Modern dietary habits put tooth enamel’s protective properties at risk

Dr. Bernhard Ganss of the University of Toronto’s Faculty of Dentistry is an expert in enamel research. supplied

Dr. Bernhard Ganss of the University of Toronto’s Faculty of Dentistry is an expert in enamel research. supplied

Nature designed enamel as a remarkably effective first-line defender of our teeth in a complex and often harsh environment – the inside of our mouth.

The hardest substance in the human body, enamel is the highly mineralized, thin outer covering of the tooth. When intact and healthy, it protects the softer inner layers from the many forces that lead to sensitivity, pain and decay.

Nature also designed enamel to last a lifetime – but our modern eating habits make that a problem. Unlike bone, enamel contains no living cells and cannot regenerate when lost – and today, our acid-rich diets are making enamel loss a growing risk.  

“Acid is enemy number one for tooth enamel,” says Bernhard Ganss, professor and associate dean of research at the University of Toronto’s Faculty of Dentistry, and a leading enamel researcher. “And consumption of acidic foods and beverages has increased dramatically over the past 40 or 50 years.”

Enamel loss caused by acids acting on the tooth’s surface is known as “acid wear.”  When acid wear occurs, the enamel loses its innate capacity to guard the teeth from harm, says Dr. Ganss.    

“Enamel is a fascinating bio-ceramic material built to withstand a challenging oral environment – extreme hot and cold, acidity and the massive mechanical forces of chewing,” he says. “It also shields the tooth from onslaught by the approximately 700 species of microorganisms inside the mouth.”

When acid hits our teeth, some of the minerals in the enamel instantly start to dissolve at a surface level, but our saliva lessens that impact, explains Dr. Ganss. “If the acid isn’t in contact with the teeth for too long, saliva then comes in to raise the acidity to normal levels and put some of the dissolved minerals back into the enamel.”

At a microscopic level, the surface layer of the enamel essentially “comes and goes,” but if all is operating properly, it remains intact, he says.

Many Canadians would likely be surprised to learn how many of today’s everyday foods and beverages are highly acidic. Acid-rich drinks include the increasingly popular sports and energy drinks, as well as coffee, soft drinks, fruitjuice, smoothies and wine. Acidic foods range from citrus fruits such as oranges, lemons, berries – such as blueberries – and other types of fruit, to tomatoes, chocolate and salad dressings.

Although many of us face multiple acidic exposures daily, dental professionals find their patients don’t often understand the risks.

“People are worried about cavities and know about gum disease, but acid erosion doesn’t typically top their list of concerns,” says registered dental hygienist Martha Szczepulski, who works at a community dental health clinic in Vancouver.

“The early effects of acid wear are almost invisible, but when it gets to a moderate stage, patients notice more changes. Patients come in complaining about the symptoms and asking why their teeth look yellow or translucent or are starting to chip, and why they are so sensitive.” Yellowing teeth can be a sign of acid wear, and whitening products can make the situation worse.  
Tooth sensitivity has other causes, but it certainly may signal acid wear, says Ms. Szczepulski.

“Enamel is a thermal insulator and once it thins, your teeth are more sensitive to extreme temperature.”

Both frequency and duration of acid exposures are factors in acid wear, but dental professionals say they’re most concerned about duration. When people expose their teeth to acids over prolonged periods – for example, sipping water with lemons throughout the day – the risk of acid wear rises.

Some people may face greater risks from non-dietary factors, including medical conditions such as acid reflux, as well as use of certain prescription drugs.

“Many drugs can alter saliva to make it less effective at buffering acidity,” says Sally Lloyd, a registered dental hygienist and owner of the Lifetime Smiles Dental Hygiene Clinic in Calgary, Alberta. “Some people have ‘dry mouth’ for other reasons – and less saliva means less protection against acids.”  

Dry mouth also results from intense exercise, and that’s just one reason why the risk of acid wear is often higher among competitive or otherwise “serious” athletes, explains Ms. Lloyd.

“Our clinic is in a wellness centre and we see many athletes. We spend a lot of time talking to long-distance runners and cyclists about the acid-wear risks of energy drinks and the other high-acid, high-glucose products they frequently use when training and competing,” says Ms. Lloyd.


Make your teeth more resistant to acidic foods

To learn more about protecting your teeth from acid wear, speak to your dentist or hygienist about Pronamel® toothpaste. Pronamel® toothpaste helps strengthen tooth enamel – protecting your teeth from the acidic foods in your daily diet.

Pronamel® toothpaste is proven to help protect from the effects of acid wear and also provides many of the benefits of a regular toothpaste: cavity protection, fresh breath and plaque removal with brushing.

Pronamel® toothpaste helps strengthen and re-harden enamel that’s been weakened by acids, making it healthy, stronger, better-protected and more resistant to enamel loss and future acid wear.

Pronamel® toothpaste can be used twice a day, every day, as your regular toothpaste.
Pronamel® toothpaste is specially formulated to be low to medium in abrasion so it’s gentle on your teeth. Toothpastes that are high in abrasion can contribute to enamel wear by scrubbing away precious enamel.

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