Age related changes in physiology of normal human tooth enamel: A review

  • Afsheen Mansoor School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
  • Faisal Moeen Islamic International Dental College, Riphah International University, Islamabad, Pakistan
  • Aleena Hussain Islamabad Medical and Dental College, Islamabad, Pakistan
  • Shahab Ud Din School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
  • Muhammad Talal Khan Bakhtawar Amin Medical and Dental College, Multan, Pakistan
  • Farrukh Said Islamic International Dental College, Riphah International University, Islamabad, Pakistan
Keywords: Age, color, Enamel, Elemental composition, Hardness, Topography


There are usually 32 teeth in adult humans which are separated equally into two arches namely the upper arch (maxilla) and the lower arch (mandible). Dental enamel is the outermost protective layer that aids the tooth in bearing the masticatory forces and helps it endure the harsh oral environment. Age-related changes occur in teeth approximately between ten weeks in utero to old age. Lacassagne in 1889 was the first to characterise changes in fully formed teeth with ageing; however, the first scientific assessment was provided by Gustafson. In 1967, Furuhata and Yamamoto added various phenomenon that may be expedient in defining an age. After twenty-five years of age, they linked an increase in the specific gravity of teeth with age. They further pointed out the process of attrition, which progresses with age, and the components of the tooth namely enamel, dentine, and cementum harden with increasing age. These investigators also defined the decreasing size of the root canals with age. Bodecher and Lefkowitz employed permeability and x-ray studies to indicate maturational effects in the human teeth. Kastelic determined through the incineration studies, an increase, upon a percentage basis, in the organic content of the whole human tooth with age. Ultimately age-related changes in teeth are based on biological markers of age. Teeth reflect the biological or physiological age of the individual and variations caused by genetic factors and chewing habits can influence tooth anatomy.

Pak J Physiol 2020;16(3):35–40


Weiss DJ, Bates JH, Gilbert T, Liles WC, Lutzko C, Rajagopal J, Prockop D. Stem cells and cell therapies in lung biology and diseases: conference report. Ann Am Thorac Soc 2013;10(5):S25–44.

Qing P, Huang S, Gao S, Qian L, Yu H. Effect of gamma irradiation on the wear behaviour of human tooth enamel. Sci Rep 2015;5:11568.

Hsu CC, Chung HY, Yang JM, Shi W, Wu B. Influence of 8DSS peptide on nano-mechanical behavior of human enamel. J Dent Res 2011;90(1):88–92.

Popowics TE, Rensberger JM, Herring SW. Enamel microstructure and microstrain in the fracture of human and pig molar cusps. Arch. Oral Biol 2004;49:595–605.

Anderson P, Elliott JC. Rates of Mineral Loss in Human Enamel during in vitro Demineralization Perpendicular and Parallel to the Natural Surface. Caries Res 2000;34:33–40.

Girija V, Stephen HC. Characterization of lipid in mature enamel using confocal laser scanning microscopy. J Dent 2003;31:303–11.

Fattibene P, Callens F. EPR dosimetry with tooth enamel: A review. Appl Radiat Isot 2010;68:2033–116.

Miranda CB, Pagani C, Benetti AR, Matuda Fda S. Evaluation of the bleached human enamel by Scanning Electron Microscopy. J Appl Oral Sci 2005;13:204–11.

Alves S, Oliveira V, Vilar R. Femtosecond laser ablation of dentin. J Phys Appl Phys 2012;45:245401.

Saisa-Ard O, Somphon W, Dungkaew W, Haller KJ. Evidence of a lead metathesis product from calcium hydroxyapatite dissolution in lead nitrate solution. Adv Mater Sci Eng 2014;2014:1–6.

Elliott JC, Holcomb D W, Young RA. Infrared determination of the degree of substitution of hydroxyl by carbonate ions in human dental enamel. Calcif Tissue Int 1985;37:372–5.

Moreira RF, Santos FP, Santos EA, Dos Santos RS, Dos Anjos MJ, de Miranda MS. Analysis of the Chemical Modification of Dental Enamel Submitted to 35% Hydrogen Peroxide ‘In-Office’ Whitening, with or without Calcium. Int J Dent 2017;2017:4646789.

Murray PE, Stanley HR, Matthews JB, Sloan AJ, Smith AJ. Age-related odontometric changes of human teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93:474–82.

de Oliveira DP, Teixeira EC, Ferraz CC, Teixeira FB. Effect of intracoronal bleaching agents on dentin microhardness. J Endod 2007;33:460–2.

Pasteris JD. A mineralogical view of apatitic biomaterials. Am Mineral 2016;101:2594–610.

Penel G, Leroy G, Rey C, Bres E. MicroRaman spectral study of the PO4 and CO3 vibrational modes in synthetic and biological apatites. Calcif Tissue Int 1998;63:475–81.

Xu C, Yao X, Walker MP, Wang Y. Chemical/molecular structure of the dentin-enamel junction is dependent on the intratooth location. Calcif Tissue Int 2009;84:221–8.

Xu C, Reed R, Gorski JP, Wang Y, Walker MP. The distribution of carbonate in enamel and its correlation with structure and mechanical properties. J Mater Sci 2012;47:8035–43.

Srivastava, S. Sorption of divalent metal ions from aqueous solution by oxidized carbon nanotubes and nanocages: A review. Adv Mater Lett 2013;4:2–8.

