What is tooth demineralization … and what can be done for it?
As we age, the enamel on our teeth begins to weaken and break down. Known as demineralization, it is a natural process caused by your teeth’s exposure to dietary acids from food or beverages, as well as bacteria which naturally reside in the mouth. As the enamel thins, the dentin layer beneath may thicken and darken, and the tooth surface becomes rougher with ridges or grooves.
What causes demineralization of the enamel?
A highly acidic environment: Consuming a lot of coffee, tea, acidic foods or carbonated beverages can create an environment that stimulates demineralization. GERD or mouth breathing can also lead to an unhealthy level of acidity in the mouth.
We see some patients with “silent GERD.” These individuals may not have GERD symptoms, but they present with more erosion on one side of their mouth (and it’s the side they sleep on). This is a sign that they could have some GERD events affecting their teeth.
Sugary and starchy foods: Consuming an excess of starchy or sugary foods can cause bacteria growth in your mouth. These bacteria feed on the sugar, and over time, break down the minerals and enamel of your teeth.
Dry mouth: Another factor that can lead to tooth demineralization is lack of saliva, or dry mouth. Saliva neutralizes acid and cleans your teeth. It also has mineral ions that help rebuild your enamel. Too little saliva can be caused by cigarette smoking, certain diseases and medications (including chemotherapy and radiation).
Poor oral hygiene: Not brushing your teeth regularly and thoroughly can also result in increased bacteria, plaque and tooth demineralization.
5 ways you can remediate tooth demineralization damage
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- Improved diet. While a diet high in sugary or starchy foods can stimulate growth of oral bacteria, a healthy diet primarily of lean proteins (think fish, eggs and beans), whole grains, fruit and vegetables can help remineralize your teeth. Cheese is also a healthier alternative to foods with higher carbohydrates and refined sugars, and it stimulates saliva flow, which naturally cleanses the teeth. The casein in cheese (also found in yogurt and milk) can help strengthen tooth enamel. Minimize sodas and sports drinks; the chemicals that add flavor can eat away at your enamel.
- Simply drinking more water can reduce symptoms and negative effects of dry mouth. Try using a timer or visual reminders to drink throughout the day in order to stay hydrated. Consuming water is especially important after meals, to help rinse away food remnants and neutralize the acidic environment. Prefer a beverage with more flavor? Make informed choices and remember that sugary or carbonated beverages can add bacteria or increase the acidity in your mouth.
- Sugar-free gum or mouth spray with xylitol can both increase saliva production. Xylitol is a natural sugar found in plants, fruits and some vegetables. While it has a sweet taste, it is non-fermentable, so it does not feed the bacteria in your mouth like starchy sugars do. In fact, research shows that xylitol actually inhibits the growth of bacteria which can cause damage to teeth.
- Remineralizing toothpastes, rinses and mouthwash: The acids in foods can demineralize teeth and make them more vulnerable to cavities. Remineralizing toothpastes and rinses are specifically formulated to undo that damage, returning the minerals to your tooth enamel and protecting the teeth from acid erosion. The fluoride in toothpaste makes your teeth more resistant to mineral loss. Some over-the-counter toothpastes (specifically Pronamel Sensodyne) contain mineral-rebuilding compounds. For patients at higher risk for tooth decay, we often recommend toothpastes with prescription level fluoride and remineralizing compounds that we can supply. As a preventative measure, we will also apply fluoride varnish for these patients at their hygiene visits.
- Be cognizant of exposure time. Sipping soda, coffee or tea throughout the day stresses your teeth and makes it difficult for them to recover. Target 3-4 hours each morning and afternoon without eating or drinking anything except water. Providing your teeth discrete periods of time during which there is not an acidic environment enables the teeth to remineralize.
While in some cases, the enamel may be damaged to an extent that intervention (such as bonding, crowns or veneers) is required, with proper care, you’ll actually be able to see evidence when teeth are remineralizing. They become smoother, healthier-looking, and have fewer white spots and less sensitivity.