The ins and outs of Dental Erosion

Dental erosion is losing the surface of your teeth due to acids. Acid can come from food, drinks or coming up from your stomach.​

First of all, let’s start by explaining what dental erosion actually is. There are 3 main layers of a tooth, the ‘inside’ of the tooth is made up of the pulp which contains the nerve of the tooth. The next layer is the dentine which is a much harder material than the pulp, it contains thousands of tiny little tubules that lead towards the pulp. Then, the very outer surface of the tooth is called the enamel. The enamel is almost like the protective shell of the tooth, it is a very hard substance, much harder than dentine and even harder than bone!

Unfortunately, some foods and drinks can eat away or ‘dissolve’ the enamel over time. Anything acidic, with a low pH generally has the ability to dissolve the enamel. This can include;

• Excessive soft drink consumption
  • Including fruit juices (orange, apple), white wine & carbonated drinks (colas etc)
• Regurgitated acid (from reflux, pregnancy sickness, bulimia etc)
• Diet high in sugar
• Vinegar, lemon juice
• Xerostomia (dry mouth)
  • Saliva contains buffering agents to help to neutralise acids in the mouth. With a lack of saliva, that buffering capacity is reduced therefore the teeth are more prone to acid attacks from foods and drinks in the diet.
• Medications (such as dissolvable asprin)
• Wear and tear:
  • Attrition: This can occur is you grind your teeth. Tooth grinding can occur at night time particularly under times of stress. If the enamel is already experiencing erosion, then it will be more prone to damage from wear.
  • Abrasion: This can occur if you brush your teeth too hard – small tooth brush abrasions can occur, wearing away the enamel. This has also be seen to occur with incorrect flossing techniques or biting fingernails!
  • Abfraction: This occurs when the tooth is flexing or bending from side to side often seen in clenching and grinding of the teeth. It can cause stress fractures in the tooths enamel.

Side effects of tooth erosion:

• Your teeth can become more sensitive as that protective layer of enamel wears away, the sensitivity can become more intense and painful as the erosion worsens.
• Discolouration/yellowing of the teeth. As the enamel wears away and dissolves, the underlying dentine of the tooth becomes exposed. Dentine is darker in colour than enamel, it can be yellow, yellow-brown or even appear orange in colour.
• Cracks in the teeth. If the dental erosion of the teeth is more severe, then the enamel becomes thin and prone to wear, cracks and chips.

Once erosion has occurred to the enamel, it is not reversible. Erosion can be identified during your 6 monthly check and clean appointments and we can help to determine what is the cause of it and come up with a management plan which will include close monitoring.

If your erosion is diet related then reducing your frequency of intake of the causative agents can help. The longer you expose your teeth to sugary and acidic foods and drinks, the longer it will take for the mouth to recover from the acid attacks. Switch to drinking water where possible and if you drink soft drink, try to limit it to meal times and consume it in the one sitting rather than sipping at it throughout the day. Avoid swishing the acidic drink around your mouth and consider drinking it through a straw instead to avoid contact with the teeth.

If you have consumed acidic foods and drinks, avoid brushing your teeth for 30 minutes afterwards, to allow your saliva to re-mineralise any demineralised (softened) enamel that has occurred. Fluoride toothpastes can also help to protect the teeth from the early stages of erosion.