Dental erosion is the loss of the protective outer layer of the teeth, known as enamel, due to direct acid exposure. This process is distinct from tooth decay, which is caused by bacteria. Instead, dental erosion is a chemical dissolution of the enamel itself, weakening the tooth from the outside in when the oral environment becomes acidic for prolonged periods.
Sources of Acidic Damage
The acids that cause dental erosion come from both external and internal sources. External sources are primarily dietary, including frequent consumption of acidic foods and beverages like soft drinks, sports drinks, wine, and citrus fruits. The regularity of consuming these items is a significant factor, as it repeatedly exposes the enamel to acid before saliva can neutralize it.
Internal sources involve stomach acid entering the mouth. Medical conditions such as gastroesophageal reflux disease (GERD) can cause stomach acid to flow back into the mouth, especially while sleeping. Frequent vomiting associated with conditions like bulimia nervosa also introduces highly acidic gastric fluids to the teeth.
Signs of Enamel Erosion
The signs of dental erosion begin subtly and progress as more enamel is lost. One of the earliest indicators is tooth sensitivity, with discomfort when consuming hot, cold, or sweet foods and drinks. At this stage, the tooth surface may also start to lose its natural luster and appear slightly dull.
As erosion advances, the teeth may take on a yellowish appearance. This happens because the thinning enamel allows the underlying dentin, which is naturally yellow, to become more visible. Another sign is transparency along the biting edges of the front teeth. The chewing surfaces of the back teeth can also appear rounded or flattened as the enamel wears away.
In cases of severe erosion, small depressions or “cups” can form on the chewing surfaces of molars and premolars. The tooth becomes more susceptible to chipping or cracking. Fillings may also appear raised as the surrounding tooth structure erodes away around them.
Strategies to Protect Tooth Enamel
Protecting tooth enamel involves specific behaviors aimed at minimizing acid exposure. After consuming acidic foods or drinks, rinse the mouth with plain water to dilute and wash away the acids. When drinking acidic beverages, using a straw can help bypass the front teeth.
Limiting acidic foods and drinks to mealtimes is an effective strategy. Saliva production increases during meals, which aids in neutralizing acids and remineralizing tooth enamel. This reduces the overall time the teeth are subjected to a low pH environment compared to sipping on acidic drinks.
Wait at least 30 to 60 minutes before brushing your teeth after an acid exposure. Acid temporarily softens the enamel, and brushing immediately can scrub away the weakened surface. Using a toothbrush with soft bristles and a non-abrasive fluoride toothpaste helps clean teeth without causing additional wear.
Restorative Dental Procedures
When dental erosion has caused significant damage, a dentist may recommend restorative procedures to repair the teeth. These interventions restore the tooth’s original shape, strength, and appearance, while also protecting it from further damage.
For mild cases, dental bonding is a common solution. This procedure involves applying a tooth-colored composite resin to the affected areas to cover exposed dentin and restore the tooth’s contour. For moderate erosion that has caused cosmetic concerns on the front teeth, porcelain veneers may be used. Veneers are thin shells that are bonded to the front surface of the teeth to improve their appearance.
In instances of severe erosion where a substantial amount of tooth structure has been lost, a dental crown is often necessary. A crown covers the entire tooth, providing full protection and restoring its function and form. While these procedures fix the existing damage, they do not address the underlying cause of the erosion, which must be managed to prevent future harm.