Exploring the Role of Tooth Enamel in Protecting Your Teeth
Medically reviewed by Edmund Khoo, DDSMedically reviewed by Edmund Khoo, DDS
Tooth enamel is the thin covering on the outside layer of your teeth. It provides a hard shell to protect your teeth from cracking and breaking. It also protects the inner layers of your teeth from damage.
Despite being the hardest substance in your body, enamel is vulnerable to damage. Factors such as bacteria, acids, and plaque can work to eat away at dental enamel. Preventing enamel damage is vital to your dental health. While treatments can help rebuild damaged enamel in the early stages, enamel cannot be replaced if it is lost.
This article describes tooth enamel and its role in keeping your teeth healthy. It also explains how tooth enamel is damaged, options for repair, and ways to preserve its health.
Illustration by Tara Anand for Verywell Health
What Is the Main Function of Tooth Enamel?
The main function of tooth enamel is to protect the natural dental crown (the part of your tooth that you can see) from damage and daily wear and tear. Its hard surface serves as the first line of defense for your teeth when performing functions such as biting, chewing, and grinding food when you eat.
Your tooth enamel also serves as an insulating barrier to protect the sensitive nerves in your teeth from extreme temperatures or irritating chemicals.
Keeping your tooth enamel intact is important because it prevents damage to the layers beneath it, which include dentin and pulp.
Dentin
Dentin is the layer just beneath the enamel. Dentin is softer than enamel but harder than the pulp that it protects. It contains microscopic tubules (tubes or canals) that allow heat, cold, or acidic foods to stimulate your tooth's nerves and cells, causing sensitivity if they are not protected.
Pulp
Pulp is the center layer of your tooth structure. It consists of blood vessels, connective tissue, and nerves. Pulp moisturizes and nourishes your teeth. It also forms dentin. As the softest layer of your teeth, pulp requires the protection of dentin and enamel to maintain tooth health.
Learn More: Your Mouth Has a Lot to Say About Your Overall Health
What Is Enamel Made Of?
Tooth enamel is made of minerals that work together to protect your teeth. The primary component of enamel is the mineral calcium phosphate, arranged in a crystalline (small crystal) structure known as hydroxyapatite. This rock-hard substance makes up about 96% of enamel.
Other components of tooth enamel include water (about 3%) and nominal amounts of magnesium, sodium, carbonate, and fluoride.
What Causes Enamel Loss?
In most cases, enamel loss is caused by tooth erosion, a process in which acids wear down the calcium in your tooth enamel. These acids are not bacterial but originate from your gut or the foods and beverages you consume.
The factors that trigger enamel loss can be intrinsic or extrinsic. Intrinsic factors include characteristics such as age, organ function, comorbid (coexisting) diseases, and other traits that affect how your body performs. Extrinsic factors originate outside your body and include characteristics such as diet, lifestyle, and medications. Some extrinsic factors can be modified.
Intrinsic factors that contribute to dental enamel loss include:
Regurgitation: The stomach acid produced during the digestive process has a high acid content to help your body digest food. However, it can also have a corrosive effect on your teeth and bones. Frequent stomach upset in which the stomach acid is regurgitated and passes into your mouth and over your teeth can gradually wear away your tooth enamel.
The erosion of tooth enamel by stomach acid is common in people who have the following medical conditions:
Chronic alcohol use
Other eating disorders
Abnormal salivary flow: Saliva helps prevent dental erosion by neutralizing dietary and gut acid. It also washes these naturally occurring acids out of your mouth through swallowing. Normal saliva flow can also promote the formation of a protective film around your teeth and can help damaged enamel remineralize.
However, hyposalivation (a measurable decrease in the amount of saliva produced) can interfere with the protective benefits of saliva. Common causes of hyposalivation include:
Age-related decline in salivary gland function
Autoimmune disorders such as Sjögren’s syndrome and rheumatoid arthritis
Medications (certain ones)
Radiotherapy treatments on the head or neck
External factors that contribute to dental enamel loss include:
High-acidic foods and beverages: Dental erosion is linked to high-acidic foods and drinks. Typically, these products have a pH below 5.7 and may be more likely to trigger dental erosion. The most common sources of dietary enamel loss include:
Acidic fruit juices
Acidic sugar-free drinks
Citric acid in carbonated/soft drinks
Citrus fruits (oranges, lemons, and grapefruit)
Environmental causes: Exposure to certain chemicals in your home, environment, or workplace can accelerate enamel loss. The erosive acids in chlorinated swimming pool water, for example, can cause enamel loss.
People who work in certain occupations that involve regular exposure to airborne acidic fumes have an increased risk for loss of dental enamel. These roles include battery plant workers, picklers, and miners. People who work in fertilizer plants and munitions are also at risk.
Medications: Certain over-the-counter (OTC) and prescription medications can promote dental loss. These medications include:
Antiemetics (drugs for nausea and vomiting)
Antiparkinsonian medications (aim to replace dopamine in people with Parkinson’s disease)
Hydrochloric acid tablets for the treatment of stomach disorders
Tranquilizers
Bruxism: Bruxism is the grinding or clenching of teeth. It can wear away tooth enamel.
