Author of the article:
Soldatova Lyudmila Nikolaevna
Candidate of Medical Sciences, Professor of the Department of Clinical Dentistry of the St. Petersburg Medical and Social Institute, Chief Physician of the Alfa-Dent Dental Clinic, St. Petersburg
Enamel is the hardest part of the tooth. This tissue consists of enameloblasts, proteins, lipids and water. Although, at first glance, the enamel has a uniform structure, this is not the case. It varies in thickness in different areas of the teeth. But, unfortunately, even the strongest enamel on teeth can begin to wear off. How to prevent this unpleasant process? Let's try to figure it out.
What is it - erosion of tooth enamel
When dental diseases develop, in most cases it is the enamel, which is the surface of the tooth, that is affected. The more serious the damage, the more dangerous the pathology, since the tooth is left without protection and its functionality is completely impaired.
Tooth erosion is a common disease in which severe thinning of the enamel to dentin occurs. The enamel is destroyed symmetrically on all teeth in the oral cavity with the exception of molars.
The pathological process is accompanied by painful sensations when eating and drinking drinks, brushing teeth and even inhaling cold air. In addition to physiological and functional disorders, there is a serious aesthetic defect. If tooth enamel erosion is not advanced, then therapeutic treatment can give a positive result. However, if the tooth is severely damaged, then it can only be restored using the restoration method.
Composite restoration
Restoration with composite materials is carried out in cases of significant damage to the tooth surface and deep caries. Restorative composite is often used to fill canals when removing nerves. The operation consists of multi-layer application of a composite. To give a natural look to molars or incisors, the surface of the tooth must be ground after each layer is applied. Then, after the procedure is completed, the teeth will not look bulky. Each applied layer is dried separately. The results can last for years, and with proper oral care, the service life is more than 10 years. Despite the final result, the composite restoration procedure involves the destruction of the protective layer of the tooth. At its core, restoration seems to be a replacement therapy: natural enamel is not restored, but is replaced with artificial material.
Causes of the disease
The exact causes of tooth enamel erosion have not been determined. Dentists do not exclude the possibility of developing the disease in every person, even with constant monitoring of oral health.
But there are a number of possible provoking factors.
- Mechanical. The enamel can be damaged by mechanical stress due to excessive pressure on the teeth with a brush with hard bristles, or the use of a whitening paste with large abrasive particles. The surface of the tooth is also often damaged in people who have the habit of gnawing something or opening jars with their teeth, etc.
- Chemical. The highest risk is the chemical factor, which involves excessively frequent consumption of drinks or foods with high acidity.
- Endocrine. The connection between the functioning of the thyroid gland and the condition of tooth enamel has not been determined, but according to research, in patients with hyperthyroidism, tooth erosion occurs much more often.
- Anatomical. In case of malocclusion or the absence of chewing teeth, the distribution of the load on the dentition occurs unevenly, which leads to the abrasion of the enamel on the teeth, onto which all the pressure is redistributed.
- Medication. Some medications also have an impact on the condition of teeth as a side effect.
- Hereditary. Problems with tooth enamel can be genetic and are often inherited.
According to statistics, erosion of tooth enamel is detected mainly in women over the age of 35 years. But pathology is increasingly being diagnosed in children with baby teeth.
Do you need a strengthening diet for teeth?
In everyday life, it is important to adhere to an anti-caries diet. This diet involves limiting the consumption of sweets and, in particular, sugary drinks. The menu should be dominated by solid, granular, even fibrous foods.
A restorative diet for enamel involves increasing the calcium content in the daily menu. If there are no other health contraindications, it is recommended to increase the consumption of milk and dairy products, such as white cheese and natural yogurt.
How to detect the disease in time
Erosion on the enamel should be treated immediately. The disease can progress very quickly and within a few months completely destroy not only the surface of the tooth, but also the dentin, leaving the pulp exposed.
There are three main stages of pathology.
- First. This is the initial stage, during which it is difficult to independently detect signs of dental damage. During examination, the dentist may detect a loss of shine and a change in the shade of the enamel.
- Second. At the middle stage, more pronounced signs already appear indicating increased sensitivity of the enamel: reaction to food (salty/sweet, hot/cold, spicy, etc.). Pigmentation becomes obvious.
- Third. It is considered a deep and advanced stage. Part of the enamel may be completely missing. Dentin is exposed. Brown or yellow spots are visible on the preserved surface of the tooth.
The disease is also classified according to the nature of its course. There are two forms: active and stable. In the active form, the disease progresses quickly with a characteristic change in the color and structure of the enamel. The stable form is characterized by the absence of symptoms and restoration of enamel using the body’s resources.
