Weak Enamel

Dear Dr. Phillips,

I have a 5yo and a 3yo who both have “weak enamel” determined by their dentist. The 3yo has many many chipped teeth and the chewing surfaces are down. Both children have no cavities. I was told their weak enamel is due to genetics. Although I’m not completely satisfied with that answer, I did not find any other information to be useful. Since I was looking for ways to remineralize their teeth, I came upon your excellent website. I’m starting to buy the products and will try your regimen. A few questions:

1. They have been using “Trader Joe’s” brand toothpaste which lists xylitol as the 4th ingredient. (CaCO3, water, glycerin, xylitol, sodium Cocoyl Glutamate, Fennel oil, myrrh resin, hydrated silica, carrageenan, propolis wax, peppermint oil). To supplement fluoride, they use Tom’s of Maine Natural whole care toothpaste. They brush with 2 toothpaste mixed together. I will switch to recommended regular crest toothpaste. However, is the additional xylitol in Trader Joe’s toothpaste beneficial in additional to crest?

2. Are there any modifications to the mouth rinse system for young children?

3. Do you have any information or advice regarding “genetically weak enamel”?

Thank you!


Dear RW

Hello and thanks for your message,

In 35 years of being a dentist, I have not found any reason to blame genetics for weak enamel.
That’s not to say that patients have not arrived in my office believing they inherited weak enamel.

It’s just we found a reason when we started to look into diet, and other factors.
Before thinking about oral care products, I suggest you look closely at your children’s diet and see if citrus drinks or fruits may be to blame.

You need to look for acidity or mouth dryness.
One or other of these conditions, or sometimes both, are the reason for “weak enamel”.
The reason for your search, is so that you can help protect your children’s teeth from whatever may be damaging them.

For example, I had a patient one time who ate a lot of lemons.
Every morning she would slice lemons into small sections, and suck them during the day. Her enamel had become so thin and weak, that she needed root canal treatments on three teeth! It would have been difficult for her to give up the habit of sucking lemons. Once we were able to pinpoint the problem, we were able to provide a solution. The solution was to eat a small fruit Zellie after each citrus attack.

I’m hoping you can do the same thing for your children.
If you can identify why they have a problem, you will be able to help them protect their teeth.
Acidity is often from fresh fruits like lemons, oranges, or from juice drinks.

Sometimes the problem is dry mouth.
I wonder if your children have allergies or blocked nasal passages?
Children who have ear infections often suffer from acid reflux.
This acidity can damage their teeth. Medications are another problem, particularly if they are taken before bed at night.

I think you’re toothpaste choices are fine.
I don’t think they have anything much to do with this weak enamel problem.

I do however feel that if you want to strengthen teeth, it is necessary for you to combine xylitol and fluoride together. I don’t mean literally, but have xylitol throughout the day and use some kind of fluoride in your oral care routine.

If you can identify what may be damaging your children’s teeth, simply use xylitol to take away the acidity. You can use xylitol in any form: mints, gum, granular xylitol in any form, or you can even dissolve granular xylitol in water as a tooth wash!

I urge you to consider a serious hunt for the “reason”. Finding “the reason” will empower you!
You may enjoy my book, Kiss Your Dentist Goodbye, since it explains a lot about mouth acidity and reasons for it.

Please let me know if you have any more questions.

Best wishes,

26 Corporate Woods
Rochester, NY 14623

Categories: Uncategorized


  • amosclarkson says:

    My daughter has this issue and her dentist said that while the enamel was forming on her first molars (where the weak enamel and chipping are occurring) in utero, an event occurred that took the focus away from her enamel development. Sickness, diet, etc are ideas but I honestly am healthy and was not sick during pregnancy. I have started my 20 month old daughter on xylitol water. We put a teaspoon a day in her water and she drinks it all day. I was considering buying zellie bears, too. Then we use fluoride toothpaste (very little since she cannot spit) twice a day and brush with water once a day. We also rub remineralizing paste on her teeth once a day. We reduces and almost eliminated dry fruit or other chewy food and she never drinks juice. Does this sound like a good regimine? Dentist said caps are inevitable and just to focus on keeping her teeth clean. Fluoride is not added to our water so does she need more or is the toothpaste enough? Thank you!!

  • Dr. Ellie says:

    Your regimen sounds good – the xylitol is very important.Make sure you have the correct toothpaste – I suggest Crest Original paste if your daughter will tolerate the taste, otherwise brush her teeth with bubblegum ACT.MI paste is basically from milk powder – so you can use it – or simply ensure your daughter has enough dairy in her diet.I would be happy to give you extra help about these teeth if that would be helpful.A photo of the teeth would be really useful if you want me to comment about the crowns.In my office we do not use crowns on baby teeth – at least very rarely.I offer coaching through my website http://www.DrEcoaching.com if you think you would like a half hour to talk about your daughter's teeth.Best wishes,Ellie

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