My teeth just took over my life.

April 13, 2009 12:35 AM

ThinningToothEnamelFilter: So my latest trip to the dentist (three weeks ago) was a bit of a nightmare, in which I was told the enamel on my teeth is "very thin". Looking for advice on anything I can do to keep what's left, and (dubious) whether there's any way to get it back, as well as what I can expect from here on just generally. A few questions inside for those who have experienced the same thing, or others who genuinely know anything about the problem.

1. From most of what I've read, it's impossible to get back enamel that's gone. I've come across the odd website created by people I suppose are probably quacks, telling me this isn't the case if I take their super special blend of exclusive herbs and spices or whatever; that's bullcrap, right? Or can anyone tell me is there anything I can do to make it, uh, come back?

2. I read something about synthetic enamel having been developed by dentists in Japan but it not having been released. The article I found online was dated a few years ago, though. Does anyone know anything about this?

3. I'd like to keep what enamel I have left by paying attention to the acidity of the foods I eat, but lists I come across starkly contradict one another. The list my dentist gave me said that cauliflower and broccoli and mushrooms are "very high" in acid, for example, but other lists I've seen online indicate that these are fine. What gives? How do I know what I need to avoid if I can't find two lists that agree with one another? Basically I trust my dentist, but the list she gave me doesn't contain *everything* that I'd like to eat, so I need some way of working out if I need to be finding substitutes for stuff, and it's alarming and confusing to come across things online indicating quite the opposite to what she's said.

4. Is there anything else I could be doing that you've had success with? Any other advice? Stories? Anecdotes on what to expect? How they fix this if it degenerates further? Are my options for dealing with this the same everywhere in the world? Are my odds such that I should be getting me some private health insurance right about now? Anything else you can offer?

I'm 30 years old, for what it's worth. Female. Vegetarian. Living in a city that has fluoride in its water, but only as of early this year.

What I'm doing at present:

* Giving up all soft drinks, entirely. (I was having 1-3 a day before this, for much of my adult life.)
* Limiting my eating as best I can to three meals a day (eliminating all the snacking I've always done in between) so my poor abused enamel gets a chance to reharden (remineralise?) between meals. If I want a chocolate now, I eat it at the end of a meal and not between meals. Mostly cutting out the snacks entirely though.
* Rinsing my mouth with water at the end of every meal.
* Drinking more water generally to get more saliva happening in my mouth. (I've always been bad with drinking enough water.)
* Becoming a gum addict for the same reason. (But not chewing 'til 30-60 minutes after I eat, so that no enamel gets polished off by my chewing!)
* Brushing twice a day, gently (apparently I've been brushing too enthusiastically all along), with Sensodyne, and not 'til 30-60 mins after I've eaten. Flossing once a day.
* Using Tooth Mousse morning and night.

Please ask about anything else that might be relevant. Thanks!

posted by springbound to health & fitness (23 comments total)

I don't know if this is available in Australia, but my dentist suggested Act Restoring Mouthwash. I have thin enamel in spots thanks to my braces when I was a kid, and the dentist said this would help. However, I haven't been back to the dentist since then, so I can't say for sure whether it was actually effective.
posted by Caravantea at 3:04 AM on April 13

I'm the same as Caravantea, with soft spots due to braces.

By Tooth Mousse, I hope you mean the toothpaste with Recaldent?
posted by Houstonian at 4:15 AM on April 13

(Sorry, posted too fast).

Do you mean the toothpaste with Recaldent? If not, you might want to try that.

Also, you can get prescription fluoride toothpaste from the pharmacy (with a prescription from your dentist) to help harden what you've still got.
posted by Houstonian at 4:17 AM on April 13

Caravantea, thanks for that suggestion. She didn't recommend a mouthwash and I only came across that later as possible ammunition for the problem; I'll see if I can get that ACT stuff as it sounds good: at the moment I'm rinsing with only water after I eat and I'm feeling a bit vulnerable while I wait long enough for it to be okay to brush!! :)

Houstonian, yep, that's the one; it must be getting sold here under a different name (GC Tooth Mousse); the packaging looks the same as in your picture, it's just the name that's different. Thanks for the suggestion on the toothpaste! I'll ask my dentist about it!
posted by springbound at 4:28 AM on April 13

I have the same problem. What you list should halt erosion, but it seems unlikely that it can reverse it. I'm holding steady doing pretty much the same things you are, although one respondent to my question said they had seen some aesthetic improvements using MI Paste/Tooth Mousse.

