Acid Reflux

Dental Erosion: Acid Erosion

Dental erosion is the loss of tooth structure due to chemical dissolution by acids. These acids are not the same as those responsible for individual tooth decay processes, or cavities, but the effects of dental acid erosion of can be very damaging to multiple teeth simultaneously.

If unchecked the effects of dental tooth erosion can lead to significant deterioration in the appearance of the teeth specifically their colour and shape combined with growing tooth sensitivity and in some cases impaired chewing function.

The more extensive the dental erosion processes the more complex the treatment requirement to correct the damage to the appearance and function of the teeth.

Causes of Dental Tooth Erosion

Foodstuffs and drinks with low pH that is having a high level of acidity are quite common. They range from citrus fruits, to carbonated drinks and wines. For list of these refer to the “Measures of Acidity pH” table below”. Remember combinations of foodstuffs and habits described below can lead to more rapid loss of tooth structure resulting from dental erosion.

The damaging effects of Dental Erosion are caused by three distinct factors:

1. Acid sources from dietary sources outside the mouth.
Foodstuffs, drinks with a low pH.

2. Acid sources from inside the mouth.
Gastric Fluid. This can be caused by a condition known as GORD(GERD) Gastroesophegeal Reflux Disease. This is a disease where gastric fluid from the stomach comes in contact with the teeth causing erosion and commonly occurs during sleep. People who suffer from Bulimia and Anorexia Nervosa can experience very significant tooth erosion similar to GORD(GERD) patients.

3. Habits and behaviors that cause erosion. Excessive tooth brushing with abrasive toothpastes and habits such as swishing of acidic low pH drinks or biting lemons can increase the acidic content of oral fluids. Teeth subject to acid erosion can also significantly contribute to the toothwear caused by tooth grinding or Sleep Bruxism due to removal of the harder outer enamel surface.

Measures of Acidity pH

The term pH is used to measure the acidity of a foodstuff or fluid. The lower the pH figure the more acidic the substance the more likely it is to cause tooth erosion if consumed in significant quantities

A pH of below 5 can begin the process of Tooth erosion. For example a citrus fruit like lemon juice has a pH of 2. Gastric fluid from the stomach has a pH of 1.

Signs Changes to look out for if you suspect Tooth Erosion

– Sensitivity to cold drinks, and sweet substances

– Colour changes teeth can become more transparent see through

– Teeth can become more yellowish and have a glassy smooth feel

– Shape changes become more rounded or crack due to the loss of supporting tooth structure depending on the source of the acid erosion.

– Little pits or concavities appear on the surface of molar teeth

– Old metal fillings if present in teeth, more commonly back teeth, may appear raised as the tooth structure surrounding them is eroded away.

Questions to be answered about Tooth Erosion

What is causing the erosion?

– Are the changes due to erosion only or are there other dental issues or medical problems contributing to the picture of dental erosion and the changes to the teeth? Your dental professional will elicit this.

– Medical problem GORD, Bulimia, Anorexia Nervosa? A medical Diagnosis is required. If your dental clinician suspects possible medical condition an onward referral is indicated.

– Excessive consumption of Diet issue foodstuffs drinks with low pH?

– Inadequate or inappropriate dental hygiene procedures? Too much tooth brushing with abrasive toothpastes? Not using a remineralising fluoride based toothpaste?

How is tooth erosion managed?

Diagnosis by the dental clinician as to what the primary cause or causes of the problem are.

Medical Intervention if the erosion is found not to be primarily due to dietary factors or habits a medical referral is necessary

Dietary Modification to manage identified tooth erosion causing foodstuffs or drinks and habits.

Dental Intervention to PREVENT further damage to tooth structure and appearance and to control sensitivity.

Dental Intervention to RESTORE and protect the teeth from further damage due significant loss of tooth structure form ongoing exposure to dental erosion. This could involve where appropriate bonding procedures, crowns or veneering treatments depending on the severity of the problem. Treatment would be accompanied by necessary preventative dental or medical interventions.

Dental Hygiene information including where appropriate altering toothbrushing devices and techniques and other tooth cleaning devices. Provision of advice on the appropriate toothpastes and mouthwash use is also an important aspect of home care.