You take impeccable care of your teeth. You brush twice a day (sometimes more if your lunch was garlic or onion heavy), use mouthwash, floss, avoid staining beverages, and attend regular dental checkups every year. Since you started cutting teeth, you have had routine x-rays, and there isn’t a tooth in your mouth that contains a filling so, when you flash your pearly whites, you expect them to be, well, pearly white.

Unfortunately, regardless of your flawless dental routine, you are beginning to notice some of your teeth appear translucent or even transparent around the edges. This can happen to anyone, regardless of how dedicated your dental care routine is. Learning what can cause translucent or transparent teeth is the best way to help prevent the problem before it starts.

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A little science

Your teeth have a thin, outer shell of enamel. The enamel layer is semi-transparent, to begin with. The reason it appears to be white is because it covers the visible second layer and the white portion of the tooth called dentin. Dentin is responsible for providing the majority of the visible color of the tooth. However, dentin does not extend all the way to the edges of the teeth, which means the tops consist only of the enamel coating. When the enamel wears away, teeth can take on a dull, translucent, or even wax-like appearance. Unfortunately, contrary to what many advertisements would have you believe, the process of enamel loss is permanent. You cannot grow back, replace or replenish worn or lost enamel, so it is important to understand what contributes to enamel loss or damage before it happens.

Six reasons why teeth appear transparent or translucent

Transparent or translucent teeth are quite simply, the result of eroded or damaged enamel. Certain medical conditions can contribute to enamel damage (or lack of enamel formation). There are also “self-induced” causes for enamel damage. Let’s explore a few of those.

· Enamel Hypoplasia

Enamel hypoplasia is a genetic condition that causes the enamel coating on your teeth to be weak, chalky looking or thin. This results in enamel, which appears more translucent than usual. Enamel hypoplasia occurs while the teeth are still developing, yet it can affect both baby teeth and adult teeth. Visual signs of enamel hypoplasia include white spots on the enamel, pitting, and grooves that are visible on the outer layer of the teeth. Enamel hypoplasia can also cause teeth to appear underdeveloped when they erupt. These teeth will spear small and present with a variety of dental issues. Various prenatal causes of enamel hypoplasia can include maternal vitamin D deficiency, maternal smoking or drug use, lack of prenatal care, and premature or low birth weight. There are also environmental causes that include tooth trauma, infections in the mouth or gums, calcium deficiency, and various vitamin deficiencies. Unfortunately, tooth enamel does not contain any living cellular tissue, so it cannot repair itself (as with bone injuries) or improve without intervention. If you or your child has enamel hypoplasia, you will want to make sure the condition is monitored closely by a dentist so areas can be quickly repaired before they lead to more severe problems. Failure to monitor or treat enamel hypoplasia can lead not only to translucent or transparent teeth but to more significant issues such as browning of the entire tooth, increased need for tooth extractions, and increased incidence of cavities or crumbling teeth.

· Celiac Disease

Many people would believe that celiac disease only impacts the gastrointestinal system. Yes, celiac disease causes challenges for the gastrointestinal system when it comes to the consumption and digestion of gluten, but it can also cause issues inside your mouth. Celiac disease can lead to poor enamel development in children. It can also lead to defects in the enamel and delayed dental development. Children who are diagnosed with celiac disease at an early age (generally before the age of seven) when the adult teeth and some of their baby teeth are still developing can have problems with the tooth development process. These children may experience disruption in the enamel formation process. The defects in the enamel appear throughout the entire mouth as white or yellow opaque spots on the teeth or as rough lines or grooves in the surface of the teeth where the enamel should be smooth. The enamel that does form also appears dull or wax-like. These issues with enamel development are caused by an immune-mediated reaction that affects the cells that form enamel. It is also caused by the nutritional disturbances associated with celiac disease. Early diagnosis of celiac disease, at a stage where the enamel is still forming, may help to decrease the amount of future enamel defects the child experiences. For adults who have enamel defects, there are also cosmetic treatment options available, which will be discussed later.

· Bulimia

Bulimia nervosa is an eating disorder where people binge eat large amounts of food and then purge their systems of that food immediately after. Purging can include a variety of forms, including laxative use, excessive exercise, or self-induced vomiting. It is the vomiting that can be highly damaging to the teeth and specifically, the enamel coating of the teeth. Vomit is highly toxic and contains large amounts of stomach acid. These acids are designed to break down food particles so your body can properly digest them. They work very well when they remain where they belong and do the job they are designed to do. However, outside of the stomach, these acids can be very damaging. In the mouth, they are corrosive enough to wear away the enamel covering on the teeth. The acids produced by frequent vomiting can wear away the enamel to the point where it is no longer able to protect your teeth. This can cause cavities and increased tooth decay. The loss of enamel can also cause your teeth to appear yellow. Your teeth will also become weaker, more brittle, and prone to damage and breakage due to the loss of the protective enamel coating.  

· GERD and other gastrointestinal problems

GERD or acid reflux is caused when the sphincter (the tight muscle) at the base of the esophagus allows acid to seep out of the stomach and into the esophagus. Often, this causes symptoms of heartburn, so the person knows they are experiencing reflux. However, this is not always the case. Sometimes, the first indication someone may have that they are experiencing reflux is when their dentist notices erosion of the tooth enamel on the molars or the backside of the teeth. As with bulimia, the stomach acid wears away the enamel on the tooth.

