Synonyms
Tooth erosion, degradation of tooth enamel In dentistry, the term enamel degradation refers to the process of wear or dissolution of the outermost layer of the tooth. The enamel (lat. Enamelum; Substantia adamantinea) belongs from an anatomical point of view, just like the dentin, to the hard tooth substance of a tooth.
The enamel is the outermost layer that covers the surface of each tooth in the area of the crown. Enamel is the hardest substance in the human body and surrounds the dentin. It contains large quantities of: calcium, phosphorus, magnesium, sodium, proteins and water.
The main component of the enamel consists of phosphate-containing compounds, which are attacked by acids and can dissolve. In contrast to dentine, dental enamel is not connected to nerve fibers or blood vessels. This means that damaging influences can spread for a long time before the patient even notices them.
Carious defects, which are limited to areas of the enamel, generally do not cause any discomfort. This means that a painful caries attack on a tooth indicates that it has penetrated into the deeper dentine layer. However, not all patients perceive pain as soon as the enamel-dentine border is broken through. Many affected patients even notice a caries only when the defect has already reached the pulp and the consequences for tooth preservation are devastating.
What is an enamel defect?
An enamel defect is an injury to the uppermost layer of the tooth in which the dentin, which lies directly under the enamel, remains undamaged. This defect can be caused by mechanical or chemical irritation. In most cases it is caused by caries.
If the caries only affects the enamel layer, it is called initial caries or initial caries. At this stage, the caries is still reversible and can be made inactive at this stage by good oral hygiene and regular fluoridation. This means that the caries exists but does not continue to grow towards the dentin and pulp.
It is practically rendered harmless. No filling therapy is necessary at this stage. This enamel damage is often visible as black spots in the grooves of the molars or in their pits.
It is important to clean this area well and to fluoridate it preventively. If this is not the case, the inactive caries can turn back into an active form and show tendencies to spread. Once the caries has reached the dentine, the dentin, it must be treated with a filling therapy, otherwise it will spread to the nerve chamber, the pulp, and cause permanent damage to the tooth.
This is no longer just a defect in the enamel, but a lesion in the enamel and dentine. There are also enamel defects that are not caused by caries. For example, anyone who regularly brushes their teeth with too much pressure and a highly abrasive toothpaste will damage their teeth.
With each brushing, more enamel is broken down or worn away, which can no longer be reproduced. The result is an enamel defect, which is typically found in the area of the neck of the tooth. This is called a wedge-shaped defect. In addition, enamel defects can be caused by acid exposure from food or by grinding of the teeth.
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