Methods for restoring the hard layer
However, even with complete dental health, our external dental structure is not completely intact. It is always rough, with small inclusions of microcracks formed due to expansion of the enamel due to frequent consumption of hot or cold food or interaction with tobacco smoke. And since this tissue, which is considered the strongest in our body, does not receive nourishment from blood vessels, it is important for us to take care of the timely restoration of tooth enamel ourselves. Dentistry can offer several methods, the price of the issue is from 100 rubles per tooth. And here success is directly related to the degree of initial damage to the protective shell.
Remineralization
In essence, this is a strengthening. The doctor will first clean the surface of the teeth from plaque. Next, he will carry out the restoration procedure - apply a special composition (this can be a solution of calcium with gluconate). As a rule, this is a protective fluoride varnish. This remedy differs from the procedure described below in that it contains less minerals, so it can be repeated quite often. On average, once every six months, that is, when you carry out preventive cleaning. The price of the procedure is included in the hygiene package.
Fluoridation
A type of remineralization is fluoridation. With this method, the dentist protects the thinned hard layer from decay by saturating it with minerals. The doctor applies - using mouth guards or just a brush - a restorative agent to the problem teeth: compositions (gels or varnishes) with a high content of fluoride and calcium. These microelements penetrate the damaged structure of the outer shell, fill voids and cracks, nourish and strengthen it. On the eve of fluoride treatment, it is good to carry out hygienic cleaning, which will remove plaque and hard deposits. But! Sometimes, if there is severe sensitivity, it is better to do the procedure after strengthening the hard layer.
This procedure is much more expensive – it costs from 300 rubles per tooth. It is recommended to carry it out in certain courses. It is needed for those patients who really have problems with the hard shell of teeth.
Restoration with artificial materials
In advanced cases, when the enamel is severely damaged or completely absent, the main thing is to protect the main part - dentin. For this purpose, dentists have successfully used restorations using veneers, lumineers or light-cured fillings. Thanks to modern technologies, the quality and durability of the polymers used, the tooth will become strong, and in appearance it will not differ at all from its “brothers” - neither in color, nor in transparency and shine.
Changing your diet
A deficiency of vitamins and minerals in the diet will inevitably lead to a lack of these beneficial substances in the tissues of our teeth. You must know by heart the “foods of power” (cottage cheese, fish, chicken breast, dairy products, nuts, fruits, herbs, vegetables) and be sure to introduce them into your daily diet. It is only important to remember that foods high in calcium are not friendly with acids. Such a duet will only cause the enamel to deteriorate even faster.
It is useful to drink water enriched with calcium, fluorine and phosphorus and supplement with vitamin D (5-10 thousand units per day), this excellent helper for our immunity.
Using special pastes
Sensitive enamel, being a very thin and very vulnerable tissue, requires special attention and care from a person. Among the home methods of remineralization, pastes saturated with fluoride and calcium are used.
Important! Drug therapy, a special “diet” and remineralization procedures should be carried out in combination - this will achieve the best effect.
How is the treatment carried out?
Erosion of enamel can be detected by a dentist during a preventive examination; this most often occurs at the initial stage during regular visits to a specialist, or it can be diagnosed after a patient complains.
If indicated, the dentist may refer you to an endocrinologist or gastroenterologist for consultation. For successful treatment, it is important to correctly identify the provoking factor and draw up an individual plan for complex therapy.
Damaged tooth enamel cannot be restored naturally. If treated in a timely manner, the dentist must take measures to block the process of tooth decay. After treatment is completed, teeth are restored to restore their appearance.
Ceramic veneers
Ceramic veneers are thin ceramic plates that are attached with special slots-locks on the front surface of the fangs or incisors. The method allows you to eliminate gaps between teeth, slight curvature, congenital or acquired defects of the oral cavity. Veneers have a long service life (more than 10 years) and do not change their quality characteristics. Often, veneers are placed on all teeth, as they create a flawless appearance of the smile line. The installation of veneers is not a restorative procedure, as it involves even greater destruction of dental structures, as is the case with the implant method. If the patient ever decides to remove the veneers, the enamel cannot be restored using alternative methods. You will have to either re-use ceramic onlays or install crowns.
Even if you follow all the rules of daily oral care, it is not always possible to maintain the strength of the enamel. This may be due to irreversible pathological processes in the body, congenital defects, or the need to constantly take special medications. Our clinic’s specialists will help patients gain self-confidence and maintain dental health for many years.
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