DENTAL EROSION

Dental erosion or acid erosion is a type of tooth wear. More precisely, erosion is the loss of tooth enamelcaused 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 bruxism, 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.

Causes of Tooth Erosion

  • Excessive soft drink consumption (high level 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 (high in sugar and starches)
  • Acid reflux disease (GORD)
  • Gastrointestinal problems
  • Medications (aspirin, antihistamines)
  • Genetics (inherited conditions)
  • Environmental factors (friction, wear and tear, stress, and corrosion)

Types of Tooth Erosion

Friction, wear and tear, stress, and corrosion (or any combination of these actions) can cause erosion of the tooth surface. More clinical terms used to describe these mechanisms include:

  • This is natural tooth-to-tooth friction that happens when you clench or grind your teeth such as with bruxism, often occurring involuntary during sleep.
  • This is physical wear and tear of the tooth surface that happens with brushing teeth too hard, improper flossing, biting on hard objects (such as fingernails, bottle caps, or pens), or chewing tobacco.
  • This occurs from stress fractures in the tooth such as cracks from flexing or bending of the tooth.
  • This occurs chemically when acidic content hits the tooth surface such as with certain medications like aspirin or vitamin C tablets, highly acidic foods, GORD, and frequent vomitingfrom bulimia or alcoholism.

Signs

The signs of enamel erosion can vary, depending on the stage. Signs include:

  • Certain foods (sweets) and temperatures (hot or cold) may cause a twinge of pain in the early stage of enamel erosion.
  • As the enamel erodes and more dentin is exposed, the teeth may appear yellow.
  • Cracks and chips. The edges of teeth become more rough, irregular, and jagged as enamel erodes.
  • Severe, painful sensitivity. In later stages of enamel erosion, teeth become extremely sensitive to temperatures and sweets.
  • Indentations appear on the surface of the teeth.

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.

Prevention

  • from bulimia or alcoholism.

To prevent enamel loss and keep teeth healthy, be sure to brush and floss teeth daily. See your dentist every six months for regular checkups and cleaning. You can also try the following:

  • Eliminate highly acidic foods and drinks from your dietsuch as carbonated sodas, lemons, and other citrus fruits and juices. Rinse your mouth immediately with clear water after eating acidic foods or drinking acidic drinks.
  • Use a straw when you drink acidic drinks. The straw pushes the liquid to the back of your mouth, avoiding your teeth.
  • Monitor snacks. Snacking throughout the day increases the chance of tooth decay. The mouth is acidic for a few hours after eating foods high in sugar and starches. Avoid snacking unless you’re able to rinse or brush teeth.
  • Chew sugar-free gum between meals. Chewing gum boosts saliva production up to 10 times the normal flow.
  • Drink more water throughout the day, especially if your mouth is dry
  • Use fluoride toothpaste.

Treatment

Treatment of tooth enamel loss depends on the problem. Once the enamel of a tooth is lost, it cannot be replaced naturally. With a strict remineralisation regime, tooth enamel loss may be limited and no further treatment will be required.  Sensitive toothpaste may be used to manage any discomfort.

Please refer to the “Tooth erosion remineralisation” section in the “Existing patient treatment instructions” tab for a detailed regime for tooth erosion.

Sometimes fillings may be placed to protect the tooth and increase cosmetic appearance.  If the enamel loss is significant, the dentist may recommend covering the tooth with a crown. The crown may protect the tooth from further decay.

Dental Erosion Remineralisation Phase

Remineralisation Phase

The remineralisation phase will take a minimum of 6 weeks.

  • Drink one glass of hot water before breakfast.
  • Cut down acidic food and drinks, such as wine, carbonated drinks and citrus fruits and juices. If you do drink them, do so at mealtimes to minimise their effects on the enamel.
  • Avoid mid meal snacks (5-6 intakes/ day is best). I.e. breakfast, morning tea, lunch, afternoon tea and dinner.
  • Switch to modified products, such as low-acid orange juice.
  • Drink sodas and fruit juices with a straw, which helps acids to bypass the teeth. Don’t swish acidic drinks around in your mouth.
  • Finish a meal with a glass of milk or piece of cheese to neutralise acids.
  • Stay hydrated. Drink lots of water and limit caffeine intake.
  • Chew sugar-free gum with xylitol, at least 15 minute twice a day. This stimulates saliva and neutralises acids from foods and drinks.
  • Use Tooth Mousse at least twice a day and before and after acidic food and drink.
  • Apply Tooth Mousse for 5 – 30 minutes prior to consuming acidic food or drink such as wine, soft drink or fruit juice.
  • Acid leaves the enamel softened and more prone to erosion during brushing. To limit damage, wait one hour to brush your teeth after an acid attack, either gastric (e.g. reflux or vomit), or dietary. If absolutely necessary, rinse with water or mouth rinse to neutralise acids prior to brushing.
  • Use fluoride toothpaste or a fluoride mouth rinse to strengthen your teeth.
  • Apply Tooth Mousse before bed.
  • Use a soft toothbrush and avoid scrubbing or brushing too aggressively.
  • Seek medical advice for disorders that can expose the mouth to acid, such as bulimia, alcoholism, or gastric reflux. Medications are available both on prescription and over the counter to eliminate attacks and reduce damage caused.
QUICK CONTACT