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.

Definition

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.