Dental Erosion

Erosion is the loss of the surface of the tooth – especially enamel – that is caused by acid attack. This is different from bacterial acid attack that we call tooth decay. Enamel is the hard outer surface of the tooth seen when we smile, and it protects the sensitive dentine underneath. Erosion of the enamel can lead to exposure of the dentine, which may lead to pain and sensitivity especially with cold food and drinks.

Erosion is a slow process that people generally do not become aware of until significant enamel is already lost. Erosion often shows up as hollows on the top surface of the molar teeth or the teeth seem to become smaller or thinner as the enamel erodes away. As the enamel wears away exposing the underlying dentine, the teeth may appear a darker yellow colour – the colour of the dentine – and sensitivity to hot, cold or acidic foods and drinks may become noticeable.

Causes of dental erosion

Eating or drinking anything acidic will cause the enamel on your teeth to become softer for a short time, as the enamel will lose some of its mineral content. Your saliva will act to slowly remove the acid, repair the enamel, and restore your mouth to its natural balance. If acid attack takes place frequently through the day, there is not enough time for the balance and repair to take place. Tiny particles of enamel can be brushed away, and over time the surface of the enamel will wear away. Examples of people at risk from frequent acid drinks of food are those who sip acidic drinks from bottles, frequent wine taster or those who suck citrus fruits.

Some medical conditions can add to the acid imbalance in your mouth and lead to erosion.

Bulimia is a condition where people deliberately vomit in order to lose weight. The high level of acids in the vomit can cause damage to tooth enamel. Anorexia nervosa is another eating disorder where high levels of gastric acid may be found in the mouth.

Gastro-oesophageal reflux, where acids from the stomach come up into the mouth can lead to the same enamel erosion. People with hiatus hernia, or who drink too much alcohol, may also suffer from dental erosion due to vomiting.

Seeking medical help is recommended if you think you have a medical condition such as described above.

Can I change my diet to help prevent dental erosion?

Food and drink that acidic (with high pH lower than 5.5) have a high erosive potential. Reducing or eliminating these from the diet can help prevent dental erosion.

Fizzy drinks – even the so-called “diet” ones – are harmful, and if taken frequently can lead to erosion. Acidic fruit juices or fruits, particularly citrus ones such as lemon, grapefruit or oranges, contain natural acids that are harmful to the teeth – especially if you take a lot of them, or use them frequently. Drinks made up from packet concentrates are extremely acidic also.

Alcopop drinks that contain acidic fruit juices and are fizzy can also lead to erosion. Some wines also have a low pH an can be harmful to the enamel – especially when held in the mouth against the teeth for a time.

Reducing the amount of these acidic food and drinks, and especially the frequency that you have them, is essential for the prevention of dental erosion. Avoid such habits as swishing the drink around the mouth, or holding the drink in the mouth against the tooth surfaces. Using a straw to get the drinks to the back of the mouth, reducing contact with the teeth, can be helpful.

Are sports drinks safe?

Many drinks that are marketed as sports drinks have acid levels that can lead to dental erosion, and care should be taken to check on the pH of the drink before its use. Drinking water is the best way to stay hydrated during the after exercise, and sipping frequently on acidic drinks is a significant risk factor for dental erosion. If you do use these drinks, use them only at one time, such as after exercise, to avoid the time they are in contact with the teeth.

Can I help to prevent dental erosion in my mouth?