Understanding the essential role of tooth enamel in oral health

Mr D* maintains a relatively healthy diet, strategically avoiding sugary snacks, desserts and fizzy drinks. His habits, on paper, align with a top practice for preserving dental health – minimising the intake of sugary foods. 

However, when he sought help from Dr Bernard Siew at Smilefocus for cracked teeth caused by the consumption of nuts, he discovered that his dental concerns went beyond the immediate issue – a thorough dental assessment revealed significant deterioration of his teeth. According to Dr Siew, Mr D’s enamel had eroded to the extent that “it was paper-thin and had started to break away like sheets of glass, exposing the underlying dentine”. 

The root cause? Mr D ate grapes and nuts six times a day over an extended period, believing it to be a healthy habit. Unfortunately, the acidity in grapes led to tooth erosion, while the hard nuts, requiring substantial chewing force, exerted sustained pressure on his teeth, ultimately causing cracks.

“It’s a common mistake to think that food and drinks usually considered healthy would be harmless to one’s teeth,” said Dr Siew.

Acid-related enamel breakdown, a form of demineralisation, stands as one of the most preventable issues Dr Siew encounters in his daily patient assessments. Enamel erosion is a gateway to a host of oral health issues, including tooth decay and chipped or cracked teeth, often resulting in costly and uncomfortable dental visits. This situation, said Dr Siew, can be mitigated with proper dental care.

THE FUNDAMENTALS OF ENAMEL HEALTH

Tooth enamel, comprising approximately 97 per cent hydroxyapatite (a form of calcium phosphate) serves as a robust shield vital for maintaining dental resilience and durability. While tooth enamel is the hardest substance in the human body, it lacks the ability to repair itself. Much like skin, the ageing process plays a role in the progressive deterioration of enamel, a factor exacerbated by food and drink preferences. 

“Regionally, lime and chillies are commonly used to enhance the flavour of food. Many Southeast Asian dishes tend to be acidic in nature and could have damaging effects in the long run,” observed Dr Siew. 

Prioritising the care of tooth enamel is a crucial aspect of dental well-being, he noted. While instrumental in preventing enamel issues, it is often overlooked in broader discussions on oral hygiene.

A simple step to cushioning the impact of daily habits on teeth is to use toothpaste with remineralising components, said Dr Siew. “Early prevention can be highly effective in halting further enamel breakdown,” he added. 

STRENGTHENING TOOTH ENAMEL WITH THE RIGHT INGREDIENTS

According to Dr Frederic Meyer, senior scientist for oral care at Dr Wolff Group, toothpaste formulations enriched with hydroxyapatite have been shown to reinforce and remineralise tooth enamel. “Such products allow one to ‘brush back one’s enamel health’, as hydroxyapatite mimics the human enamel, therefore supporting the repair of microscopic enamel defects,” shared Dr Meyer.  

He recommends the Bioniq Repair Toothpaste, which is formulated with 20 per cent biomimetic enamel (hydroxyapatite/BioHAP), for individuals facing enamel-related issues. “Through daily brushing, BioHAP initiates enamel repair through remineralisation and bonds to the surface of teeth, establishing a protective layer. Consistent use of Bioniq Repair Toothpaste can contribute to a smoother tooth surface and offer protection against daily wear, acid exposure and bacterial attacks,” explained Dr Meyer. 

Presently, two formulations of the Bioniq toothpaste are available in Singapore. Both versions help to repair and remineralise the enamel as well as provide protection against daily wear, while the Bioniq Repair Toothpaste PLUS offers these benefits and more. Enriched with hyaluronic acid and lactoferrin, the latter aids in alleviating gum issues by combating harmful bacteria and maintaining moisture essential for oral health.

When using a remineralisation toothpaste, Dr Meyer and Dr Siew advise against rinsing after brushing to preserve the active ingredients and optimise efficacy. According to the former, hydroxyapatite is safe if accidentally swallowed. Dr Meyer elaborated: “It dissolves in the stomach, releasing calcium and phosphate ions, common elements found in bones and teeth. As such, Bioniq Repair toothpaste is safe for use without rinsing.” 

PREVENTION IS BETTER THAN CURE

While leveraging fortified oral agents can contribute to preserving enamel health, it should not be the sole preventive measure.

It is important to recognise acidic content in daily dietary choices, shared Dr Siew. “Adopt a daily practice of sipping on or swirling water in the mouth during or after meals. This can aid in neutralising acid and maintaining optimal oral hydration,” he shared. 

Additionally, he recommends that individuals prone to teeth grinding use a night guard to minimise enamel deterioration. “Safeguard enamel health by discussing with your dentist about the risk of enamel breakdown and draw up a protocol to keep the condition at bay,” said Dr Siew.

Bioniq Repair Toothpaste and Bioniq Repair Toothpaste PLUS are available on the Dr Wolff Asia online store respectively for S$14 and S$16 each.
*Patient’s preferred moniker