What Is Tooth Erosion?

One of the most basic things you need to know about oral health and caring for your teeth concerns tooth erosion. Many people have incorrect information about the causes and prevention of tooth erosion.


Tooth erosion is the irreversible wearing away of the outer enamel of the tooth. According to the American Dental Association (ADA), more than one-third of adults and children in the U.S. have some level of tooth erosion. Tooth erosion can cause several types of damage to teeth, and the most common symptom is often pain or sensitivity. The good news is that tooth erosion can be prevented in many cases.

Causes of Erosion

Tooth Erosion is caused by diet – specifically by acids in your mouth. Most often, these acids are introduced in carbonated drinks, fruit juices, alcohol, and energy drinks. It can also be caused by poor oral hygiene, eating disorders (bulimia or anorexia) and by stomach disorders (acid reflux) that produce acid in the digestive system. The erosive properties of these acids may be exacerbated by swishing these liquids in your mouth before swallowing. The ADA also says that people who are regularly exposed to “environments with higher levels of acid” (factory workers, swimmers) may also experience tooth erosion. Special note: beware sour candy. Some sour candies are “almost as acidic as battery acid.” (ADA)

The chart below gives examples of the amount of acid in many foods and beverages. [Image source: ADA patient education brochure Tooth Erosion: The Harmful Effects of Acid – W301*]

Acidity of beverages chart ADA

Types of Tooth Wear

In addition to the erosion of your teeth caused by contact of acids with your teeth, there are other kinds of tooth wear that contribute to loss of tooth enamel. Three major types of wear are:

  1. Attrition occurs with tooth-to-tooth contact. This often occurs with teeth grinding or inability to bite correctly. Attrition tends to break down the enamel and flatten the chewing surfaces of your teeth.
  2. Abfraction results when regular grinding or a mis-aligned biting action creates an unbalanced or otherwise abnormal load on a particular tooth. This typically causes a notch on the side of the tooth at the gumline. This can be addressed in one of two ways: use of a customized night guard or orthodontic treatment to align the teeth so they meet correctly.
  3. Abrasion looks like abfraction. It is caused, however, by a mechanical force, such as brushing too hard or with a toothbrush that has hard bristles. Your brushing technique can be modified easily, and your hygienist or dentist can show you how to brush correctly.

Symptoms of Tooth Erosion

  1. Early Symptoms
    1. Discoloration
    2. Sensitivity
    3. Rounded teeth
    4. Transparent appearance
    5. Sandblasted appearance
  2. Advanced Symptoms
    1. Cracked tooth
    2. Dents in teeth
    3. Extreme Sensitivity

What Tooth Erosion Does to Your Teeth

Depending upon the cause of the erosion, the effect on your teeth will likely be:

  • Pain or sensitivity when drinking sweet, hot, or cold beverages.
  • Yellowish discoloration of the teeth.
  • Changes in fillings.
  • Greater risk of more cavities in time.
  • In extreme cases, development of an abscess.
  • Tooth loss, also in extreme cases.

Treatment of Tooth Erosion

Treatment for tooth erosion focuses on restoration of function of the tooth and, perhaps, its appearance. Lost enamel cannot be replaced (yet). Often a filling will be placed over the eroded tooth surface to protect it against additional wear. Another approach is applying fluoride at each regular six-month dental visit. Using a toothpaste with fluoride will help with sensitivity. Your dentist may recommend special products that will help you protect your teeth.

In some cases, the treatment will be more radical. Sometimes your dentist may recommend veneers to protect the tooth. If the tooth is very damaged, your dentist may recommend a root canal and crown to protect the interior structure and elements of the tooth.

Your dentist may choose to measure and watch affected teeth for changes. This will enable him or her to determine when treatment options are necessary.

