Tooth Enamel Erosion and Restoration

Written by Kendall K. Morgan
Medically Reviewed by Shruthi N, MD on October 07, 2025
10 min read

Tooth enamel erosion is when the protective enamel on your teeth wears away, causing it to become thinner and weaker than it should be. This makes your teeth more likely to get stained and feel sensitive to hot or cold. The erosion and thinning of your tooth enamel also make you more likely to have cavities. Many things can lead to tooth enamel erosion, and some people are more prone to it than others.

Most of the time, tooth erosion happens over time. But there are some things you can do to slow or stop it. Once you've lost enamel, there's no way to make it grow back. So, it's a good idea to take steps to protect your teeth before your enamel erodes. To start, brush and floss regularly and see your dentist for routine cleanings and checkups.

Enamel is on the outside of your teeth. It covers the crown — the part of your tooth visible above the gums.

"Tooth enamel is the hard tissue covering your teeth," says Ada Cooper, DDS, a practicing dentist in New York City and consumer advisor spokesperson for the American Dental Association. "It, in fact, is the hardest substance in the body, and it serves as a protective layer. It is composed of 96% minerals, which is the highest percent of any tissue in your body, making it durable and damage-resistant, but not damage-proof."

Because your tooth enamel doesn't have living cells, there's no way to repair damage to your enamel from erosion or decay, Cooper says. Your enamel can also get stained if you drink cola, tea, red wine, or other dark beverages.

It protects your teeth from daily use, such as chewing, biting, crunching, and grinding. Although enamel is a hard protector of teeth, it can chip and crack. Enamel also insulates the inner parts of your teeth from potentially painful temperatures and chemicals. If your enamel erodes, you may react more to hot or cold foods, drinks, and sweets, as they can get through your damaged enamel to the nerves inside.

Unlike a broken bone that your body can repair, once a tooth chips or breaks, the damage is permanent. Fortunately, dentists can help strengthen, repair, or restore your enamel if it gets worn away, chipped, or damaged.

"The causes of erosion are many, and they include both external factors from your diet and lifestyle, as well as internal factors from your health and your own body," Cooper says.

Some common causes of enamel erosion include:

  • Brushing hard
  • Exposing your teeth to acids
  • Grinding your teeth
  • Normal wear and tear over time
  • Genetics

What causes tooth enamel acid erosion?

Acids in your mouth can soften your enamel and make erosion more likely. When your diet includes lots of sugars and starches, it's more likely to happen. Your dentist may call this process corrosion.

Here are some foods and drinks that make your mouth more acidic, leading to enamel erosion:

Soft drinks. These bubbly beverages have lots of phosphoric and citric acids and often plenty of sugar. Bacteria in your mouth thrive on sugar, and they make acids that can eat away at enamel. It gets worse if you don’t clean your teeth regularly.

Acidic fruits or fruit drinks. Some acids in fruit drinks are more erosive than battery acid.

Sour foods or candies. These sweet treats also have lots of sugar and acid.

"If you consume these things, rinse your mouth with water immediately to help neutralize the acids," Cooper cautions.

Other factors that can lead to acid erosion include:

Dry mouth or low saliva flow (xerostomia). Saliva helps prevent tooth decay by washing away bacteria and leftover food in your mouth. It also helps keep acid in your mouth at a safe level.

Acid reflux disease, or gastroesophageal reflux disease (GERD), or heartburn. These bring stomach acids up to the mouth, where they can damage enamel.

Gastrointestinal problems, binge drinking, binge eating, or bulimia. Vomiting is often hard on your teeth. Frequent vomiting erodes tooth enamel and can lead to cavities.

Medications, such as antihistamines, aspirin, and vitamin C. Some medicines are acidic or can lead to dry mouth.

What are other causes of enamel erosion?

Friction, wear and tear, and stress (or any combination of these actions) can cause erosion of the tooth surface. More clinical terms used to describe these mechanisms include:

Attrition. This is the natural wearing down of enamel from tooth-to-tooth contact. It happens when you clench or grind your teeth, such as with bruxism, which often occurs involuntarily during sleep.

Abrasion. This is physical wear and tear of the tooth surface that happens when you brush your teeth too hard, improperly floss, bite on hard objects (such as fingernails, bottle caps, or pens), or chew tobacco.

Abfraction. This occurs from stress fractures in the tooth, such as cracks from flexing or bending of the tooth.

Sometimes, acid erosion leads to more wear and tear on your teeth, Cooper says. "Believe it or not, brushing too hard or too soon after consuming acidic foods or drinks can physically erode and soften the enamel," she says. Wait at least 30 minutes to an hour before brushing.

Plaque is a sticky film made up of saliva, food particles, bacteria, and other substances. Plaque forms between your teeth and gets inside the tiny holes or pits in the molars. It also gets around your cavity fillings and next to the gumline, where the teeth and gums meet.

Sometimes, the bacteria in plaque change food starches into acids. When this happens, the acids in plaque start to eat away at the healthy minerals in the tooth enamel. This causes the enamel to wear down and become pitted. Over time, the pits in the enamel deepen and grow in size.

"It's that acid that slowly erodes away the tooth structure, and repeated attacks of that acid can cause the enamel to break down to such an extent that you eventually develop cavities," Cooper says. "No question that brushing twice a day with a fluoride toothpaste and using some kind of interdental cleaner to remove plaque from between your teeth will go a long way in protecting your teeth."

How does saliva protect tooth enamel?

Saliva plays a key role in keeping teeth healthy and strong. Not only does saliva increase the health of your body tissues, but it also protects enamel by coating the teeth with protective calcium and other minerals. Saliva also dilutes erosive agents such as acid, removes waste material from the mouth, and boosts protective substances that help fight mouth bacteria and disease.

