Acid Wear and Dental Erosion

What is Acid wear and Dental Erosion?

Dentally related acid wear and erosion is a type of dental wear that affects your dental hard tissues (Teeth). Acids consumed or produced by the body causes an “acid attack” in which the teeth are exposed to. This is an irreversible process caused by first the dissolution of the enamel then followed by the dissolution of the dentine. This process is often progressive and over time the acid wear can cause your teeth to become hypersensitive and painful (Dentine hypersensitivity). Your saliva may help dilute the acid attack and neutralise the acid for short periods of time, however the more acids that are present in the mouth the saliva may not be able to compensate. This then results in the loss of your dental structure.

Often this may be exacerbated by heavy brushing and gritty toothpaste (abrasion and attrition).

Causes

The causes of acid wear are broad and often non-specific. Most frequently many patients do not know that they have dental erosion. There are 2 main causes for dental erosion. Extrinsic erosion which is caused by an external source, generally acidic foods such a vinegars and lemons contribute to this irreversible process. These foods often have a LOW pH of below 6.  Intrinsic erosion which is caused from inside the body, often via gastric acids is another cause.

Extrinsic Erosion

Common foods and drinks that may cause dental erosion with prolonged consumption:

  • Vinegars (white, balsamic, apple cider)
  • Carbonated beverages daily (sparkling water, soft drinks)
  • Citrus (oranges, mandarins, lemons, limes)
  • Lemon water
  • Sports drinks
  • Fruit juices
  • Sour lollies
  • Red wine
  • Excessive consumption of Vitamin C chewable tablets.
  • Certain medications
  • Prolonged exposure in chlorinated swimming pools

Intrinsic Erosion

Health related issues that may cause dental erosion with prolonged exposure.

  • Acid reflux (Gastroesophageal reflux disease GERD)
  • Anorexia nervosa
  • Bulimia nervosa
  • Pregnancy symptoms
  • Dry mouth (xerostomia)

Signs and Symptoms

There are various levels of dental erosion that may be present in your mouth.

Some signs include:

  • Increased sensitivity
  • Discolouration of the teeth
  • Changes in the shape of the teeth (more rounded)
  • Shiny and smooth teeth
  • Cupping in the molars (small pits found in the back teeth)
  • Hollowing of the teeth
  • Dental fillings start to stick out

Treatment and Management

Unfortunately, once dental erosion has occurred it is irreversible and you are unable to “grow or repair” your enamel back. However, there are various management and treatment methods to help stabilise the erosions and prevent sensitive teeth by treating the symptoms.

Methods of self-management and prevention:

  • Reducing the consumption of acidic foods
  • Drink water
  • Have an acidic drink with meal, rather than by itself
  • Drink the acidic beverage through a straw
  • Taking acid reflux medication after consultation with your doctor (GP)
  • Treat any health condition that may contribute to the acid reflux
  • Chewing sugar free gum after a meal (increases saliva flow)
  • Brush your teeth with fluoridated sensitive toothpaste with a soft toothbrush
  • Wait 1 hour after an acidic attack before your brush your teeth
  • Drink or eat the beverage quickly and drink plenty of water after
  • Eat cheese or drink milk after an acidic meal to neutralise the acid attack

The most common symptom of dental erosion and acid wear is dental hypersensitivity.

This can be treated with fluoridated sensitive toothpaste. Each sensitive toothpaste has their own unique active ingredient, if one does not work for you please explore the other brands. If sensitive toothpaste does not help with your symptoms then you should consult a dental practitioner.

Dental treatment options can include:

  • Fillings and restorations
  • Crowns and veneers

These treatments are usually for cosmetic reasons but can be recommended for severe cases.

 

The best treatment for dental erosion is to prevent it!

References

https://www.dentalhealth.org/dental-erosion

https://www.ada.org/en/member-center/oral-health-topics/dental-erosion

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