Tooth Erosion

Causes of Teeth Erosion

The oral cavity is not an acidic medium. The acids attacking the tooth surface can come from an intrinsic or extrinsic source.

• Intrinsic source

  The intrinsic acid source is the stomach. The stomach contains high-concentration acids that help in the digestion process. When these acids find their way to the oral cavity this leads to tooth erosion. Acids from the stomach may appear in the mouth due to gastro-esophageal reflux in GIT disorders and eating disorders, such as bulimia nervosa (frequent vomiting following eating due to fear of obesity).

• Extrinsic source

  The source of extrinsic acids is represented in the consumption of acidic foods and drinks with a pH lower than 5-5.7, such as lemon, orange, carbonated beverages, and sports and energy drinks. Unhealthy habits, such as frequent sipping of carbonated beverages, keeping them long in the mouth before swallowing, and citrous fruits sucking prolong the contact between these acids and the tooth surface which causes faster and more generalised erosion. Some medications of acidic nature, such as chewable vitamin C tablets may also contribute to teeth erosion.

  When these factors are combined with a diminished salivary flow, this causes more severe erosion, because there is no sufficient saliva to dilute these acids and the loss of the buffering action of saliva.

Teeth Erosion vs. Attrition

Both teeth erosion and attrition are characterised by protective enamel layer loss. The main difference exists in the cause.

Teeth erosion is the chemical loss of the enamel layer due to acids dissolving of the enamel layer. As the enamel layer becomes soft due to demineralisation, it can be easily worn off leading to dentine exposure.

Teeth attrition is the mechanical wear of the enamel layer. This can be caused normally by aging, excessive teeth contact due to bruxism, or a bad habit when you frequently bite on a hard object, such as a pen.

Consequences of Teeth Erosion

The inside surface of the teeth is the most affected by erosion, especially when caused by internal acids, while the external and the biting surfaces of the teeth are the least affected.

Acids cause demineralisation of the enamel layer and its subsequent wear. When the enamel layer is lost, this exposes the dentine layer to the oral environment.

Teeth erosion causes:

• Easy breaking and chipping of the tooth
• Sensitivity to hot and cold
• Tooth discoloration (due to the exposure of the more yellowish dentine layer)
• Raised restoration margins due to the breaking down of the surrounding tooth structure
• Easy caries progression

Diagnosis of Teeth Erosion

Dulwich Dental Office is London’s number 1 dental centre offering high-quality diagnostic services using innovative technologies. Our professionals have a wide experience backed up with continuous education to be always updated with the latest dental advancements.

The tooth erosion diagnosis is reached through the distinctive clinical features of erosion and the collected medical history and lifestyle habits.

Teeth erosion shows distinctive clinical features, including the loss of the enamel layer in the back surface of the teeth. This leads to subsequent discoloration, tooth fracture, and sensitivity.

Our dental experts collect a thorough medical history using detailed questionnaires to determine the root cause of erosion, such as: Do you feel heartburn? Do you have frequent vomiting episodes? If the questionnaire reveals an underlying medical condition, a referral to your healthcare provider is essential to manage the underlying condition and prevent further damage.

Additional lifestyle habits collection can point to the reason behind erosion, such as whether you consume soda, acidic fruits, sports drinks, and chewable vitamin C tablets.

Treatment of Teeth Erosion

After reaching a definitive diagnosis and eliminating the main reason behind tooth erosion, a treatment plan is designed to reverse the damage.

The treatment solutions for eroded teeth include:

• Topical fluoride application

  If teeth erosion is diagnosed in its early stage, where the damage only includes demineralisation without complete wear of the enamel layer, topical fluoride application can help remineralise the affected spots. If the damage causes complete wear of the enamel layer, topical fluoride application will not be effective.

• Dental bonding

  Dental bonding involves the use of a tooth-coloured restoration to cover the affected surface and prevent further damage and teeth sensitivity. This represents a conservative treatment solution because no tooth structure is removed.

• Veneers

  When the erosion affects the front surface of the anterior teeth, dental veneers represent a suitable solution. Dental veneers are shells of ceramic material used to cover the front surface of the teeth in a way similar to artificial nails. Dental veneers are durable and provide a naturally looking appearance. They are also a conservative treatment option, as they require little or no preparation.

• Dental crowns

  Dental crowns are recommende d when tooth erosion results in significant loss of tooth structure and a reduced height of the dental crown. A dental crown is a full-coverage restoration that encases the entire tooth crown, created after the tooth has been prepared to accommodate the crown.

Prevention of Teeth Erosion

• Limit your intake of acidic foods and drinks.
• Avoid brushing your teeth for 30 minutes after consuming acidic food or beverages to give the saliva the time to dilute acids, as immediate brushing causes enamel layer abrasion.
• Use a straw to drink acidic drinks to limit the contact between your teeth and the acids.
• Rinse your mouth with water or milk after consuming acidic food or drinks and after vomiting.
• Use a soft toothbrush and fluoridated toothpaste to avoid further damage to your teeth.
• Treat any underlying medication condition that may cause teeth erosion.
• Chew sugarless gum to stimulate saliva secretion.