Tooth erosion

What Is Tooth Erosion and Is It Dangerous?

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Tooth erosion happens when acids wear away the enamel which is the outer layer of the tooth and is the hardest tissue in the human body.

What is the tooth enamel?

The enamel covers the crown which is the part of the tooth that's visible outside of the gums. It is translucent, but the main portion of the tooth, the dentin, is the part that's responsible for your tooth color, whether white, off white, grey, or yellowish. Your enamel helps protect your teeth from daily wear and tear such as chewing, biting, crunching and grinding. Although the enamel is hard, it can chip and crack. Unlike a broken bone that can be repaired by the body, once a tooth chips or breaks, the damage is done forever. Because enamel has no living cells, the body cannot repair chipped or cracked enamel.

What are the dangers of tooth erosion?

When enamel erodes, the tooth is more susceptible to decay. Small cavities may cause no problems at first. But as the decay extends and penetrates the tooth, it can affect the nerve of the tooth, resulting in an extremely painful abscess or infection.

What are the signs of tooth erosion?

  • The early stage of enamel erosion may cause a twinge of pain when eating certain food like sweets or when exposed to hot or cold food and drinks.
  • The teeth may appear yellow as the enamel erodes and more dentin is exposed
  • The edges of the teeth may become more rough and uneven as enamel erodes.
  • In later stages of enamel erosion, teeth become extremely sensitive to temperatures and sweets.

What causes enamel erosion?

  • Excessive soft drink consumption (high levels of phosphoric and citric acids)
  • Fruit drinks (some acids in fruit drinks are more erosive than battery acid)
  • Dry mouth or low salivary flow (xerostomia)
  • Diet that’s high in sugar
  • Acid reflux
  • Environmental factors (friction, wear and tear, grinding from stress)
  • Conditions such as bulimia nervosa

Acidic foods and drinks will lower the pH level of your mouth resulting in demineralization of your teeth. A variety of drinks contribute to dental erosion due to their low pH level. Examples include fruit juices, such as apple and orange juices, sports drinks, wine and lemon water.

Carbonated drinks, such as soft drinks are also very acidic. Foods such as fresh fruits like lemons, oranges, pineapples and apple, as well as ketchup and pickled food plays a part in causing acid erosion.

Frequency, rather than total intake of acidic drinks, is seen as the biggest issue in causing dental erosion; infants using bottles containing fruit juice or people drinking lemon water or fruit smoothies on a daily basis are therefore at greater risk of acid erosion.

Saliva acts as a buffer, regulating the pH when acidic drinks are ingested. Drinks vary in their resistance to the buffering effect of saliva. Studies show that fruit juices are the most resistant to saliva's buffering effect, followed by fruit based carbonated drinks and flavored mineral waters, non-fruit-based carbonated drinks, sparkling mineral waters. Because of this, fruit juices in particular, may prolong the drop in pH levels in the mouth.

What can we do to avoid enamel erosion?

  • Reducing the frequency of acidic food and beverage intake. This decreases the acid exposure time and allows the eroded tooth surface to remineralise.
  • Changing lifestyle to avoid certain foods or beverages that causes enamel erosion.
  • Drinking through a straw to reduce contact between acidic fluids and teeth. Drinks should not be held in the mouth or sipped for a longer period of time.
  • Avoiding abrasive forces. Use a soft bristled toothbrush and brush gently. Avoid brushing immediately after consuming acidic food and drink as tooth surface will be temporarily softer. Wait at least half an hour before brushing
  • Using a remineralising agent, such as a fluoride-containing mouthwash, tablets or chewing gum. This can also help prevent further demineralisation if erosion has already occurred.
  • Applying fluoride gels or varnishes can increase enamel hardness and increase resistance to erosion.
  • Drinking milk and other dairy products causes increased mineral deposition on the tooth surface allowing it to remineralise.
  • Treating any underlying medical conditions or diseases like acid reflux or bulimia nervosa

Tooth erosion is just one of the many various conditions that we see in patients. Remember, prevention is always better than cure.

If you have any concerns about the health of your teeth, visit your dental provider right away.

Felicia Bjurfjall

Felicia Bjurfjall
Dental Hygienist, Sweden
Jumeirah Clinic, Dubai

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