Tooth Mousse does fix white spots, but that's a different issue than the translucent look you get from loss of enamel. And while that ACT mouthwash looks great, don't worry if you can't find that exact brand. Any drugstore should have some fluoride rinse at that concentration.
posted by rosemere at 5:22 AM on April 13

rosemere, thanks heaps for tipping me off on your other question: that's awesome, I don't know how I didn't find it when I searched. So that was two years ago and you're holding steady? PHEWWWW! *panics marginally less*

I have both white spots and some translucency around the bottoms of my top front teeth (which I can remember first noticing 10 years ago! I'm so annoyed that I've seen several dentists in that time and nobody said anything to me 'til now!). Well, good to know at least the white spots will be fixed and there's hope for it not worsening...

Thanks for the advice on the mouthwash too: I've got no bloody idea about the stuff.

Reading on your question that this Recaldent stuff comes in a gum, too, is also good to learn - particularly since the link is to a local website! Many thanks for that!
posted by springbound at 5:52 AM on April 13

GC Tooth Moose is what I have been recommended. It is developed from an Australian discovery I think, but is mostly found in Japanese made products. It is derived from Casein, a milk protein. I've used it sensitive teeth before with much success. Talk to your dentist, get their opinion. If they like it, they'll probably make a tray similar to what is used to whiten teeth and you'll wear it over night.

I'm sure that it is TGA Registered rather than merely Listed, but I can't see a number on the tube I've got at home.
posted by dantodd at 6:25 AM on April 13

Xylitol is good for teeth, but I don't think it will grow enamel
posted by crayz at 6:39 AM on April 13

I'm a dental student, so I know a thing or two about this.

1) Forget about growing back your enamel. It isn't going to happen. The cells that produce enamel die when they finish their job. The only way to get them back would be with stem cells. The Japanese thing sounds too good to be true. I haven't heard anything about it aside from the article itself which I just looked up. It obviously hasn't gone through any real clinical trials and if it has, it's failed them.

2) The 1-3 soft drinks per day that you used to drink are probably 90-100% of the reason your enamel is thin. It's really that simple. The worst thing a person can do to their enamel is drink soda. They are acidic, plus they contain huge amounts of sugar which allow bacteria in your mouth to produce even more acid. Having an acidic environment in your mouth erodes away enamel.

3) What you have already done is enough to halt enamel erosion. Replace soda with tap water and eat very few snacks containing sugar or starch. Brush or rinse after eating anything.

4) Just do that and try not to stress out about it too much. It's not the end of the world to have thinned enamel. You just have to stop doing what got you here in the first place, which isn't too hard. If you must drink soda, have a diet one w/ no sugar. If you must chew gum, chew sugarless (or even better, one that contains Xylitol, which has an antibacterial effect).
posted by swellingitchingbrain at 6:44 AM on April 13

You might consider using a fluoride rinse. I use Fluorinse by Oral-B, which I buy at a local pharmacy. Be aware that it comes in two strengths, one for daily use, and one for weekly use (I use the weekly one).

A dental hygienist told me to use the rinse to reduce tooth sensitivity (I already use Sensodyne toothpaste). I think that fluoride helps to strengthen tooth enamel.

(I have NO connection with any of these companies.)
posted by mbarryf at 6:57 AM on April 13

springbound, I also wish my dentist had caught the problem earlier. I'm leaving his office for several reasons, but his failure to catch this problem early, plus his inability to give me a straight answer when I asked if the MI Paste (Tooth Mousse) could restore my enamel, sealed the deal.

swellingitchingbrain, I recognize your expertise, but I would disagree with one thing: even sugar-free soft drinks are sufficiently acidic to be dangerous. I was drinking only diet pop for years and they trashed my teeth at least as well as sugary pop would have. I drink diet pop VERY occasionally now, but I make sure I rinse immediately afterwards and brush 30-60 minutes later. (I've read that brushing your teeth immediately after they've been exposed to acid actually makes things worse.)

Some Internet wandering has also convinced me that even club soda is best avoided, but sparkling mineral water may be a good substitute.

This fact sheet (PDF) is pretty useful.
posted by rosemere at 7:12 AM on April 13

Flouride. When flouride is in contact with tooth enamel, it combines with the enamel to strengthen it. When you brush, use a soft brush so you don't scrub off enamel, and leave the flouride toothpaste on your teeth as long as possible. Use the flouride rinse, too.
posted by theora55 at 7:39 AM on April 13

Brush or rinse after eating anything

I'm not a dentist. However, my dentist warned me not to brush after eating acidic foods (eg an apple). He gave me a leaflet which said that it was best to wait an hour after eating these foods before brushing. Apparently first these foods weaken the enamel, and then the brushing can damage it further. Please ask your dentist for her advice on this.
posted by different at 7:46 AM on April 13 [1 favorite has favorites]

I just read something recently about how they'd discovered that people given large doses of Vitamin D actually rebuilt tooth enamel. I'm not sure where, or how reliable it was, but maybe that's an avenue of research?
posted by bink at 7:54 AM on April 13

Dentist here. Your current plan is a good one. Second the advice from 'swelling' about eliminating drinks with carbolic acid (soda pop) and sugar.
Good hygiene, good diet, fluoride and chewing sugar free gum will help prevent cavities, which is your main goal at this point.

