Dental erosion or acid erosion is a type of tooth wear. More precisely, erosion is the loss of tooth enamel caused by acid attack.
Besides erosion, other types of tooth wear can be described :
Attrition : This type of tooth wear is caused by natural tooth-to-tooth friction. This can happen while clenching or grinding your teeth, for example in cases of bruxismBruxism is the excessive grinding of the teeth and/or excessive clenching of the jaw, which often occurs involuntarily during sleep.
Abrasion : This is physical wear and tear of the tooth surface that happens with brushing teeth too hard or using an improper toothbrush, improper flossing or biting on hard objects (such as fingernails, bottle caps, or pens).
Dental erosion has been recognized as a dental health problem only relatively recently. Many times dental erosion can coexist with abrasion and attrition.
What causes dental erosion ?
Dental erosion is caused by acid attacks that happen too frequently.
Acidic foods and drinks
The most common cause of erosion is due to acidic foods and drinks. Drinks low in pH levels that cause dental erosion include fruit juices (mainly orange and apple), sports drinks, wine, beer and carbonated drinks (such as colas or lemonades).
A diet high in sugars can also cause erosion. Frequency rather than total intake of acidic juices or foods is seen as the greater factor in dental erosion.
Saliva acts as a buffer, regulating the pH when acidic drinks are ingested and protecting the enamel from demineralization (which is the loss of its mineral content).
However, if acid attacks happen too often, the buffering capability of saliva decreases and the enamel does not have a chance to repair itself. Over time, you start to lose the surface of your teeth.
People with bulimia or gastroesophageal reflux disease (GERD) are all at higher risk of dental erosion because the gastric acid from the stomach comes into contact with the teeth.
For example, bulimia is a condition where patients make themselves sick so that they lose weight. Frequent vomiting erodes tooth enamel and can lead to cavities.
Other causes include :
- a number of medications such as vitamin C, aspirin or antihistamines
- dry mouth or low salivary flow (also known as xerostomia), because the buffering capability of saliva is not present to counterbalance the acidic environment
- genetic or inherited conditions
- environmental factors such as friction, wear and tear, stress etc.
Signs and symptoms
The signs of enamel erosion can vary, depending on the stage.
In the early stage of enamel erosion, there may be an increased sensitivity when eating hot, cold, or sweet foods. In later stages, teeth become extremely sensitive to temperatures and sweets ; the enamel has been eroded away, exposing the sensitive dentin.
The first change of color usually happens on the cutting edges of the central incisors as they become transparent. In later stages, the enamel erodes and more dentin is exposed. This will cause the teeth to appear yellow.
Changes in shape
Teeth may show a broad rounded concavity (image above) and the gaps between teeth can become larger. Indentations may appear on the surface of the teeth and there can be evidence of wear on surfaces of teeth not expected to be in contact with one another.
The edges of teeth become more rough and irregular as enamel erodes. In later stages of dental erosion, teeth begin to crack off and become coarse.
What can I do to prevent dental erosion ?
Reduce highly acidic foods and drinks from your diet and try to keep them to mealtimes. Remember, the frequency plays a higher role in dental erosion than the total intake.
Drink quickly without holding the liquid in your mouth or use a straw to help acidic drinks go to the back of your mouth and avoid long contact with your teeth.
Finish a meal with cheese or milk as this will help cancel out the acid.
Wait for at least one hour after eating or drinking anything acidic before brushing your teeth (this gives your teeth time to build up their mineral content). If you can, rinse your mouth immediately with clear water after eating acidic foods or drinking acidic drinks.
Use a fluoride toothpaste. Fluoride acts as a remineralizing agent for the enamel. You can also apply fluoride gels or varnishes to the teeth.
Chew sugar-free gum between meals. This will boost saliva production, which will help cancel out the acids formed in your mouth.
Keep a regular oral hygiene routine and try to keep snacking throughout the day to a minimum.
Treat any medical condition or disorder that may cause erosion. Talk to your dentist about that.
Is there any special treatment for dental erosion ?
Dental erosion does not always need to be treated. Regular checkups with your dentist can prevent the problem from getting any worse.
However, in some cases, the dentin is exposed and it is important to protect the tooth to prevent sensitivity. Sometimes, simply bonding a filling onto the tooth will be enough to repair it. In more severe cases, the dentist may need to fit a veneer or a dental crown.
Last review and update: May 2019