Wefel JS, Harless JD. The effect of topical fluoride agents on fluoride uptake and surface morphology. J Dent Res 1981;60:1842–8.

Pearce EI, Moore AJ. Remineralization of softened bovine enamel following treatment of overlying plaque with a mineral-enriching solution. J Dent Res 1985;64:416–21.

Aoba T, Shimoda S, Moreno EC. Labile or surface pools of magnesium, sodium, and potassium in developing porcine enamel mineral. J Dent Res 1992;71:1826–31.

Barone JP, Nancollas GH. The growth of calcium phosphates on hydroxyapatite crystals: The effect of fluoride and phosphonate. J Dent Res 1978;57:735–42.

Buchalla W, Imfeld T, Attin T, Swain MV, Schmidlin PR. Relationship between nanohardness and mineral content of artificial carious enamel lesions. Caries Res 2008;42:157–63.

Watts A, Addy M. Tooth discolouration and staining: A review of the literature. Br Dent J 2001;190:309–16.

Chander K. Effects of aging on dentin bonding and mechanical properties of restorative glass ionomer cements. (MSc Dissertation). Vancouver, BC, Canada: University of British Columbia; 2016.

Smeuninx B, McKendry J, Wilson D, Martin U, Breen L. Age-related anabolic resistance of myofibrillar protein synthesis is exacerbated in obese inactive individuals. J Clin Endocrinol Metab 2017;102:3535–45.

Gustafson G. Age determination on teeth. J Am Dent Assoc 1950;41:45–54.

Pillai PS, Bhaskar GR. Age estimation from teeth using Gustafson’s Method –A study in India. Forensic Sci 1974;3:135–41.

Komuro T, Tsutsumi H, Izawa H, Katsumura S, Saitoh H, Sakurada K, et al. Social contribution of forensic odontology in Japan. Jpn Dent Sci Rev 2019;55:121–5.

Joiner A. Tooth colour: A review of the literature. J Dent 2004;32:3–12.

Bommannavar S, Kulkarni M. Comparative study of age estimation using dentinal translucency by digital and conventional methods. J Forensic Dent Sci 2015;7(1):71–5.

Kunin AA, Evdokimova AY, Moiseeva NS. Age-related differences of tooth enamel morphochemistry in health and dental caries. EPMA J 2015;6(1):3.

Hattab FN, Qudeimat MA, al-Rimawi HS. Dental discoloration: an overview. J Esthet Dent 1999;11(6):291–310.

Behaviour therapy. Br J Psychiatry 1965;111(479):1007–10.

Parreiras SO, Vianna P, Kossatz S, Loguercio AD, Reis A. Effects of light activated in-office bleaching on permeability, microhardness, and mineral content of enamel. Oper Dent 2014;39(5):E225–30.

Driessens FC, Heijligers HJ, Borggreven JM, Wöltgens JH. Posteruptive maturation of tooth enamel studied with the electron microprobe. Caries Res 1985;19(5):390–5.

Palti DG, Machado MA, Silva SM, Abdo RC, Lima JE. Evaluation of superficial microhardness in dental enamel with different eruptive ages. Braz Oral Res 2008;22(4):311–5.

Niinomi M, Narushima T, Nakai M, (Eds). Advances in Metallic Biomaterials, Tissues, Materials and Biological Reactions. Part of the Springer Series in Biomaterials Science and Engineering book series (SSBSE, volume 3). Berlin, Heidelberg: Springer Berlin Heidelberg; 2015. Available from:

White SN, Luo W, Paine ML, Fong H, Sarikaya M, Snead ML. Biological organization of hydroxyapatite crystallites into a fibrous continuum toughens and controls anisotropy in human enamel. J Dent Res 2001;80(1):321–6.

Yamaga T, Sato Y, Akagawa Y, Taira M, Wakasa K, Yamaki M. Hardness and fracture toughness of four commercial visible light-cured composite resin veneering materials. J Oral Rehabil 1995;22(12):857–63.

Gutiérrez-Salazar MP, Reyes-Gasga J. Microhardness and chemical composition of human tooth. Mater Res 2003;6(3):367–73.

O'Brien WJ, Groh CL, Boenke KM. One-dimensional color order system for dental shade guides. Dent Mater 1989;5(6):371–4.

Joiner, A. Tooth colour: A review of the literature. J Dent 2004;32:3–12.

Alqahtani MQ. Tooth-bleaching procedures and their controversial effects: A literature review. Saudi Dent J 2014;26(2):33–46.

Bommannavar S, Kulkarni M. Comparative study of age estimation using dentinal translucency by digital and conventional methods. J Forensic Dent Sci 2015;7(1):71–5.

Goodkind RJ, Schwabacher WB. Use of a fiber-optic colorimeter for in vivo color measurements of 2830 anterior teeth. J Prosthet Dent 1987;58:535–42.

Hasegawa A, Motonomi A., Ikeda I, Kawaguchi S. Color of natural tooth crown in Japanese people. Color Res Appl 2000;25:43–8.


Download data is not yet available.
How to Cite
Mansoor A, Moeen F, Hussain A, Din S, Khan M, Said F. Age related changes in physiology of normal human tooth enamel: A review. PJP [Internet]. 30Sep.2020 [cited 27Feb.2021];16(3):35-0. Available from: