Dental Erosion

What is Dental Erosion?

Dental erosion is the term used to describe what occurs where the enamel of the tooth (outside layer of the tooth) is lost due to an exposure to acid.

The amount of erosion that occurs due to exposure to acid can vary and can range from being slight with only a small amount of enamel being lost, to severe. In severe cases the enamel of the tooth can be lost completely with the acid then continuing to affect the dentine (inner layer of the tooth) and the pulp (the part of the tooth that holds the nerve vessels) can then become exposed.

Dental erosion can occur in people of all ages and is becoming more prevalent. It has been reported that dental erosion is becoming more frequent in children, teenagers and young adults.

It is important to clarify that dental erosion and tooth decay are two separate things although they can occur at the same time.

What Can Happen if Dental Erosion is Not Treated?

If dental erosion is not treated, then symptoms can include:

  • Sensitivity,
  • Pain; and
  • In some cases where the damage is severe and the dentine and pulp of the tooth have become exposed, it can lead to abscesses or the tooth requiring root canal treatment or extraction.

What Causes Dental Erosion to Occur?

There are a variety of causes that can cause dental erosion to occur. The most common causes of dental erosion are:

  • Acidic Food and Drinks
    It is recommended that teeth are only exposed to acid on an average of around 5 times per week. It is also recommended that when teeth are exposed to acid that it is for the shortest period of time possible. For example, rather than sipping on a soft drink over the course of the day, it is better to drink the soft drink over the course of half an hour, this limits the amount of time that your teeth have been exposed to acid.
    Foods and drinks that may include higher levels of acid include carbonated drinks, energy drinks, sports drinks, fruit juices, citrus fruits, alcohol (this includes overuse of alcohol-based mouthwashes), vinegar and vinegar-based foods, and some salad dressings.
  • Stomach Acid
    Stomach acid can cause dental erosion where it appears in the form of reflux. Reflux occurs where the acid used to break down food in the stomach, travels up the oesophagus, damaging the oesophageal tissue, this is what causes symptoms such as the feeling of indigestion or heart burn. Where this occurs some of the stomach acid can escape into the mouth causing dental erosion. It is important to acknowledge that sometimes acid reflux can have no symptoms and despite the lack of symptoms can still be causing damage to the body and teeth. If you are suffering from dental erosion and the cause cannot be found you may suffer from silent acid reflux.
  • Medications
    Such medications especially some anti-inflammatory or pain relief medications can lead patients to suffer from conditions that can lead to dental erosion. This is more common where medications are required to be taken for a prolonged period of time. The most common condition is that such medications can cause an increase in gastric reflux or in conditions such as dry mouth, these conditions can then in turn cause an increase in dental erosion. It is important however that if you wish to change your medications, that this is only done on the advice of a medical professional such as a GP.

What are Some Other Causes of Dental Erosion?

Other less common causes of dental erosion can include, but are not limited to:

  • Dry mouth which can be caused by a variety of alternative factors
  • Conditions that cause regurgitation or chronic and constant vomiting
  • Chronic dehydration
  • Frequent exposure to highly chlorinated water
  • Bruxism in severe cases

Things you can do to Assist in Preventing Acid Reflux

Most treatments for acid reflux begin at home or begin with seeking alternate medical attention beyond your dentist. However, if you wish to help prevent acid reflux there are some things you can do at home. These include:

  • Limiting your intake of foods and drinks high in acid. It is recommended that acidic products are only consumed on average 5 times a week and for small periods of time.
  • Immediately after consuming acidic foods or drinks you can rinse your mouth with water, this will help prevent the acidic product remaining in your mouth and continuing to damage your teeth. You can also consume more water throughout the day, especially in between meals.
  • Drink acidic drinks through a straw that is placed a good distance behind the front teeth, this will prevent the acidic product directly touching and remaining on the teeth.
  • Brush your teeth twice daily using a soft toothbrush. Other toothbrushes with harder bristles should be avoided as these can be abrasive to the tooths surface. Ensure that when brushing teeth, a fluoridated toothpaste is used, this will also help with the prevention of tooth decay.
  • Teeth brushing should not occur for at least 30 minutes after consuming any acidic products or after having symptoms of acid reflux. This is because the saliva in the mouth helps stabilize the enamel of the teeth. When there is acid in the mouth the enamel becomes unstable and the enamel of the tooth can be worn easily with a toothbrush

Professional Dental Treatments for Acid Erosion

There are a variety of dental treatments available to assist in the treatment of eroded teeth. The type of treatment that will be suitable varies greatly depending on the extent of the damage caused by the erosion.

Where dental erosion is diagnosed in its early stages, treatment can be as simple as implementing at home measures to prevent dental erosion, paired with a treatment such as a high fluoride toothpaste or other fluoride treatment.

In severe cases where the enamel of the tooth has been lost completely and the dentine of a tooth has also been lost, the tooth may require root canal treatment if the tooth wants to be maintained. In other severe cases a tooth may unfortunately require extraction.

When dental erosion is diagnosed and treated where the teeth are still salvageable then restorative work can be undertaken to restore the enamel to the teeth, reopen a bite lost due to the erosion when required, and also to improve the aesthetics of the teeth where the tooth surface has been lost.

It is important to note that no restorative work will be attempted until the cause of the erosion has been identified and treated. This is because if the restorative work is undergone while the erosion is still occurring it can also erode the dental material used to restore the teeth.

It is important if you have suffered from dental erosion in the past to maintain regular visits and check-ups by your dentist, even after treatment for this condition. This is because unfortunately some of the symptoms of dental erosion can be reoccurring.