Does Tooth Enamel Regenerate?

I am frequently asked if there is anything that can be done to reverse damage to our teeth. Can tooth structure repair itself like a broken bone or other tissue, such as the liver? To understand the answer, let’s talk about the basic differences between bone, organ tissue, and enamel. Bone and organ tissue are vascular. They receive blood supply and have nerve connections. Enamel is avascular and has no nerve supply within it.

Enamel is an extremely hard and durable outer surface of the tooth that protects the dentin. The dentin of the tooth has a more elastic quality, it has pulp which contains blood vessels and nerve endings. Dentin provides more flexibility against the brittle surface of the tooth enamel. Enamel is the hardest structure in the human body.

So if tooth enamel is the hardest structure in the human body, what makes it deteriorate? Acid, sugars, and bacteria. Diet plays an enormous role in the destruction of tooth enamel. With the increase in consumption of energy drinks and continued use of soft drinks and sweet tea, I see a tremendous amount of decay and erosion of patients’ tooth structure. Sometimes the damage is so severe, the patient must endure extensive and expensive dental treatment and, in extreme cases, risks losing teeth.

Good oral hygiene is extremely important in maintaining healthy enamel. Daily flossing, brushing, and fluoride treatments are important defenses against harmful dietary habits.

Is remineralization of the enamel possible? Once decay has started, can it be stopped without a filling? As far as reversing the damage from decay we currently do not have any predictable method of stopping decay once it has penetrated the enamel, except by physically removing it. This means a filling. If decay has not reached the dentin, it may be possible to arrest the decay by practicing extremely good home care, reducing sugar intake, and using higher concentrated fluoride gels. Decay induced decalcified zones on teeth in areas around the gum line sometimes can remineralize.

If a tooth has a crack, can it be strengthened to avoid a crown? A cracked tooth cannot repair itself through natural healing like bone or other tissue can. Even with modern adhesive techniques, we have no product that can permanently glue a tooth back together with any long-term predictability. Over time, with normal chewing function, these cracks will continue to increase in size and depth. Once a tooth structure erodes, it is gone forever. No toothpaste or gel can make enamel grow. In this situation, the only way to give the tooth back its original pre-eroded shape and strength is through restorative procedures.

Because enamel is vulnerable to demineralization, prevention of tooth decay is the best way to maintain the health of teeth. A healthy diet, reduced sugar intake, and good daily oral hygiene are the best defense in preventing long-term tooth enamel loss.

Dr. Jeff Blackburn is a Fellow of the Academy of General Dentistry and has been a senior evaluator for the industry’s largest independent research firm Clinician’s Report for over 30 years.