Tooth Erosion -
Causes and Treatment

By dentist Dr. Richard Mitchell

The tooth they show is actually perfectly normal. If you shine a strong light through anyone's front teeth, you can see the light shining through them! Teeth are translucent. They transmit light, as well as reflect some and absorb some.

SO WHAT IS REAL TOOTH EROSION?

Erosion is usually caused by something acidic. It's where a tooth has been worn down, BUT NOT by rubbing on another tooth (attrition), or by rubbing on something else hard like a really hard toothbrush (abrasion).

So it's NOT caused by grinding or clenching your teeth at night. And also not by scrubbing your teeth with a hard brush. These things may make the effects of erosion worse, but erosion itself is caused by acids in your mouth.

How do I know if I have tooth erosion?

You may notice two things;

First, that your teeth seem to be worn down at the biting edges or biting surfaces. This can be caused by grinding your teeth alone, but is more noticeable if you are getting a lot of acids in your mouth too.

The picture above shows badly worn down biting edges on the visible teeth, especially the lower teeth.

Second, you might notice that the neck of some teeth (near the gum) seems to be worn away, and maybe a little yellower than the rest of the tooth. This is where the enamel has become thinner or else has disappeared from the necks of the teeth. This can also look and feel like small "notches" in the teeth that you can get a fingernail into.

Is enamel erosion important?

It can be, if it goes on for a long time. In the early stages it can cause sensitivity to cold drinks, acidic foods and sometimes sweet things. As the enamel surface gets more eroded, you can start to see the different yellower color of the next layer of the tooth (the dentine), and this may become a cosmetic concern. Finally, after a lot of tooth erosion, the tooth may become weaker.

What are the exact causes, and what can I do about it?

There are several possible sources of excess acid in your mouth. Here are the main ones, the most common sources are listed first:

• Sodas and soft drinks, such as Coke, Pepsi, Dr Pepper, Mountain Dew, Seven-Up, etc. Even the sugar-free versions are loaded with acid. Drinking these sodas occasionally is OK, but if you're drinking them regularly every day, then you are at increased risk of getting acid erosion on your teeth. ALSO, sports drinks such as Gatorade are acidic.

• But it's not just the "artificial" drinks - natural fruit juices are also acidic. Again, a glass of orange juice in the morning is fine, but if you are sipping juice the whole day long, your teeth are being bathed in acid for hours at a time.

• Stomach acids. This comes in two flavors; first, acid reflux. You may feel like you get indigestion a lot, and can taste acid in your mouth. Doctors call it gastro-oesophygeal reflux. Apart from being unpleasant, the stomach acids can damage your teeth over time.

• Second, bulemia. If you suffer from bulemia, and make yourself throw up after eating, then again your teeth are getting hit by stomach acids. The only difference here is that the inner surfaces of the teeth suffer more than the visible outer surfaces.

Enamel Erosion - Treatment

The first thing to do is cut down on acidic drinks. That means all sodas. If you drink a lot of fruit juice, try diluting it 50% with plain water. The best thing is simply to switch to water, period.

Then look at what you are eating. If you eat a lot of fruit, try to cut down, and limit it to once a day. Do not suck lemons or orange skins! Try switching to different types of vegetables.

Finally, to reduce the effects of tooth erosion, use a high-fluoride toothpaste, such as Colgate Gel-Kam, and remember to NOT rinse out with water after brushing; just spit out any excess toothpaste, and leave the rest.

The advertising industry has frightened a lot of my patients with pictures of so-called "acid" tooth erosion, but for most people it's not a problem.

Tooth erosion tends to occur more in people who are trying to have a healthy diet, but go overboard on the fruit juice! My advice is to dilute all fruit juices by 50% with plain water, and to use a high-fluoride toothpaste to brush with afterwards.

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