Gastroesophageal reflux disease (GERD) involves the frequent backflow of stomach contents into the esophagus. This condition is primarily associated with symptoms like heartburn, but it also poses a threat to dental health. Acid reflux can damage teeth, leading to a specific type of irreversible breakdown called dental erosion. Chronic exposure to stomach acid severely weakens the protective outer shell of the teeth, making them highly vulnerable to subsequent cavities and decay.
How Reflux Acid Attacks Tooth Enamel
The chemical dissolution of tooth enamel by gastric acid is the mechanism of damage. Stomach acid has an extremely low pH, typically ranging between 1.5 and 3.5. Tooth enamel, the hardest substance in the human body, begins to demineralize rapidly when the oral environment’s pH drops below a critical level of approximately 5.5.
When acid reflux occurs, the highly acidic fluid instantly overwhelms the mouth’s natural defense system, which relies on saliva to neutralize acids. This direct chemical assault causes dental erosion, which is the direct, non-bacterial loss of the hard tooth structure. Erosion is distinct from dental caries or decay caused by bacterial activity.
The loss of enamel exposes the underlying dentin, a softer layer that is significantly more susceptible to wear and bacterial decay. While reflux causes the initial erosion, the resulting vulnerability can quickly lead to cavities. The prolonged or frequent presence of this powerful acid leads to a cumulative and permanent loss of tooth structure.
Recognizing the Signs of Acid Erosion
Acid erosion from reflux presents with distinct physical signs. The most common early indicator is increased tooth sensitivity, particularly in response to hot, cold, or sweet temperatures, as the enamel thins and exposes the dentin beneath.
Because the acid washes over the teeth from the back of the throat, the damage is often most concentrated on the lingual, or inner, surfaces of the upper back teeth.
- The teeth may begin to appear translucent or glass-like, especially along the edges of the front teeth.
- Smooth, rounded depressions, sometimes described as “cupping,” may appear on the chewing surfaces of the back teeth.
- Fillings may stand out from the tooth surface, creating a noticeable step, because the surrounding natural tooth structure has dissolved while the restorative material remains intact.
Strategies for Protecting Your Teeth
Managing the underlying GERD with a physician is the most effective step in protecting dental health. After any reflux episode, a person should immediately rinse their mouth with plain water or a solution of baking soda mixed with water to quickly neutralize the acid.
It is important to avoid brushing the teeth for at least 30 to 60 minutes following a reflux event or consuming acidic foods. Brushing immediately can mechanically scrub away the compromised tooth structure, worsening the erosion. Instead, use a soft-bristled brush and a fluoridated toothpaste to strengthen and encourage the remineralization of the enamel.
Chewing sugar-free gum, especially those containing xylitol, stimulates saliva flow. Saliva is rich in bicarbonate, which helps to neutralize acid. Regular dental check-ups are also necessary. A dentist can spot subtle signs of erosion and recommend prescription-strength fluoride treatments or other preventative measures before significant damage occurs.