Sensitivity is another issue. It does not sound like you are suffering from this to a great degree, so your regimen is fine.

I have many patients who have erosion problems and have managed without any further loss of enamel for years and years. You swallow most food before its innate acidity can do your teeth harm, and your saliva should buffer the rest. Stomach acid is the biggest culprit (after pop) for outright erosion (vs acid demineralization leading to decay), so if you are bulemic or have a serious reflux problem you should also seek the help of a physician.

Gum chewing will not 'polish off' your enamel. Enamel is the single hardest substance in your body, harder than nails or bone. If you can't brush after meals, chewing gum immediately after (where appropriate) is better than waiting, you want the buffering action of your saliva to work as soon as possible.

Have regular check-ups and remark on any sensitivity. Good luck.
posted by OHenryPacey at 9:17 AM on April 13 [2 favorites has favorites]

What about coffee? Not for staining, but for making the teeth weaker?

I have forgotten the source, but I read that caffeine blocks calcium absorption. My last dentsist seemed only vaguely interested in the idea, and dismissed it out of hand -- as he did with everything his patiens said/asked/did.

Or isn't calcium relevant to tooth strength?
posted by wenestvedt at 10:32 AM on April 13

I located the article about vitamin D. Again, I have no idea if these people are crazy or crazy like foxes, but you can read it here.
posted by bink at 10:42 AM on April 13

Thanks for the link, bink. Interesting stuff, but in the comments, the blogger says this: "I'm not sure how long it takes, but the interventions I posted lasted 6 months. Enamel will not regenerate. Once that's formed during tooth development, you can't make it any more. But dentin will regenerate, and that's enough to heal cavities."

Too bad my ex-dentist couldn't say as much as clearly to me. Grrr.
posted by rosemere at 11:04 AM on April 13

Regeneration of dentin happens from the pulp side, not the surface side, as a response to low grade irritation. Decay is too rapid and most always leads to pulpal inflammation and ultimately pain and or abscess if untreated.
Neither of these scenarios are relevant to springbound's case, as i see it, other than the formation of secondary dentin (which she cannot control) may defer sensitivity. Calcium is much more easily uptaken by bone than by teeth and supplements have no effect on enamel.
posted by OHenryPacey at 12:20 PM on April 13

If this is your first visit to this dentist, and he/she recommended a costly series of treatments, the first thing I'd do is get a second opinion.
posted by justcorbly at 1:04 PM on April 13

bink and rosemere (tandem effort!), thanks, yas just cleared up the process to me as well. I was reading, "Once enamel's gone, it's gone" while at the same time reading all this stuff about "your teeth remineralising" (with tooth mousse or saliva or whatever) and was a bit confused in the seeming contradiction. So it's dentin that can regenerate. Aha!

OHenryPacey, thanks for weighing in and for your thoughts. I'm gonna keep at the Tooth Mousse thing even if you're dubious: too many people, including the counter staff at my dentist who's apparently had the same problem, have said how awesome it is for me to not want to give it a try as a possible solution for remineralising spots I've got showing that I suppose must be dentin (up around the gums on some teeth). No eating disorders or anything so that's not an issue. Carbonated drinks are dead to me.

I figure no harm in trying D3, too, bink, since a friend has recommended Vitamin D to me for other reasons anyway and I *was* meaning to check it out. Thanks for that.

different, yeah, my dentist told me not to brush right after eating (wait 30-60 mins), and ditto for chewing gum. Since I'm pretty impressed with this dentist all up, but also would like to be stimulating saliva ASAP after eating (like OHenryPacey recommends), I'm thinking I might get hold of some soft sugar-free candies that I can *suck* against the roof of my mouth after meals rather than do anything that involves toothy contact. That seems like it should win the seal of approval from *all* the experts! ;)

justcorbly, this is my first visit to this dentist, but she hasn't recommended a costly series of treatments or anything: using Tooth Mousse is the only non-behavioural change she's suggested I make. I reckon she's pretty trustworthy, but thanks for the concern! :)
posted by springbound at 4:48 PM on April 13

Oh and all the fluoride recommenders: ta! Somewhere out of all this reading and following links I've come across the notion of using the stuff *before* eating acidic foods to strengthen the enamel first... For someone who likes the occasional balsamic/lemon juice-based salad dressing, that certainly seems like a strategy worth keeping around too.

Thanks also to everyone I've not replied to specifically! All your thoughts are appreciated! :)
posted by springbound at 4:54 PM on April 13

PS: Oh! Xylitol mentioners - that stuff sounds wicked! Gonna get my hands on some of that too... see how it goes in cookies! Thanks! :)
posted by springbound at 5:26 PM on April 13