What You Can Do to Protect Your Teeth from Erosion

Reducing and controlling the amount of acid in your mouth by controlling stomach acid reflux, limiting acidic drinks and foods, and following your dentist’s instructions with regard to brushing, flossing, and care of your teeth. These steps may include:

  • After consuming acidic foods or beverages, rinse your mouth with water. This will neutralize some of the effects of acid.
  • Wait at least one hour before brushing your teeth after consuming acidic food or beverage to allow time for your teeth to remineralize after exposure to acid.
  • Reduce consumption of carbonated drinks, replacing them with water, milk, unsweetened tea or unsweetened coffee.
  • Use a straw when consuming acidic beverages. This allows the liquid to go directly to the back of your mouth instead of washing over our teeth. Swallow these acidic drinks quickly and so not swish them around in your mouth.
  • Chewing sugar-free gum can help dry mouth and increase flow of saliva.
  • Using a soft toothbrush and toothpaste with fluoride.
  • Manage acid reflux.
  • Talk with your dentist about food and beverage substitutions that can protect your teeth.

By understanding tooth erosion and the damage it causes to your teeth, you and your dentist can determine the adjustments that will help to protect your teeth from erosion.

Can a Minipig Save Your Gums?

Difficult as it may be to believe, a minipig may be able to save your gums (and your teeth). A new therapy currently under development at Tohoku University in Japan suggests that stem-cells from minipigs may regenerate periodontal tissue in humans. This will, they say, heal gum tissue faster and at lower cost. It will also improve the quality of the minipig- pixabay cco free - 3986310 1280new tissue, according to scientists.

Periodontitis is one of the most common human dental diseases. It has been estimated that as much as 75 percent of the adult population in the USA has periodontitis. It is a painful disease. It results from bacterial inflammation of the gums and, eventually, loss of gums and supporting structures around the teeth. This inflammation creates infected pockets that cause erosion of bone and tooth loss. But this inflammation has been connected with heart disease, Alzheimer’s Disease, and more.

Current treatments for gum disease include infection fighting, use of growth factors, and tissue regeneration using autologous mesenchymal stem cells (a patient’s own bone marrow stem cells from cartilage, bone and fat. The goal, of course, is to regenerate whatever tissue has been lost to the disease. Side effects have been limited, but they have caused some defects.

The scientists developing this treatment report that their new treatment can regenerate gum tissue safely and more efficiently than any other treatment currently available. If this treatment proves effective, it can save the gums and prevent tooth loss in millions of patients.

The new treatment does not use an organism’s own stem cells. Instead, stem cells from a healthy organism are transplanted into an affected organism. These “allogeneic stem cells” overcome the shortcomings of current treatments. Specifically, this treatment uses stem cells derived from fat tissue transplanted from healthy minipigs. The treatment has thus far been safe and effective for treatment of gum disease.

The study is “a powerful first step towards further development of stem cell-based therapy for the treatment of periodontal disease,” according to one of the researchers. The researchers plan to take the next step and conduct a clinical trial in humans to demonstrate the positive results of transplanting stem cells and stimulation of successful periodontal tissue regeneration.

This kind of significant advance in treatment could change the oral health and the lives of many Americans. We will be eager to see the results of the next step in development of the treatment. We will keep you informed.

New Appliance Reduces Episodes of Sleep Apnea by Half

A new oral appliance has been developed at the Hiroshima University Hospital for sleep apnea patients. This new treatment for mild to moderate sleep apnea has proven effective in opening the airways. In obstructive sleep apnea, causes throat muscles to relax. This narrows the airways while you sleep. Indicators of the condition include snorting, choking or gasping while sleeping. If you have obstructive sleep apnea, you do not sleep properly. You will notice dailySleep Apnea effects - paid - Depositphotos 51055441 s-2019 fatigue and a short attention span due to lack of sleep. In more serious forms of the condition the effects can be far more severe, even causing death in some cases.

Primary treatments at this time include CPAP (Continuous positive airway pressure) machines and single-piece oral appliances (typically made by your dentist). This new appliance brings the jawbone forward and enlarges the air passages at the back of your mouth. The new appliance is custom made for each patient. The new device allows movement of the jaw. This, unlike current oral appliances, eliminates effects on your teeth and eliminates changes in the shape of your face.

In a number of previous studies, measurement of the airways was accomplished while the patient was standing. This does not replicate the changes to the airways when sleeping. In the new study, measurements were made while patients were lying down. Based upon these measurements, the device was designed to widen the air passageways in sleep apnea patients. Researchers found that patients using the devices almost halved the number of sleep apnea episodes during the night because it widened passageways to facilitate easier breathing.

