth twice a day. Use a soft-bristled toothbrush that’s not too abrasive.
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• Visit your dentist regularly: You should visit your dentist twice a year to check on the health of your teeth and gums. This can allow your dentist to correct any abnormalities before they become too severe.
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• Dental sealants: Sealants are protective coatings that can be applied to the back teeth. It essentially seals off the nooks and grooves that often collect food and debris that turns into plaque and acid. Sealants can last for several years.
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• Fluoride treatments: Your dentist might suggest fluoride treatments, especially if you aren’t getting enough fluoride from your water. This can help to strengthen your enamel against damage.
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• Eat tooth-healthy food: Foods like fresh fruits and vegetables increase saliva flow which can protect your teeth. But foods like refined carbs, fried foods, and sodas can damage your teeth. Being mindful of what you’re eating can make a big difference.

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Can Enamel Be Restored?

Once enamel has been damaged to a degree, it cannot be brought back. However, mineral content in the enamel can be improved, which can enhance the remineralization process and improve the health of your enamel.

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Remineralization includes introducing minerals like calcium back into your teeth. These can bond to the tooth’s surface and adhere to weak points in your enamel. This can address weak points in the tooth’s surface that are invisible to the eye.

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How Are Cavities Treated?

If your enamel wears away and turns into a cavity, a dentist can help you get the help you need. In fact, cavities are the second most common disease in the United States (besides the common cold). The good news is that this means they can be easily treated.

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Cavities can be treated in a few different ways depending on the severity of the decay. For smaller cavities, you might not need more than a filling. These are made of porcelain or another composite. They are used to fill the decayed holes in a tooth after the infected material is removed.

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However, for severe cavities that reach the inner pulp, you might need a root canal. With these, diseased pulp is drilled out and removed. Fillings are then used to fill in the missing pulp to replace the root of the teeth.

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If a tooth becomes so badly damaged that it can’t be fixed with a root canal, you might need to get the tooth extracted. Extraction leaves a gap for other teeth to shift, so this is always a last resort. You might want to consider getting a bridge or an implant to replace the missing tooth if this happens.

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How Much Do Cavity Treatments Cost?

A root canal can cost anywhere from $1,300 to $1,600 out of pocket. Cavities are common, and these procedures are fairly routine — but that doesn’t mean they’re entirely accessible.

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While insurance usually covers the cost of these treatments, over 33% of the American population lacks dental insurance, leaving many people without the opportunity to receive necessary oral care.

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No insurance? Perfect. Flossy is a pay-as-you-go service where you only pay for the dental procedures you receive. And we can save you up to 50% on common dental treatments from root canals to fillings, from oral exams to bridges.

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In Conclusion

Enamel is the hard outer covering on your teeth that protects the inner structures while also giving your teeth their white color. It is made of minerals that, once removed, will never grow back. So keeping your enamel strong is vital to avoid sensitivity and cavities.

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Worn-away enamel is caused by plaque building up and eating away at it. This can be accelerated through eating acidic foods, poor oral hygiene, age, smoking, and more. You can protect your enamel with certain kinds of toothpaste and lifestyle habits. Ensure that you keep up with oral hygiene using a soft-bristled toothbrush.

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Lost enamel can lead to a cavity, which can cause pain and even serious infections. If you need to get a cavity treated, fillings and root canals are the go-to methods that can bring you relief. However, these can be pricey if you’re stuck paying out of pocket. 

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Flossy is for patients without dental insurance. Schedule an appointment with a dentist in your area today and start saving up to 50% on out-of-pocket dental procedures.

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Sources:

What is Sepsis? | Sepsis | CDC

Oral Cancer and Tobacco | Johns Hopkins Medicine

5 Amazingly Simple Things You Can Do to Prevent Cavities | University of Illinois Chicago

Dental coverage, access & outcomes | ADA

​​Caries - Dental Disorders |. Merck Manuals Professional Edition