Poor or excessive toothbrushing: Using a stiff-bristled toothbrush rather than one with soft bristles can contribute to dental erosion, as can brushing too often or harshly.
What Happens If Your Enamel Is Gone?
If your enamel is gone, it cannot be replaced. Mature tooth enamel does not contain cells, so it can't be regenerated like other biomineralized tissues in your body such as dentin and bone. Noticing tooth erosion early can help you identify the problem and consult a dentist as early as possible.
As your enamel erodes, you may notice changes on the biting surfaces, inside surfaces, and edges of your teeth. Tooth enamel loss often involves one or more of the following signs:
Cracks and chips in the edges of your teeth
Cupping (cuplike indentations, dents, or grooves) on the surface of your teeth
Sensitivity to temperatures and sweets
Sharp, irregular, jagged edges on affected teeth as pieces chip off or break away
Shorter appearance of the affected teeth as they wear away
Yellow discoloration as the underlying yellow dentin layer is revealed
Can Dentists Restore Damaged Tooth Enamel?
While lost tooth enamel can't be restored, damaged tooth enamel can often be repaired. The type of treatment necessary to restore your damaged tooth enamel depends on the extent of damage present.
Depending on the condition of your teeth, your dentist may advise one of the following treatments to restore damaged tooth enamel:
Restorative treatments for early-stage damaged tooth enamel, which include:
Fluoride toothpaste and fluoride treatments: Fluoride toothpaste and fluoride treatments at your dentist's office can help rebuild damaged tooth enamel in its early stages.
Remineralization: Remineralization treatments include toothpaste and treatments with minerals like fluoride, calcium, and phosphate, which can work to help rebuild tooth enamel naturally. These treatments can be performed at home or in a dentist's office.
Cosmetic and functional repair of tooth enamel too advanced for restorative treatments includes:
Dental bonding: Dental bonding involves the application of a tooth-colored resin to the damaged surface of a tooth. The resin protects the tooth and improves its appearance.
Dental veneers: Dental veneers can help prevent further erosion and improve tooth appearance when enamel damage is more advanced. These custom-made, natural-looking tooth coverings can provide protection and cosmetic improvement to repair enamel damage, especially when limited to the front (outward-facing) side.
Dental crowns: Dental crowns may be necessary if you have severe enamel damage, damage not limited to the front of your tooth, or the enamel has worn off completely. A dental crown covers the entire surface of your tooth to protect it and restore normal appearance.
Learn More: 7 Types of Cosmetic Dentistry Procedures
How to Take Care of Your Tooth Enamel
Dental erosion is a complex process affected by chemical, behavioral, tooth, saliva, and health factors. Taking care of your tooth enamel begins with proper oral hygiene. The American Dental Association (ADA) advises the following steps for overall oral health:
Brush your teeth twice a day with fluoride toothpaste for two minutes.
Floss (clean between your teeth) daily.
Eat a healthy diet that limits sugary beverages and snacks.
Visit your dentist regularly for the prevention and treatment of oral diseases.
Following these additional strategies can help you take care of your tooth enamel and reduce your risk of tooth enamel damage:
Limit your consumption of soft drinks, juices, energy and sports drinks, alcohol, and other acidic beverages.
Drink plenty of water daily to remain hydrated and promote healthy levels of saliva, which performs valuable functions in removing acids and promoting enamel production.
Chew sugar-free gum if you do not produce adequate saliva levels to keep your mouth moistened naturally.
Rinse your mouth with water thoroughly after consuming acidic foods or beverages.
Avoid bad food or drink habits such as sucking on acidic fruits, holding acidic drinks in your mouth, or prolonged sipping of acidic drinks throughout the day.
Rinse your mouth or brush your teeth after vomiting or belching since these actions release stomach acid into your mouth. If possible, mix in a teaspoon of baking soda and rinse to neutralize any remaining acid.
Wait at least an hour to brush your teeth after consuming acidic foods or beverages. This allows minerals in your saliva time to help re-harden the surfaces of your teeth.
Consume milk, cheese, or yogurt at the end of a meal to help neutralize acids you may have consumed.
Use toothpaste and mouthwash that contain fluoride. Calcium and phosphate in these toothpastes can help strengthen tooth enamel by remineralizing teeth.
Avoid toothpastes, whitening products, and other oral substances with a low pH (in the acidic range).
Talk to your dentist about using topical fluoride or fluoride rinses that may help.
Contact your healthcare provider for the diagnosis and treatment of conditions such as GERD, bulimia, or alcohol use disorder.
Summary
Tooth enamel is the protective shield that exists on the outer layer of your teeth. It is made of minerals that provide a rock-hard shell over the more vulnerable areas of your teeth. Healthy tooth enamel protects your teeth from breakage, decay, and the effects of extreme heat and cold.
While tooth enamel is strong, it is not invincible. Over time, it can suffer damage from internal and external acid sources. Stomach acid and certain types of foods, drinks, and drugs can damage enamel when they remain on your teeth. Changing to a low-acidic diet and treating health problems can help maintain healthy tooth enamel.
The best way to support your enamel health is to maintain a routine of regular dental visits. Your dentist can see signs of enamel loss in its early stages. This is when the problem may be repaired with the least amount of treatment and expense.
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