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There are lots of ads out there for toothpastes that claim to repair damaged tooth enamel.

Can you treat cavities and tooth decay at home? Well, mostly, no, you can’t.

Can you strengthen your enamel at home? Very possibly—in some circumstances. Let us explain!

Cavities and tooth decay start forming when the enamel on the tooth’s surface breaks down. To discover what causes this breakdown, we need to see how chemistry works with our biology.

Tooth enamel is mainly made from calcium and phosphate ions. These minerals combine to form hydroxyapatite, crystals which make up around 95% of our enamel. Hydroxyapatite crystals are so strong that tooth enamel is the hardest part of our bodies. What can weaken a substance this strong?

Acids. Acidic foods and drinks, as well as acids created by the bacteria in plaque, strip away calcium and phosphate ions in enamel, weakening the surface of the tooth. This is a process called demineralization, and it’s the first stage of tooth decay. Left alone, weak spots will become bigger and deeper until they form cavities.

And tooth enamel, unlike the rest of your body, isn’t living tissue. It can’t regenerate. Once bacteria and acids have created a deep enough cavity, only Dr. Sheets, Dr. Paquette, Dr. Wu, Dr. Guichet, and Dr. Melwani can repair it by removing decay and filling the tooth.

Wait, this sounds a lot more like “No, you can’t repair your enamel” and much less like “It’s possible to strengthen your enamel.” But we’re not through!

Demineralization doesn’t equal cavities—yet. Careful attention to your habits and your diet can make a difference in whether your enamel continues to weaken or becomes stronger.

Our body’s first defense against demineralization is saliva. Calcium and phosphate ions in saliva bathe the teeth throughout the day, restoring the minerals which have been lost. This is called remineralization. Saliva also helps neutralize acids from the foods we eat. But with a diet heavy in acids, or a lot of plaque buildup, saliva just can’t keep up with the damage.

That’s where “enamel-repair” toothpastes come in. Toothpastes are available that contain hydroxyapatite to restore calcium and phosphates to weakened enamel. But for many of the most common enamel-repair toothpastes, the not-so-secret secret to their effectiveness is fluoride.

Dentists recommend fluoride toothpastes for several very good reasons. Fluoride is attracted to the minerals in tooth enamel and bonds with them. Once bonded, fluoride attracts the calcium and phosphate ions in saliva, helping restore lost minerals to the enamel. Even better, when fluoride bonds with the calcium and phosphate in our enamel, fluorapatite is created. This is a crystal even stronger and more acid-resistant than hydroxyapatite.

If you’re concerned about the strength of your enamel, and especially if you notice any signs of acidic erosion, talk to our Newport Beach dental team right away. Dr. Sheets, Dr. Paquette, Dr. Wu, Dr. Guichet, and Dr. Melwani can:

• Recommend over-the-counter toothpastes or professional fluoride applications to help reverse early demineralization
• Provide dental bonding, a crown, or a veneer to protect a tooth with serious erosion
• Treat a cavity caused by more advanced tooth decay.

Keeping your enamel healthy at home can take many forms. By careful brushing and flossing to remove plaque, by watching the acids in your diet, by making sure you’re properly hydrated, and by using fluoride toothpaste, you can both reduce the risk of demineralization and help restore weak spots in your tooth enamel.

So, can enamel-repair toothpastes effectively repair your teeth? Yes, they can be effective—if demineralization is in its early stages and if you make them a regular part of your daily dental routine.

During the second week in April, we recognize and celebrate the expert care dental hygienists provide. Let’s take a moment this week to explore how the special skills of this valued member of your dental team in Newport Beach enrich your dental health.

Regular Cleanings

Dentists typically recommend routine dental examinations twice a year, and these visits will almost always include an in-office cleaning by your hygienist. Dental hygienists are highly trained healthcare professionals who are specialists in caring for your teeth and gums.

• Plaque and tartar need to be removed from tooth enamel to help prevent cavities and gum disease. While you can brush away plaque, it takes a dental professional to remove tartar, which is plaque which has mineralized over time. The hygienists who work with Dr. Sheets, Dr. Paquette, Dr. Wu, Dr. Guichet, and Dr. Melwani might use a hand scaler, an ultrasonic scaler, or both tools to gently scrape sticky plaque and hardened tartar from your tooth enamel.
• Your cleaning will also include polishing, where surface stains on the enamel are removed using a gentle abrasive. This cleaning might be done with a special toothpaste applied with a small rotating cup or with an air polisher, which removes stains with a stream of fine abrasive powder, water, and pressurized air.
• An expert flossing will remove any remaining plaque from between the teeth.

Deep Cleaning

Hygienists help prevent gum disease. Plaque and tartar on tooth surfaces below the gum line increase your risk of gum disease. Irritated gum tissue gradually pulls away from the teeth, creating pockets of bacteria and causing inflammation and infection.

• Your hygienist will use a probe to gently measure the depth of the space between the teeth and gums. Deeper than normal spaces or bleeding could be a sign of gum disease.
• Tartar on the tooth surface below the gum line will be removed using a treatment called scaling, a non-surgical procedure where your hygienist uses hand scalers or ultrasonic tools to carefully scrape hardened plaque from the tooth.
• Root planing might be done to smooth the root surfaces so that gum tissue can attach snugly around the teeth again, protecting the roots from plaque buildup and bacteria.

Preventative and Cosmetic Care

Some hygienists work with dentists to help provide additional diagnostic, preventative, and cosmetic services:

• X-rays and digital imaging.
• Oral cancer screenings.
• Sealants, thin plastic coatings which protect the top surfaces of molars—the most likely places to develop cavities—from accumulating food particles and plaque.
• Fluoride treatment, if recommended, applied in varnish, foam, or gel form.
• Professional whitening treatments.

Education

Finally, your dental hygienist is an educator!

• When it comes to brushing, there are effective techniques and . . . not so effective techniques. Your hygienist can teach you the best way to clean away food particles and plaque and the best tools for the job.
• During a cleaning, your hygienist will point out any spots where plaque has built up. Discovering the spots where you tend to leave plaque behind allows you to do a better, more thorough cleaning job at home.
• Flossing can be difficult for some of us because we have braces, or because of the way our teeth are aligned, or because of dexterity issues. Your hygienist can show you the best way to floss, as well as recommend products such as specially designed flosses or water flossers which will make flossing easier and more effective.

The dental hygienists at Sheets, Paquette & Wu Dental Practice are skilled professionals who work to create cleaner, brighter, healthier smiles for their patients every day. This week, we appreciate them for helping us achieve the beautiful smiles we get to appreciate all year long!