Dental erosion

What is dental erosion?

Dental erosion, or tooth erosion, is a common problem that can occur at any age. It happens when part of the enamel surface of your teeth is dissolved and softened by contact with acids. These acids could come from your stomach or from food and drinks.

Dental erosion is different to tooth decay, which is caused by bacteria.

Dental erosion can be severe if you have a dry mouth and don’t make enough saliva to flush out and neutralise acids.

What are the symptoms and complications of dental erosion?

If you have dental erosion your teeth can:

• become discoloured
• become sensitive to heat and cold
• look shorter, due to wearing away
• chip or break more easily
• have sharp edges

Dental erosion is most common on the biting surfaces, inside surfaces and top edges of your teeth. The inside surfaces are more likely to be affected when the acid source comes from your stomach.

If not treated early, dental erosion can cause gradual loss of the tooth surface. Acid dissolves the tooth enamel over time, exposing the dentine underneath the enamel. Dentine is a yellowish-brown colour.

Tooth fillings can also become elevated if the surrounding enamel is worn down by acids.

What causes dental erosion?

Dental erosion happens in 2 steps.

1. Contact with acid starts to weaken and soften the enamel on the outside of your teeth.
2. The softened tooth surfaces are worn away during eating and chewing.

There are both external and internal sources of acid that can cause dental erosion.

External sources

These include diet, medicines and other acids in your environment.

Acidic food and drinks that can cause dental erosion include:

• fruit juices
• soft drinks (including sugar-free)
• sports and energy drinks
• citrus fruits (lemon, orange, grapefruit)
• vinegar
• foods with additives such as citric acid, sodium citrate or phosphoric acid
• alcohol

Taking frequent sips of acidic drinks can increase the time that acid is in contact with your teeth.

Some medicines and health products, such as chewable vitamin C tablets, can cause dental erosion.

Internal sources

Tooth erosion may occur as a result of:

• excessive vomiting, which can be from conditions such as bulimia nervosa
• gastric reflux from gastro-oesophageal reflux disease (GORD)
• reduced saliva production

When should I see my dentist?

If you’re concerned about your teeth or have signs or symptoms of dental erosion, visit your dentist for a check-up.

How is dental erosion treated?

Your dentist can help you to work out the source(s) of acid that is causing the problem. Once you know the possible food or drink source, try to avoid it.

Your dentist may suggest applying a fluoride varnish or a remineralising treatment to strengthen the remaining enamel.

If gastric reflux or some other medical condition is causing your dental erosion, discuss treatment options with your doctor.

If dental erosion is not treated, it can damage your tooth structure. Tooth enamel can’t grow back once it is gone. Treatments to repair tooth structure can be done by your dentist and include:

• veneers
• fillings
• crowns
• root canal treatment
• tooth extraction

Can dental erosion be prevented?

You can help prevent dental erosion by:

• Limiting your intake of acidic foods and drinks, such as fruit juice and soft drinks.
• Using a straw to drink acid-containing drinks, to limit the acid contacting the teeth.
• Rinsing your mouth with water after acid exposure.
• Drinking plain water in place of acid-containing drinks.
• Rinsing your mouth with water or milk after vomiting.
• Chewing sugar-free gum to increase saliva and dilute acid.
• Cutting down on alcohol.
• Having regular dental or oral health check-ups.

Always use a soft toothbrush and fluoride toothpaste to brush your teeth.

Wait for at least half an hour to brush your teeth after consuming acidic drinks or vomiting. This is because acid causes your tooth enamel to become softer for about 20 to 30 minutes, until saliva dilutes the acid. While waiting, you can rinse your mouth with plain tap water or a fluoride mouthwash.

If you have acid reflux, talk to your doctor about how to manage it and reduce this source of acid.

Avoid giving babies sugary drinks or fruit juice. Baby tooth enamel is softer than adult tooth enamel and can be more easily damaged by acids.