Erosion
Erosion is increasingly evident, affecting all ages and requires additional preventive care
How will I know if I have dental erosion?
The signs of dental erosion may include:
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teeth appearing yellow (due to darker dentine showing through thinning outer enamel)
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teeth appearing glazed and smooth (due to the tooth surface being worn away)
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front teeth edges becoming square, transparent and chipping, eventually becoming shorter
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fillings sitting higher than the surrounding tooth surface
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chewing surfaces of back teeth showing smooth, concave craters
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teeth becoming sensitive to hot, cold or sweet food and drinks
(Before and after the restoration of teeth damaged by erosion)
What causes dental erosion?
The cause of dental erosion is acid attack. Sources of acid in the mouth are dietary, gastric or occupational.
Every time acid touches the surface of your teeth the enamel becomes softer and loses some of its mineral content. Your saliva will slowly neutralise the acid in your mouth and restore it to its natural balance. However, if the acid attack happens too frequently, the teeth do not have a chance to repair themselves and tiny particles of enamel can be washed or worn away. Minerals dissolve from the tooth surface and like a cliff face with a tide moving in and out, eventually collapses lost forever.
Dietary foods and drinks containing acid are the most common causes of erosion. Examples include fruit, pickles, fizzy drinks, energy and sports drinks, wine, squashes and fruit juices. Many of these foods and drinks also contain natural or added sugar which can in addition cause tooth decay.
A diet of frequent acidic food and drinks will cause tooth wear. The type of acid, calcium chelating properties, temperature and exposure time are factors that determine the amount of erosion that occurs.The lower the pH of a product, the more acidic it is but products such as citrus fruits appear worse as they bind (chelate) more calcium from the tooth. Hence orange juice is actually worse than cola.
Any food or drink with a pH lower than 5 may cause tooth wear and tooth sensitivity.
The pH of some common foods and drinks are indicated below:
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Milk pH 6.9
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Flavoured milk pH 6.7
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Tap water pH 6.0
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Cheddar cheese pH 5.9
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Coffee pH 5.0
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Beer pH 4.5
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Orange juice pH 3.5
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Apple juice pH 3.4
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Grapefruit pH 3.3
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Pickles pH 3.2
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Sports energy drinks pH 3.0
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Common soft drink pH 2.7
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Cola pH 2.5
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Red wine pH 2.5
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Lemon juice pH 2.2
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Vinegar pH 2.0
Other factors that contribute to erosive tooth wear include:
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a dry mouth, which increases the risk of damage from acid attack
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frothing or swishing acidic drinks around the mouth increases the risk of acid erosion
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erosion often coexists with dental abrasion. Abrasion is most often caused by brushing teeth too hard and exacerbates erosion if the tooth surface is already softened by acid.
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grinding of the teeth can worsen erosion.
Which gastric conditions contribute to erosion?
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Vomiting (eg morning sickness, bulimia and excessive alcohol)
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Acid reflux (eg gastro oesophageal reflux disease, hiatus hernia, heartburn)
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A number of medications such as vitamin C, aspirin and some iron preparations are also acidic and may contribute towards acid erosion
Which occupations might risk erosion?
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Industrial processes risk exposure to acids but hopefully adequately protected nowadays
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Professional wine tasters (if only I was so lucky)
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Competitive swimmers in poorly controlled chlorinated pools (again less likely nowadays)
What should I do to minimise the risk of dental erosion?
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Eat a well balanced diet, and reduce the amount of acidic and sugary foods and drinks. Try to limit snacking so that acidic foods and drinks are at mealtimes only.
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Eat foods that act as a buffer by neutralising saliva pH more quickly (eg. dairy products contain a protein called casein which protects teeth from acid).
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Avoid holding or ‘swishing’ acidic drinks around the mouth as this increases the likelihood of tooth decay and tooth wear. Use a straw whenever possible as this minimises exposure of the drink to your teeth.
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Do not brush immediately after eating or drinking acidic drinks as tooth enamel will be softened at this time. Leave at least an hour before brushing eg after wine in the evening and brush before breakfast fruit juices.
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Apply a remineralising paste eg GI Tooth Mouse or GI MI Paste after meals and before bed. Apply with a finger and leave this on the teeth without rinsing.
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Use a high fluoride toothpaste eg Duraphat to make your enamel more resistant to erosion
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Drink plenty of water frequently throughout the day, especially if exercising and avoid caffeinated beverages, as caffeine causes dehydration.
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Have treatment for any underlying medical condition. Perhaps use a neutralizing agent such as antacid tablets
Remember
Maintaining your body’s fluid levels by drinking water frequently is the best way to prevent a dry mouth, quench thirst and protect teeth from dental erosion.
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