How to help strengthen tooth enamel

Your teeth work hard for you every day, so it makes sense to look after them. From the foods you eat to the type of toothpaste you use, small daily habits can help support your enamel and help keep your teeth strong for the long haul. 

It’s true that tooth enamel can’t grow back once it has been completely worn away or chipped because it contains no living cells. However, early enamel damage caused by demineralisation may be reversed. A natural process called remineralisation means weakened enamel may be strengthened with the help of saliva, fluoride and good oral care. 

What is tooth enamel?  

Tooth enamel is the hard, outer layer of your teeth that protects them from decay, chewing and grinding, as well as insulating them against hot and cold temperatures. Enamel is composed primarily of hydroxyapatite (crystalline calcium phosphate) making it the most mineralised substance in the human body. 

Enamel is made up of around 96% minerals.³ It’s so durable that it’s actually harder than bone, but that doesn’t mean it’s indestructible. 

That’s why taking care of our enamel is so important. 

What causes tooth enamel to erode? 

Enamel erosion and tooth decay are two different processes but both damage teeth. Tooth decay is caused by plaque, a sticky film of bacteria that feeds on sugars and produces acids that dissolve enamel.

Tooth enamel erosion is the loss of tooth minerals caused by acids that are not produced by oral bacteria. Both weaken enamel, but they have different causes and progress in different ways.

Common symptoms of enamel erosion include discolouration, sensitivity to heat or cold, chipping or teeth that break off and sharp edges to your teeth. 

Ashleigh Ayo, a registered dental practitioner and lecturer at Sydney Dental School says the most common causes of enamel erosion are diet and existing health conditions.

“They include frequent consumption of soft drinks, sports drinks, energy drinks, fruit juice, wine, citrus, vinegar-based foods, and acidic 'health' drinks,” she says. “Medical causes can also contribute, including reflux, vomiting, eating disorders, some pregnancy-related vomiting, or conditions or medications that reduce saliva.”

Here are some common causes of tooth enamel erosion:  

Acidic foods and drinks

Fizzy drinks, energy drinks, fruit juice and acidic ‘health’ drinks (think protein or vitamin drinks) can all strip minerals from the enamel surface in a process called demineralisation.

But Ayo says a common mistake is brushing straight after something acidic. “Acid temporarily softens the enamel surface, and brushing immediately afterwards can accelerate wear. It’s usually better to rinse with water, wait and allow time for your saliva to buffer the acids before brushing,” she says.

Sugary foods and poor oral hygiene

When we eat sugary foods, the bacteria in our mouths have a field day. They produce acid as they digest the sugar as a by-product, and that attacks the enamel. Poor brushing and flossing habits mean the enamel stays exposed to these bacterial acids for longer and this may increase the risk of damage.  

The Australian Dental Association recommends limiting the sugar we eat or drink to no more than 24 grams (six teaspoons) per day.⁴

Teeth grinding (bruxism)

Teeth grinding or bruxism (often during sleep) can harm tooth enamel due to excessive, repeated pressure on the tooth’s surfaces. Over time, this can wear the enamel down so it becomes thin and weak. Grinding can cause flattened biting surfaces and chipped or cracked teeth.

Dry mouth and low saliva production

Saliva is the mouth's natural buffer against acid because it neutralises pH, delivers calcium and phosphate to enamel, and physically rinses away food particles. Certain medications, including some decongestants, inhalers and antihistamines, and being dehyrdrated can reduce saliva flow, leaving enamel more vulnerable to acid attack. Staying well-hydrated is a simple, everyday protective measure to reduce this risk.

How to help strengthen tooth enamel 

One of the most effective ways to help support enamel is with fluoride. Fluoride is a naturally occurring mineral that helps strengthen enamel, which helps defend your teeth against harmful acids – the kind you get from some foods and bacteria. 

“Fluoride is especially important,” says Ayo. “It helps strengthen enamel and supports remineralisation of early enamel changes.”

“Brushing twice daily for two minutes with fluoride toothpaste, cleaning between the teeth once daily, drinking water and limiting frequent snacking or acidic drinks are simple habits to strengthen tooth enamel, but their benefit comes from being repeated every day,” says Ayo.

After you’ve eaten very acidic food or drinks, there are simple ways to help protect your teeth from erosion. These include, drinking water or a glass of unsweetened milk, eating a piece of hard cheese or chewing sugar-free gum.

READ MORE: The best way to care for your teeth

How to treat tooth enamel erosion 

Treatment of enamel erosion usually focuses on protecting the remaining enamel and reducing further acid damage. Dentists may recommend a fluoride toothpaste and cutting back on acidic drinks, consistent tooth brushing and flossing, this is to help the process of remineralisation. Speak to your dentist about what is best for you. 

When erosion is more advanced, your dentist may recommend treatment to repair your teeth. Depending on your individual needs and circumstances, this could include:
 

• Veneers: Thin covers of porcelain or resin that are fixed to the front of your tooth and improve the appearance. 
• Dental fillings: Dentists use various materials to fill a hole (or cavity) in your tooth.
• Crowns: Covering a broken or damaged tooth with a cap which can improve the appearance and make the teeth stronger. 

Can tooth enamel grow back? 

No, enamel cannot truly regenerate, says Ayo, because mature enamel is not a living tissue and does not contain cells that can regenerate it in the way bone can. 

“Once enamel structure is physically lost, it cannot naturally regrow,” she adds. “Dental treatment may be needed to protect the tooth, reduce sensitivity, or restore function and appearance.”