Tooth Enamel Erosion: Causes, Signs and Whether Enamel Grows Back

Decay is caused by bacteria in plaque that turn sugar into acid and dissolve a spot in the tooth, which ends as a hole. Erosion is the loss of enamel from acid that comes from outside or from the stomach, with no bacteria needed. It tends to wear a broad surface rather than make a pit.

The two often occur together and both lower the protection of the tooth. If you want the decay side, read what a cavity in teeth looks like. Erosion also differs from wear caused by brushing too hard or grinding, though all three can add up.

Acidic drinks are the main external cause: fizzy drinks, energy drinks, fruit juices, squash, sports drinks and some flavoured waters. Citrus fruit, pickles, vinegar and some sour sweets add to it. How often matters more than how much, because each sip drops the mouth into an acid state, and sipping through the day keeps teeth in it.

Acid from inside the body is the other group. Reflux, where stomach acid comes up into the mouth, especially at night, can wear the inner surfaces of the teeth. Repeated vomiting, from an eating disorder, pregnancy sickness or alcohol, does the same. A dry mouth makes all of it worse because saliva is what neutralises acid.

Brushing straight after acid can also cause harm. Enamel is softened for about thirty minutes, and brushing then scrubs away the softened layer. Rinse with water and wait.

Erosion is usually painless and slow, which is why it is often found at a check-up rather than noticed. Look for these signs.

Teeth that look more yellow, because the thinning enamel shows the darker dentine beneath. Edges of the front teeth that become thin, rounded and slightly see-through. Smooth, shiny worn surfaces, and small dips or cups on the chewing surface of back teeth. Existing fillings that seem to stand proud of the teeth around them.

Sensitivity to cold, hot or sweet food is another sign, as exposed dentine reacts to temperature. Our sensitive teeth page covers it, and the yellow teeth page explains the colour change. None of these is a diagnosis, because a dentist needs to look at the pattern.

Early detection matters because the damage is cumulative. Photographs or models taken at a check-up let the dentist compare the teeth over time and see whether the wear is progressing.

No. Enamel has no living cells, so once it is worn away the body cannot regrow it. Toothpastes that claim to regrow enamel do not do that.

What can happen is repair at the earliest stage. Where enamel is only softened and has lost some mineral but is not yet worn away, fluoride and saliva can put minerals back and make the surface harder, a process called remineralisation. That is why fluoride toothpaste, used properly, is the central step, as covered in how to stop tooth decay. The dentist may add a fluoride varnish or a stronger paste.

Drink acidic drinks quickly with meals, not slowly through the day, use a straw to keep them off the front teeth, and finish with water. Do not brush for at least thirty minutes after acid. Use a soft brush and fluoride toothpaste, and spit out the foam without rinsing.

Chewing sugar-free gum can raise saliva flow. If reflux or vomiting is behind it, the cause needs treating by a doctor, because the teeth cannot be protected while the acid keeps coming. Tell your dentist about it, since they can help protect the teeth meanwhile.

If you vomit, rinse with plain water or a fluoride mouthwash afterwards and wait before brushing. If you sip fruit juice or soft drinks regularly, swapping some of them for water makes a larger difference than any product.

Mild erosion needs monitoring and prevention, with fluoride and diet changes. Moderate wear, with sensitivity or visibly thinned edges, can be rebuilt with bonded tooth-coloured composite, which adds material back onto the tooth. Fillings of a worn cupped surface are described in types of dental fillings.

Where many teeth are affected, veneers can cover the front surfaces, and crowns can cover badly worn back teeth that have lost most of their height. These treatments cost tooth and money, so they come after the cause has been controlled. Call the clinic to ask which would suit your teeth. The tooth fillings page explains bonding.