July 31, 2019 - Roland Chong

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What is tooth erosion?

Erosion of teeth is breakdown of teeth from frequent exposure to acid in the mouth. The breakdown of the teeth results from acid softening the tooth, weakening the outer tooth surface leading to destruction.

Dental erosion is happening more frequently today. The foods we choose to consume, such as carbonated soft drinks and some artificial sweetened foods with flavoring affect teeth in a bad way.

   

Figure 1. Generalised erosion of teeth.

In Figure 1, teeth in this individual has dissolved from over consumption soft drink. In addition, teeth grinding has led to shortened teeth. The yellow discoloured parts on the teeth are the dentine. Dentine is the inner portion of the tooth which is softer than enamel. Once the enamel wears away exposed dentine will dissolve and wear down faster.

What causes tooth erosion?

Tooth structure is very hard and tough but under conditions of acidity it will soften and break down. The loss of minerals from the tooth weakens the structure. Over time the teeth shorten as seen in figure 1.

Acid can be from foods we consume or from the stomach. The latter is from gastric reflux. There may be a problem with the ring of muscle located between the oesophagus and stomach. However undetected sleep apnoea can also lead to gastric reflux. When this muscle does not constrict acid will make it’s way into the mouth. Stomach acid is very erosive and frequent exposure from reflux will lead to tooth erosion.

Food acids are present in natural foods and man made beverages. Even soda water with no  sugar can cause erosion because it is carbonated. Any fizzy drink consumed will have some level of acidity which can harm your teeth. Natural foods like citrus fruits have high acidity especially lemon drinks.

Early signs of tooth erosion appear as cupping lesions on the tooth surface. In figure 2 below the front teeth of this individual are typical presentation of teeth which have been exposed to acid and active tooth grinding leading to the teeth being destroyed.

Figure 2. Upper front teeth showing signs of erosion and attrition from teeth grinding (bruxism).

Steps to take for protecting against tooth erosion.

  1. Reduce frequency of carbonated drink consumption, like coca cola.
  2. Avoid sugary drinks including fruit juices between meals. Stick with tap water.
  3. Don’t suck on lemons.
  4. Do drink plenty of tap water to stay hydrated.
  5. Rinse with water after consuming acidic foods like soft drink and wine.
  6. Consumption of soft drinks and alcoholic beverages like wine and ciders should accompany meals.
  7. Using a straw when drinking acidic drinks helps reduce contact with the teeth.
  8. See your dentist regularly so early erosive lesions can be managed and protected.
  9. Use fluoridated toothpaste and drink fluoridated water.

Regular dental examinations are important.

Early detection of erosive tooth destruction is important to avoid costly repair of teeth. When dentine become exposed the teeth will become sensitive to cold and hot beverages, sweet foods and sometimes to chewing. The longer the tooth is left exposed to the oral environment the greater the damage. In the long term rehabilitating teeth which have been destroyed by tooth grinding and erosion is very costly. The reason is replacing large portions of lost tooth structure require more complex dental work. Furthermore, the bite may also need to be re-engineered and this is a very costly exercise.

Dental erosion is becoming a big problem in modern society. Tooth erosion left alone will lead to significant problems for the individual. The dental problems are both cosmetic and dysfunction. Don’t ignore tooth erosion-act sooner rather than later.

 

Roland Chong

Roland has over 18 years experience as a general dentist. Roland does all aspects of general dentistry with a special interest in prosthodontics (crown and bridge work) and cosmetic dentistry. A member of the International Team of Implantology, Roland is constantly developing his skills by collaborating with international experts.