Natural ways to strengthen tooth enamel

Tooth enamel is the hardest substance in the human body, but sadly, it’s not indestructible, and even people who brush their teeth regularly get cavities.

Poor tooth enamel can cause uncomfortable sensitivity to hot and cold foods, tooth decay, and overall poor oral health, leading to possible infections and tooth loss in both adults and children. Many factors contribute to weakened enamel, including consuming sweet drinks, antibiotic use, nutritional deficiencies and certain health conditions related to reflux or gut malabsorption.

Worryingly, over 47,000 teeth were extracted in the under-19s alone in the UK during 2022/23 and most of these were due to tooth decay. This was a 17% rise from the year before, so the UK sugar tax since 2018 can hardly be said to be a success.

Sugar is the biggest culprit, but I know it is hard to avoid yourself, and even harder to stop your kids eating it. But it’s usually not just sugar’s fault and understanding and addressing the root cause of thinning tooth enamel is crucial to naturally remineralising teeth. This is something the NatureDoc clinical team can explore with you. In this blog I share some daily habits to help restore and strengthen tooth enamel, plus nutrients that can protect from cavities and tooth decay. Let’s protect you and your kid’s smile!

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Things you should know about toothpaste

Fluoride is widely accepted by dentists as the best way to strengthen teeth and it’s naturally found in drinking water (and it is sometimes added in by water authorities at safe levels, but this is rare in the UK).

Excessive use of fluoride can discolour and mottle teeth, affect a child’s neurological system and development and compete with iodine for uptake by the thyroid gland and iodine is critical for optimal thyroid and metabolic function. However, in normal use, unless you are swallowing large amounts of it, this should not be a concern.

Hydroxyapatite is a newer ingredient that you can find in toothpaste (either with or without fluoride). The legal maximum strength of nano-hydroxyapatite is not as effective as normal strength fluoride on its own, but it can help to remineralise teeth and helps with tooth hypersensitivity and pain. However, with a much shorter track record than fluoride, little is known about its potential toxicity.

So, my main suggestions around toothpaste are:

Make sure you brush for at least 2 minutes twice a day
Spit out the toothpaste properly and don’t swallow it, but don’t rinse your mouth as it will carry on working for a bit after you stop brushing.
Read up on the NHS’s advice on fluoride for different ages.
Once milk teeth have gone, look after your adult teeth as if they won’t be making any spares!
Try to avoid sodium laurel sulphate (SLS).

Extra daily habits to support oral health

Here are some basic daily habits to help protect your teeth beyond brushing normally:

Oral hygiene: Maintaining good oral hygiene is crucial. A remineralising toothpaste including hydroxyapatite can add some benefits. Floss daily or use interdental brushes. Prebiotics are now sometimes added to toothpaste to help bolster a healthy oral microbiome.
Regular dental check-ups: Visit your dentist regularly for professional cleaning and check-ups. They can provide personalised advice and treatments to help protect and remineralise your enamel.
Limit sugary and acidic drinks: Sweet drinks can erode enamel, so avoid sports drinks and energy drinks as well as sweet cordials. When drinking acidic things like fruit juice, apple cider vinegar and lemon juice it is good to drink them out of a straw to bypass touching the teeth.
Hydration: Drink plenty of water to maintain saliva production, which helps wash away food particles and bacteria, and provides minerals to the teeth.

Understanding the root causes

Before diving into nutritional remineralisation strategies, it’s essential to identify and treat potential root causes of poor tooth enamel. There have been over 100 causes identified, and here are some of the most common factors that can influence tooth enamel:

