Tooth erosion is the irreversible loss of enamel, the hard, protective outer layer of your teeth. This process is caused by chemical dissolution from acids, not bacteria. When enamel wears away, it exposes the softer, more sensitive layer beneath, called dentin. The gradual nature of erosion means it can go unnoticed in its early stages, but over time, it can lead to significant changes in the appearance and feel of your teeth.
Causes of Enamel Loss
The acids that cause tooth erosion come from two distinct sources: extrinsic and intrinsic. Extrinsic, or external, sources are primarily related to diet. Frequent consumption of highly acidic foods and drinks, such as carbonated soft drinks, fruit juices, and citrus fruits, bathes the teeth in acid. This constant exposure prevents saliva from effectively neutralizing the oral environment, leading to the gradual dissolving of enamel. Wine and foods with acidic additives also contribute to this chemical wear.
Intrinsic causes of erosion originate from within the body. Conditions like gastroesophageal reflux disease (GERD) consistently bring strong stomach acid into the mouth, where it can damage enamel. Frequent vomiting associated with conditions like bulimia nervosa also exposes teeth to gastric acids. Another contributing factor is dry mouth, or xerostomia. Saliva plays a large part in neutralizing acids, so a reduced flow leaves teeth more vulnerable.
Identifying Tooth Erosion
One of the earliest signs of tooth erosion is increased sensitivity. As the protective enamel thins, the underlying dentin becomes more exposed, which can cause a short, sharp pain when consuming hot, cold, sweet, or acidic foods and drinks. This sensitivity often serves as the first indication that the enamel has been compromised.
Visual changes to the teeth are also common indicators of erosion. Teeth may begin to appear yellow as the thinner enamel reveals the naturally yellowish dentin layer beneath. The shape of the teeth can also be altered; they may look more rounded or develop small dents, known as “cupping,” on the chewing surfaces. The biting edges of the front teeth can become so thin that they appear transparent, and the teeth may become more prone to cracks.
Tooth Erosion vs. Cavities
While both tooth erosion and cavities damage teeth, they are different processes. Tooth erosion is a widespread chemical wear caused by acid exposure that does not involve bacteria. It affects broad surfaces of the teeth, resulting in a smooth, “melted” appearance.
In contrast, cavities, or dental caries, are a localized disease process caused by bacteria. Specific bacteria in the mouth feed on sugars from food and produce acids as a byproduct. These acids are concentrated in specific spots where plaque has accumulated, leading to the formation of distinct pits or holes in the teeth.
Management and Prevention Strategies
Preventing tooth erosion involves practical changes to diet and oral hygiene habits. Limiting the consumption of acidic foods and beverages is a primary step. When you do consume them, using a straw can help the liquid bypass the teeth. It is also beneficial to rinse your mouth with plain water immediately after consuming anything acidic to help wash away the acids.
Adjusting your brushing routine is another important preventative measure. After exposure to acid, enamel is temporarily softened, so it is recommended to wait at least 30 to 60 minutes before brushing. Using a soft-bristled toothbrush and a fluoride toothpaste can help protect the teeth. For existing damage, a dentist may recommend treatments like bonding, veneers, or crowns to restore the tooth’s structure.