When your mouth is healthy, calcium-rich saliva helps keep your teeth stronger, even if you drink an acidic soda or juice. If you have a lot of acidic foods and beverages, your saliva can't protect your teeth as well.

The signs of enamel erosion can vary, depending on the stage. Some signs may include:

Sensitivity. Certain foods (sweets) and temperatures of foods (hot or cold) may cause a twinge of pain in the early stage of enamel erosion.

Discoloration. As the enamel erodes and more dentin is exposed, the teeth may appear yellow.

Cracks and chips. The edges of teeth become rougher, irregular, and jagged as enamel erodes.

Smooth, shiny surfaces. These indicate mineral loss.

Severe, painful sensitivity. In later stages of enamel erosion, teeth become extremely sensitive to temperatures and sweets. You may feel a painful jolt that takes your breath away.

Cupping. Indentations appear on the surface of the teeth where you bite and chew.

While you may notice signs of enamel erosion, often it can happen without you noticing at all, Cooper says. She suggests seeing your dentist for a careful clinical checkup to look for signs of erosion that you could be missing.

"It's important to realize that you may have erosion and not even know it," Cooper says. "So, it's really important to see your dentist so that you can catch erosion early — really early — so that it can be prevented and treated more quickly."

To prevent enamel loss and keep your teeth healthy, be sure to brush, floss, and rinse with a fluoride and antiseptic mouthwash daily. See your dentist every six months for regular checkups and cleaning. 

These tips may help:

  • Avoid highly acidic foods and drinks such as carbonated sodas, lemons, and other citrus fruits and juices. When you have something acidic, have it at mealtimes to make it easier on your enamel. You can also switch to things such as low-acid orange juice. Rinse your mouth right away with clear water after eating acidic foods or drinking acidic drinks.
  • Use a straw when you drink acidic drinks. The straw pushes the liquid to the back of your mouth, avoiding your teeth.
  • Finish a meal with a glass of milk or a piece of cheese to cancel out acids.
  • Limit snacks. Snacking throughout the day makes tooth decay more likely. The mouth is acidic for a few hours after eating foods high in sugar and starches. Avoid snacking unless you're able to rinse your mouth and brush teeth.
  • Chew sugar-free gum between meals. Chewing gum boosts saliva production up to 10 times the normal flow. Saliva helps strengthen teeth with important minerals. Be sure to select sugar-free gum with xylitol, which can lower the level of acids in beverages and foods.
  • Drink more water throughout the day, especially if you have low saliva volume or dry mouth.
  • Use fluoride toothpaste. Fluoride strengthens teeth, so make sure fluoride is listed as an ingredient in your toothpaste.
  • Use a soft toothbrush, and try not to brush too hard.
  • Ask your dentist if sealants may help you prevent enamel erosion and tooth decay.
  • Get treatment for conditions such as bulimia, alcoholism, or GERD.

Fluoride in toothpaste or mouthwash or applied to your teeth by a dentist can help your teeth absorb minerals and stay strong, Cooper says. But it's possible to get too much. While fluoride helps prevent tooth decay, too much of it can cause problems such as enamel fluorosis. This condition can affect children and cause defects in the enamel of the teeth.

Children with enamel fluorosis may have absorbed too much fluoride from supplements or from taking supplements along with fluoridated water. Also, swallowing fluoride toothpaste raises the chances of enamel fluorosis.

Most children with enamel fluorosis have mild conditions that are not a reason for concern. Yet in some severe cases, the teeth are discolored, pitted, and difficult to keep clean.

"If the erosion has advanced to the point where lifestyle change can't keep it at bay or can't correct it, then you may need other treatments," Cooper says. 

Treatment of tooth enamel loss depends on the size and severity of the problem. Options include:

Remineralization. These procedures replace minerals that have been lost in your teeth. The goal is to strengthen your enamel before it's too late.

Dental bonding. Your dentist can apply a resin to repair minor damage, chips, or rough spots.

Veneers. These thin porcelain covers are custom-made to cover and hide defects in your enamel.

Dental crowns. When a large portion of your tooth has been damaged, you may need a crown that goes over your entire tooth. This allows you to use your tooth normally and protects it from further erosion and decay.

When your enamel erodes, your teeth are more prone to cavities or tooth decay. Small cavities may cause no problems at first. But as cavities grow and penetrate the tooth, they can affect the tiny nerve fibers to cause bigger and more painful problems.

"Erosion not only changes the appearance of your teeth, [but] it opens up the door for bacteria to cause cavities and infection," Cooper says. "In extreme cases, you might develop an abscess as a result of decay that forms in your teeth, and you may also develop, as a result of that abscess, a larger infection in your jaw. In very, very extreme cases, you might actually experience tooth loss."

Your tooth enamel is extremely strong and protective, but it can wear away over time due to acids and everyday wear. Once you've lost enamel, you can't get it back. See your dentist to find out if you have enamel erosion and learn what you can do to protect yourself from further damage. You may need restorative treatments to repair your teeth and make sure your enamel erosion doesn't get worse.

Can tooth enamel grow back?

No. Enamel is mainly mineral and has no living cells to allow it to grow back.

How much does it cost to fix enamel erosion?

Your out-of-pocket cost to fix enamel erosion will depend on your dental insurance coverage and the procedure you need. Dental bonding may cost a few hundred dollars per tooth, while veneers or crowns may cost $1,000 or more.

Is tooth erosion permanent?

Yes. Fluoride can help remineralize and strengthen your enamel, but enamel erosion can't be reversed.