Gut malabsorption of nutrients: Conditions like inflammatory bowel disease, long-term parasite infections and Coeliac disease can impair nutrient absorption, leading to overall deficiencies that affect tooth enamel as well as bone health. Poor tooth enamel can be one of the first signs of malnutrition due to gut malabsorption and is a red flag to have malabsorption checked out.
Reflux: When you regurgitate food from the stomach or acid from the stomach is brought up to the mouth, this acidic matter can wash over the teeth and slowly erode the enamel. This is one of the primary reasons for tooth decay and often goes along with bad breath.
Microbiome disruption: Amoxicillin antibiotics, which are commonly taken by children, are now thought to play a role in the reduction of tooth enamel in early life as well as reducing the diversity of the gut microbiome. There is also crosstalk between the gut microbiome and the oral microbiome. Longer-term issues associated with an imbalanced oral microbiome and consequent tooth decay include a higher risk of heart and lung disease and stroke. Oral microbiome imbalances have also been linked with social anxiety and depression. You can help rebalance both the oral and gut microbiome and strengthen tooth enamel through eating cultured foods like yoghurt, kefir, miso and kimchi. Probiotic strains that have been identified to help with oral health and tooth remineralisation include bifidobacterium, lactobacillus reuteri, lactobacillus rhamnosus as well as streptococcus salivarius (BlisK12).
Inadequate calcium intake: Calcium is vital for strong teeth and many people do not consume enough through their diet. Adults generally need 700-1,200mg of calcium per day. See a list of calcium-rich foods below.
Vitamin D deficiency or genetic variants: Many people do not get enough sun or do not eat enough vitamin D rich foods. Quite a few people inherit genetic variations that make it difficult for their bodies to synthesise and utilise vitamin D effectively even if they get enough sun and follow the general supplement guidelines during the winter months. Not enough vitamin D can affect calcium absorption and bone health and so if you or child are low in this vital vitamin then focus on building up blood levels to at least an adequate level.
Too many phytates: Phytates protect a plant when it is growing but can also prevent humans from absorbing the nutrients from that plant such as calcium. Foods rich in phytates include beans and pulses, nuts, seeds and grains. To reduce the phytates and increase absorption of calcium when eating these foods, soak before eating and ideally eat sprouted seeds and grains as well as activated nuts. Sourdough is a better way to eat bread if you want to reduce phytates.

Nutrient-rich foods for healthy tooth enamel and remineralisation

Consuming a diet rich in specific nutrients can help remineralise teeth and strengthen enamel. Here are some key nutrients needed and their food sources:

Calcium: Essential for maintaining strong teeth and bones. Include plenty of milk, cheese, yoghurt and kefir. Non-dairy sources include tinned sardines, almonds, chia seeds, poppy seeds, tahini (sesame paste), green vegetables (like broccoli and kale), and oats.
Vitamin A: This fat-soluble vitamin has been identified as a key nutrient for strong teeth and remineralisation of tooth enamel. It is found in liver, grass-fed butter, clarified butter (ghee) and oily fish. Cod liver oil, which also contains omega-3 fatty acids, is an excellent source of vitamin A.
Vitamin C: Helps to keep gums healthy, which protects the teeth. Foods include citrus fruits, parsley and red bell peppers.
Vitamin D3: Facilitates calcium absorption in the body. This mainly comes from sunlight and is the best natural source of vitamin D. Food sources include fatty fish (salmon, mackerel, sardines, anchovies), egg yolks and outdoor-reared meat.
Vitamin K2: This vitamin works in conjunction with vitamins A and D to help with bone development and helps to keep calcium in the body in the right places (in the bones and teeth and out of the bloodstream). You can find K2 in small quantities in natto (made from fermented soya beans), eels, cheese, live yoghurt, kefir, liver, chicken, grass fed butter and sauerkraut.
Phosphorus: Works with calcium to build strong bones and teeth and comes from protein-rich foods such as meat, fish, poultry, eggs, dairy products, nuts, seeds, beans. Bone broth made from chicken, lamb or beef contains good levels of phosphorous.
Magnesium: Helps with the structural development of teeth and bones and is found in leafy green vegetables, nuts, seeds, dark chocolate, whole grains, avocados and bananas.

Round up

Naturally remineralising teeth involves a comprehensive nutritional approach that includes understanding the root causes of poor enamel, eating a nutrient-rich diet and incorporating supportive supplements and important daily oral health practices. By addressing these factors, you can help restore and strengthen your tooth enamel, leading to better oral health and a brighter smile!

If you need help investigating gut function, potential malabsorption or an imbalanced gut or oral microbiome, contact our NatureDoc clinical team.

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