Throwing up can cause significant damage to your teeth, primarily through dental erosion. The major threat is the brief but intense exposure to corrosive gastric acid from the stomach. This acid attacks the outer protective layer of the tooth, the enamel. The resulting damage is a chemical dissolution of the tooth structure itself, distinct from traditional cavities caused by bacteria metabolizing sugars.
The Mechanism of Acid Erosion on Teeth
The corrosive power of vomit comes from hydrochloric acid, which is naturally produced in the stomach to break down food. Gastric acid has a very low pH, typically around 2.0, making it highly acidic. This pH is far below the critical threshold of 5.5, the point at which tooth enamel begins to dissolve.
Enamel is composed of calcium and phosphate minerals. When the mouth’s environment drops below pH 5.5, the acid strips away these minerals in a process called demineralization. This chemical attack is distinct from dental decay, which involves acid produced by oral bacteria.
Frequent acid exposure causes the enamel to wear away, leading to various visible effects. Teeth may appear thin, especially at the biting edges, and the underlying yellowish dentin can become exposed, causing discoloration. Enamel erosion often leads to increased tooth sensitivity to hot, cold, or sweet stimuli because the protective layer is gone.
Medical Conditions That Increase Risk
Chronic or frequent exposure to stomach acid directly causes severe dental erosion. Several medical conditions increase the risk of this type of dental damage. Conditions like Gastroesophageal Reflux Disease (GERD), or chronic acid reflux, cause stomach acid to flow back into the mouth, even without overt vomiting.
Other chronic illnesses or cancer treatments that cause persistent nausea can also subject teeth to repeated acid attacks. Eating disorders, such as bulimia nervosa, are known to cause severe erosion due to frequent, self-induced purging. The severity of dental damage correlates directly with the frequency and duration of acid exposure.
Severe morning sickness during pregnancy can also put teeth at risk due to daily bouts of vomiting. In these cases, the natural defense of saliva, which helps neutralize acids, is overwhelmed by the volume and acidity of the stomach contents. Decreased saliva production during illness further compounds the erosive threat.
Immediate Actions After Vomiting to Minimize Damage
The most important action immediately following a vomiting episode is to avoid brushing your teeth. Stomach acid temporarily softens the enamel, and brushing immediately will scrub the weakened enamel away, causing significantly more damage. Wait a minimum of 30 minutes, or ideally an hour, before using a toothbrush.
The correct immediate step is to rinse your mouth thoroughly to neutralize the acid. Swish with plain water to wash away residual stomach acid and begin the neutralization process. An even better option is to rinse with a solution of water mixed with a teaspoon of baking soda. Baking soda is alkaline and quickly helps restore the mouth’s pH balance.
Alternatively, an alcohol-free, non-acidic mouthwash can be used to rinse and help restore the oral environment. This immediate rinsing flushes the acid off the tooth surface, reducing the time the enamel is exposed to a corrosive environment. This simple step protects the teeth from further chemical dissolution.
Long-Term Strategies for Protecting Enamel
For individuals dealing with chronic acid exposure, a long-term dental care strategy is necessary to protect the remaining enamel. Regular dental check-ups are essential, as a dentist can detect early signs of erosion before they become severe. The dentist may recommend professional-strength fluoride treatments or prescription fluoride toothpaste or rinses.
Fluoride works by promoting remineralization, which strengthens the enamel and makes it more resistant to acid attacks. Chewing sugar-free gum after meals or episodes of reflux stimulates saliva flow, the body’s natural way of neutralizing acid. Saliva contains bicarbonate that buffers the acid, helping to raise the mouth’s pH.
If erosion is already significant, restorative treatments may be necessary to protect the teeth’s structural integrity. Dental bonding, which involves applying a tooth-colored resin to the affected areas, can cover and protect worn surfaces.
Restorative Treatments
In cases of severe enamel loss, crowns or veneers may be used to shield the tooth from further damage and restore its function.