· Xerostomia (dry mouth)

Dry mount is widespread in seniors, although it does occur in younger adults as well. Dry mouth is often the side effect of medications or a symptom of a more significant medical condition. Dry mouth causes a reduction in saliva production and, if left untreated, can lead to tooth decay. Tooth decay is caused because saliva helps to wash away food products and bacteria in the mouth. With decreased saliva, these bacteria stay in the mouth and work to break down the enamel on the teeth.

· Dietary causes

Unfortunately, some of the beverages and foods that are good for us in terms of nutritional requirements are terrible for our tooth enamel. Many juices are highly acidic, and frequent consumption of highly acidic liquids can lead to decay of the enamel on the teeth. Other beverages such as sods, sports drinks, and tea are quite acidic as well, even more so than juice. If you consume a diet high in these types of beverages, it is essential to make sure you brush your teeth frequently and thoroughly. It is also important to consume large amounts of plain water to help wash the acids out of your mouth.

Similarly, there are highly acidic foods which are good for us but bad for our teeth. These can include tomatoes, raisins, citrus fruits, sour candies, and diets containing excessive sweets and sugary foods.

Symptoms associated with translucent and transparent teeth

The enamel coating on your teeth protects your teeth from a variety of daily disturbances. Even before visible changes take place, you may experience other symptoms, which can be an early warning sign that enamel erosion is taking place. These can include

  • Sensitivity-tooth pain or sensitivity to cold and hot or sweet and acidic foods are indications that your enamel is eroding, and eventual tooth damage could occur if this is not treated.
  • Visual changes-As your enamel erodes, you will begin to see the telltale transparent appearance at the biting edge of the teeth. You may also see surface indentions, color changes, and even experience tooth fractures as the enamel fails to protect your teeth from damage.
  • Dry mouth and canker sores- while these are not symptoms of translucent teeth specifically, they are often symptoms that come in conjunction with the same things that cause enamel erosion. Excessive acid in the mouth not only causes enamel erosion but can also cause canker sores. As your enamel wears away, your teeth can become rough and jagged. This can also lead to canker sores. We have already discussed dry mouth above, but again, if your mouth does not have an adequate amount of saliva, it can lead to tooth decay and erosion. 

Preventing enamel erosion

One of the best ways to prevent enamel erosion is through good dental hygiene and proper annual dental care. When you brush, it is suggested you do so with a good quality toothpaste that contains fluoride. Fluoride is important to tooth health because it helps to strengthen tooth enamel. In addition to proper brushing and flossing, you can help to prevent enamel loss and subsequent transparent teeth by doing the following:

  • Use a straw- when you drink (especially soda and sugary beverages), use a straw. This will help to keep acidic liquids off your teeth.
  • Drink water- Drinking plenty of water after eating, drinking (or vomiting) can help to wash acids away from your teeth. It can also help alleviate dry mouth.
  • Watch your diet-make sure you are eating a diet that is good for your teeth as well as your body. Try to limit your consumption of highly acidic foods and beverages. When you do consume these foods, rinse your mouth as soon as you can.

Treatments for transparent and translucent teeth

First, it is essential to note that once lost; tooth enamel cannot be replaced. This is due to the lack of living cellular matter within the enamel. Without this matter, the enamel has no way to “heal” or regenerate. However, there are some options for treating the appearance of translucent teeth. Some of these require the assistance of a dentist, and some can be done in the comfort of your own home as part of your daily dental care routine.

  • Veneers- these are hard porcelain shells or coatings that are designed to sit over the front-facing portion of the tooth. A veneer can help to hide discoloration, transparency, gaps, or misshapen teeth that have occurred as a result of enamel loss. Veneers can also help to protect the dentin from further damage and the enamel from continued erosion.
  • Bonding-similar to veneers, bonds are a composite resin that is colored to match your teeth. The resin is then molded and shaped to cover the front-facing surface of the teeth.
  • Crowns-If the tooth is highly damaged, a crown may be recommended. A crown fits directly over the entire tooth (not just the front surface) and protects the entire tooth from further damage and enamel erosion. A crown can also provide added strength and structure to a tooth that is weak, broken, or crumbling.

Enamel remineralization is the option for home-based treatments. Again, enamel cannot be replaced, but it can be remineralized. This is done through the use of enamel repair products that are typically advertised on television or in magazines. These products aid in the process of remineralization, which introduces calcium and minerals called phosphates back into the tooth. The minerals adhere to the enamel, essentially patching the weak spots in the tooth’s natural enamel coating. This patch is not enamel but is just as hard and lasting.

The most common mineral in enamel is calcium phosphate, also called hydroxyapatite. Products that contain this are beneficial to remineralization, as are those with the mineral fluoride, especially stannous fluoride. If you are looking to treat the early signs of enamel loss at home, look for products that contain these ingredients. 

The best way to avoid enamel loss and subsequent transparent appearance of the teeth is to follow a good oral health routine. Of course, there are situations where dental health will not help to control the speed of enamel loss. If this is the case, you may consider contacting your dentist to see what options are available to you to limit the appearance of tooth transparency.