While many factors can contribute to dental erosion, you can certainly take positive steps to avoid it and keep your teeth healthy. But with so many dental products claiming to be effective against erosion, how can you best protect your teeth? The first step is to understand what erosion is and what causes it, so let’s look at the facts.
What is dental erosion, and why does it occur?
Dental erosion occurs when the enamel on the surface of your teeth wears down due to exposure to acid. This type of surface wear differs from abrasion, which can occur due to brushing your teeth improperly or too vigorously, improper flossing, or biting and chewing on hard objects such as pens or fingernails. It also differs from attrition, which results from friction between teeth, i.e., teeth clenching or grinding (bruxism).
What causes the acid that leads to this condition?
A number of conditions can produce the acid that causes dental erosion:
- Medical Conditions. Medical conditions such as acid reflux disease and bulimia (which involves self-induced vomiting) can result in gastric acid (from your stomach) reaching your teeth. Some patients suffer from xerostomia (dry mouth). Having sufficient saliva protects the teeth from plaque and acid in the mouth. In xerostomia, saliva production is insufficient to protect the teeth from excess or even normal exposure to acid. Other patients have genetic conditions that lead to dental erosion.
- Medications. For some patients, medications such as antihistamines, aspirin, or vitamin C can contribute to excessively acidic conditions in the mouth, and over time, these may result in dental erosion.
- Acid-Forming Foods and Drinks. Acid-forming foods and drinks are the most frequent reason for dental erosion. This includes drinks containing sugar (soda, fruit juices, sweetened tea and coffee (this includes most of our favorite fancy takeout coffee drinks), lemonade, punch, and sports drinks), alcoholic drinks, and foods high in sugar. Most of us enjoy a sweet treat now and then, but the more frequently you expose your teeth to these kinds of foods and drinks, the more chance there is for their enamel to erode.
- Poor sleep hygiene. If you sleep with your mouth open, it can dry out and cause more acid production, promoting erosion. Sleeping with a soft pillow can contribute to mouth breathing during sleep.
What happens when teeth erode?
Early-stage erosion often results in increased tooth sensitivity due to the exposure of dentin, the sensitive layer just below tooth enamel. Patients experience sensitivity to hot, cold, and sweet foods and drinks. Continued erosion exposes more dentin, first causing teeth to appear transparent and then to appear yellow. Teeth can become concave, begin to crack, and become coarse. Severe erosion may also cause gaps between teeth to increase.
Is dental erosion the same as tooth decay?
Acid-caused erosion is different from decay (cavities) resulting from bacteria, meaning that it can occur despite a daily cleaning regimen to rid your mouth of bacteria.
Can this condition be reversed?
Because tooth enamel is a mineral, it cannot grow back. Dental erosion is a non-reversible condition; therefore, taking steps to prevent and stop it is most important.
Are you at risk for dental erosion?
Because dental erosion can occur through everyday actions such as eating, drinking, sleeping, and taking medication; or through certain medical conditions, virtually everyone is at risk. The good news, however, is that there are things you can do to protect your teeth.
Do special toothpastes stop dental erosion and hypersensitivity?
Many toothpastes claim to be effective against erosion or excessive sensitivity, but a recent study suggests otherwise. Researchers at the University of Bern in Switzerland tested eight anti-erosion and desensitizing toothpastes (along with a ninth toothpaste serving as a control) and found that none of them actually protected against erosion or abrasion; in fact, all the toothpastes in the test actually caused different amounts of enamel loss.
How can you avoid dental erosion?
With some simple steps, you can avoid dental erosion, or stop it if it has already begun.
- Eat clean. A researcher in the University of Bern study noted that industrial processing has made many modern food and drink choices more acidic. For consumers, this means that it is more important than ever to “eat clean” by regularly choosing natural, unprocessed foods, and by drinking water and unsweetened drinks in place of drinks containing sugar. This is the most important step to take, because we expose our teeth to food and drink on a daily basis.
- Rinse with water. After eating or drinking acid-forming or sweet foods and drinks, rinse your mouth with water to reduce the acid, and wait at least an hour before brushing your teeth. This will give them a chance to remineralize.
- Breathe through your nose. During the day and at night, nasal breathing is crucial to your oral and overall health. When your mouth is closed, it’s more likely not to become dry and promote erosion. If you have difficulty breathing through your nose or suspect you might be mouth breathing when you sleep, your dentist may be able to help, with a first step of referring you for a sleep study.
- Seek treatment for serious gastrointestinal issues. If you suffer from chronic acid reflux (GERD), or if you frequently suffer heartburn, see your primary care provider or a gastroenterologist. Resolving these issues can be an important part of improving your oral health.
In addition, it is also important to use a minimally abrasive fluoride toothpaste to clean your teeth (avoid the ones with tartar control, special whitening agents, and baking soda), and to visit your dentist regularly for any treatment you might need for erosion and/or sensitivity. We are always glad to advise you on choosing an appropriate toothpaste, and to address any concerns you may have.
(Updated June 24, 2021; originally published April 11, 2018)
References
Fava, PL. (2021, June 8). What is tooth erosion and how can you prevent it? DentistryIQ. https://www.dentistryiq.com/personal-wellness/dental-disease/article/14204832/what-is-tooth-erosion-and-how-can-you-prevent-it
Fundação de Amparo à Pesquisa do Estado de São Paulo. (2018, March 13). Toothpaste alone does not prevent dental erosion or hypersensitivity: An analysis of nine toothpastes found that none of them protects enamel or prevents erosive wear.
ScienceDaily.
Ghidrai, G. (n.d.). Dental erosion. Infodentis. https://www.infodentis.com/articles/dental-erosion.php