Expert answers: Can you reverse the damage to your tooth enamel?

Can we ever reverse damage to our teeth? That’s the question on everyone’s lips after researchers recently discovered a way to regrow human tooth enamel.

Enamel – the hard, outer surface layer of your teeth that protects our teeth from normal wear and tear – can become susceptible to erosion overtime and, while you can do a lot to protect and strengthen your tooth enamel, once it’s eroded, it’s gone, leaving people exposed to cavities and in need of fillings.

But scientists in China may have found a way to say “goodbye” to fillings forever as they have developed a gel that permanently repairs damaged tooth enamel. Now speaking to Starts at 60, dentist Arosha Weerakoon explains what tooth enamel actually is, what causes erosion and how fillings could be a thing of the past.

What is tooth enamel?

Tooth enamel is the hardest tissue in the body. Enamel, which is made up mostly of minerals, plays a very important role in protecting your teeth from decay. It also protects your teeth from pain and sensitivity. But if this protective coat is destroyed, unlike other parts of your body – like your bones, for instance – enamel cannot self-repair. Why? Enamel is not living and contains no nerves.

“It can’t regrow itself,” Weerakoon explains. “The cells that form enamel die as our teeth come through into our mouth.”

What are the signs and symptoms of enamel erosion?

Weerakoon says the most common symptom of enamel erosion is increased sensitivity to taste, textures and temperature, adding: “Pain is our body’s way of telling us something is wrong.”

Other signs and symptoms of enamel erosion include cracks and chips, discolouration and indentations known as cups on the surface of your teeth.

“The enamel makes our teeth look whiter and more glassy and as it wears down it starts to show through the darker dentin [yellowish tissue directly underneath enamel] underneath it,” she explains.

What causes enamel erosion and who is at risk?

One of the main causes of enamel erosion are acidic drinks and foods, including wine, soft drinks, fruit juices, sour lollies, citrus fruits (lemons, limes, oranges), sugary foods and energy and sports drinks. Weerakoon says it’s best to avoid or limit food and drinks that are considered acidic.

Meanwhile, people who suffer from gastroesophageal reflux, also known as acid reflux or GERD, may be at greater risk of their teeth eroding, as the stomach acid can also wear away the enamel on your teeth.

Another concern is dry mouth, also known as xerostomia, which can also lead to severe tooth decay. Dry mouth occurs when your saliva levels decrease. Saliva is important because it protects the teeth and without this regular production, bacteria can grow in the mouth and cause bad breath, gum disease and enamel erosion.

What can we do to prevent dental erosion?

You can protect your enamel by cutting down on acidic drinks and foods that are known to cause a lot of damage, but if you must have an acidic beverage, Weerakoon recommends using a straw so your teeth are less exposed to the acid in the drink.

And while it might seem like a good idea to brush after drinking a glass of cola or tucking into a handful of lollies, doing so can damage your teeth. Acid softens your enamel, so brushing immediately after can actually accelerate the eroding process.

“You need to give your mouth some time to recover before brushing,” Weerakoon explains.

In addition to daily tooth brushing, she recommends rinsing with a bicarbonate and salt water mouthwash, and chewing sugar-free gum, which helps you make more mineral-rich saliva, to prevent or control erosion.

Can tooth enamel be repaired?

If the enamel on your teeth has eroded, it can be gone for good. But, weakened enamel can be restored to some degree by remineralisation (a process which repairs the lost enamel). Weerakoon says fluoride works great when it comes to strengthening exisiting enamel, as does toothpaste containing a milk protein.

By taking these simple precautions, she says it can delay tooth loss, slow down the process of getting a cavity and even delay the need for dentures. However, if the damage is more advanced, you may need fillings, crowns or a root canal.

When will we be able to regrow enamel?

“I’ll say not yet,” Weerakoon says. “Mainly because based on what they’ve published so far, the level of repair is at a microscopic level, so a very thin layer of enamel, but there is potential.”

In the study, published in Science Advances last month, the researchers tested the gel, made up of mineral clusters naturally found in teeth, on extracted damaged human teeth. The gel repaired the enamel layer to around 2.7 micrometres of thickness. While there’s a long way to go before the gel can be used on people, Weerakoon reckons the recent findings are promising.

“I think one day instead of a filling you might go in and have something applied to your tooth and it will cause it to health, which would be fantastic. It’s very exciting.”