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New York Tooth Enamel Repair in Long Island

Dental Enamel Destruction

Understanding Enamel Loss

Demineralized Tooth Enamel Long Island
Demineralized Enamel Damage

Oral Health Habits

Sucking lemons, keeping candies and mints in mouths for hours or during sleep, sipping sugary drinks all day, chewing tobacco all day, snuff, smoking, dissolving medicines in mouth instead of swallowing. Sugary gum or sour gummy bears that have citric acid that dissolves teeth.

Oral Disease

Fevers at young age, antibiotics while teeth developing in-utero, periodontitis leading to food impaction in crevices around teeth. Xerostomia - dry mouth due to medication or illness or age. Oral disease mirrors systemic disease. Leukemia, HIV, Diabetes, cancers, all can influence caries/cavities due to immunocompromised systems.
Fluorosis Ugly Tooth Enamel
Fluorosis Damaged Teeth

Eating Preferences - Habits

Excess candy consumption, lack of proper nutrition, high fructose corn syrup

Bulimia Purging

Acid attack, gasses from stomach, acid reflux, vomit acids

Idiopathic Enamel Erosion

Unknown or undiagnosed factor causes uncontrollable eroding of upper or lower arch teeth
Restorations Gone Bad Long Island
Restoration Enamel Gone Bad


Fracture, chips, missing tooth or fillings can lead to impaction of bacteria, decay and further breakdown


Fillings that are too high, poorly shaped, pitted, old ditched, can pack food leading to deterioration and decay.


Grinding, Bruxism (nocturnal grinding), posturing things between teeth, using teeth as tools.
Bilirubin Disorder
Congenital Defect - Biliary Atresia

Incompatibility with Previous Dentistry

Leaking crowns that don't fit, cement that has leached out leaving gaps for bacteria to seep through, overhangs (rough fillings or excess fillings that tear floss and pack food) that trap bacteria.

Genetic Birth Defects

Ectodermal dysplasia

Developmental Growth Abnormalities

Amelogenesis or Dentinogenesis imperfecta are factors that can lead to pitting and decay.

Prevention - Control - Treatment of Enamel Damage

Severe Decayed Enamel
Severe Decay
Loss or deterioration of enamel can have many causes, as outlined above. Whether or not there is a fix, cure (a misnomer, really), or method for repairing affected enamel is based on the original cause.

In many situations the treatments of choice that offer strong predictability of success, both functionally and cosmetically, are the use of restorative procedures recommended by Dr. Koeppel.

New porcelain crowns for restoring deteriorating teeth to natural contours and function, buildups and fillings to test a new bite or restore lost biting relationships, implant crowns, bridges and quality feldspathic porcelain offer a variety of creative methods for overcoming the loss of enamel.

In cases where enamel loss is arrested early (perhaps due to poor dietary habits), Dr. Koeppel can prescribe specialized remineralizing agents to initiate the restoration of natural enamel properties in the form of toothpastes and rinses.

Below is a very brief outline of anticipated treatments for each of the categories of enamel loss. Some are homeopathic, and can be done at home. Others require the expert help of an experienced dentist.

Oral Health Habits

Consciously changing behavior, biofeedback, splint therapy or appliances to change habits such as NTI, Essix night guard, occlusal splint, or custom orthotic device.

Oral Disease

Cariology (study of cavities) bears out that it is a disease. Complete eradication is needed to stop the spread of the bacterial infection that is caries. Fluoride releasing fillings, mouth-rinses, and systemic medication can all be useful adjuncts to stopping carious lesions from spreading. Fluoride releasing fillings, crowns with fluoride cements, trays for at home fluoride treatments and behavior modification are all possible treatments.

Eating Preferences - Habits

High fructose corn syrup found in sodas, juice drinks, sports drinks as well as energy bars are bathing teeth in sugar and acid. Blended coffee drinks and the decrease in milk consumption have been blamed in the increase in rampant tooth decay.

Bulimia Purging

Behavioral Psychologist, medication, and restoration with crowns and orthodontics when stable.


Root canal therapy if needed, large restorative fillings to restore teeth to high strength, and crowns or protective caps.


Mouthguards, occlusal adjustments, equilibration or evening out of bite. Rehabilitation or reconstruction of bite.


Mouthguards, splints, orthotics, adjustment of bite. Possible rehabilitation of bite with crowns or posterior porcelain or gold restoration.

Incompatibility with Previous Dentistry

Replace it with modern state-of-the-art- restorative dentistry to include gold, porcelain, zirconium, pressed or feldspathic porcelain.

Genetic Birth Defects - Growth Abnormalities

Restoration of missing teeth or pitted teeth with fillings or crowns. Missing teeth to be replaced with implant supported crowns or bridges.


Patients who have additional questions about unusual enamel conditions due to genetics, growth factors, medication histories or acid erosion are invited to contact Dr. Koeppel directly with our on-line Ask The Dentist form. Dr. Koeppel will respond to you directly with the answers or information you are seeking.

An enamel replacement consult can be arranged by calling our office at 631-689-1800 or with our Consult Request form. Obtain the objective information you need for selecting the most sensible treatment option.

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New York Reconstructive Dentist
Ira Koeppel, D.D.S.
126 Gnarled Hollow Road
East Setauket Long Island New York NY 11733
Nassau - Suffolk County Spa Dentistry