If you have been diagnosed with mild to moderate obstructive sleep apnea, ask me about these custom appliances.

Oral Bacteria Linked to Colon Cancer

A new study at Columbia University, led by Dr. Yiping W. Han, establishes a link between common oral bacteria and development of colon cancer. The oral bacteria F. nucleatum is a primary factor in the development of plaque and periodontal disease. This study shows that it also plays an important role in accelerating the growth of aggressive oral health vector SM - dreamstimefree 13503595colon cancer. This knowledge is important in treating and preventing the second-leading cause of death in the U.S.

A related study discovered that one-third of all colorectal cancers were associated with F. nucleatum. Further, that the bacteria is responsible for creating a molecule called FasA adhesin, which appears to stimulate cancerous activity in colon cells. In addition, they found that a problematic protein, Annexin A1, is present in cancer-prone cells, but not in healthy colon cells. This protein fuels the growth of cancer. The oral bacteria F. nucleatum also encourages further growth of Annexin A1, in effect supercharging development of cancer cells.

It is hoped that this research will help in the understanding of the development of colon cancer and contribute to a treatment.

Your mouth is the gateway to your body, allowing bacteria, viruses, and more to travel to your organs. A clean and healthy mouth can prevent the growth and transmission of disease causing and promoting bacteria to reach other organs. Your best defense is a strong oral health regimen. Brush for 2 minutes twice daily, floss daily, and visit your dentist twice each year. You may want to add rinsing with mouthwash, as well.

Hydrogen Peroxide Teeth Whitening is More Dangerous Than Previously Thought

Brilliant white and perfectly matched teeth are considered a symbol of beauty and self-care in this country today. Statistics for 2018 indicate that 40.5 million people in the USA used tooth whitening products. We spend more than $1 billion every year on teeth whitening products. New research released this week shows that these whitening products might be causing tooth damage, as with tooth whitening strip - paid - shutterstock 1064100836

Several studies have demonstrated that most human teeth are not naturally pearly white. Most teeth are actually different shades and tints that tend more toward yellow than white. The studies also show that natural teeth are not all completely uniform in color.

Following upon several studies that have shown that hydrogen peroxide can damage teeth, researchers at Stockton University wanted to learn how hydrogen peroxide harms the teeth, and which part of the tooth it attacks. Specifically, they investigated the whitening strips you can buy in your local drug store and how they damage one of the three layers of the tooth.

About Hydrogen Peroxide

The main ingredient in over-the-counter whitening strips is usually hydrogen peroxide. It is an oxidizing agent that has many uses. It is used as a sterilizer for wounds.

It is also used as a color-lightening agent that is used to bleach hair. As many have learned the hard way, if you use too much hydrogen peroxide to lighten hair, or if you use it too often, it can seriously damage your hair and scalp.

The new research discovered that hydrogen peroxide damages the dentin of the tooth, the “middle layer.” Your tooth has three layers:

  1. An outer, shiny enamel layer
  2. A center dentin layer
  3. An inner layer composed primarily of connective tissue that helps to keep the tooth in place.

Effect of Hydrogen Peroxide on the Tooth

The researchers found that hydrogen peroxide can penetrate through the enamel and infiltrate dentin. This layer contains about 90-95 percent of the protein collagen. Specifically, they found that the hydrogen peroxide fragments the collagen in the dentin. This causes a loss of collagen mass in the dentin layer of the tooth.

The authors of the study wrote: “Our results showed that treatment with hydrogen peroxide concentrations similar to those found in whitening strips is enough to make the original collagen protein disappear, which is presumably due to the formation of many smaller fragments.”

The collagen in the dentin and the connective tissue that keeps the tooth in the jaw aids in mineralization and stability. It is also crucial for improving bone density, which is essential to healthy teeth.

At this time, the researchers are not certain whether this damage is permanent or if it can be reversed. Their plan to determine whether the hydrogen peroxide affects other proteins contained in the dentin, as well.

If you are one of the millions of people using over-the-counter tooth whitening strips, you should know that the hydrogen peroxide used may be harming your teeth. If you wish to continue a whitening regimen, see your dentist and discuss the best whitening option for your needs.


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