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Tooth Wear

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Dental erosion or “tooth wear” is the loss of enamel and dentine from the tooth as a result of direct acid attack. It can be caused by excessive exposure to acid substances such as fruit juices and fizzy drinks. It is an irreversible condition. Tooth erosion differs from tooth decay. Tooth decay is the progressive loss of tooth enamel by plaque acid attack. Bacteria in the mouth break down sugars into acids which then attack the teeth. The most common teeth affected by dental erosion are the upper front teeth, although all teeth can be affected. Teeth that have been eroded look glassy, can appear short, and have uneven tips that are easily chipped away. Teeth that have been eroded may become sensitive. Research has shown that erosion is very common (50 percent of 4-18-year-olds have some tooth erosion).

The source of acid that causes the erosion is either from an intrinsic source from within the body (eg acid from the stomach) or from an extrinsic source from outside the body (eg acidic foods, drinks or medicines). Intrinsic causes are vomiting and acid reflux (where acid from the stomach escapes up into the mouth) which can be caused by a hiatus hernia, obesity or certain drugs. Fruit juices and soft drinks, together with foods such as rhubarb and citrus fruits, are examples of extrinsic sources of acid.

Regular check-ups at the dentist mean signs of erosion can be detected early. If dental erosion has been diagnosed the first stage is to record accurately how severe and extensive the damage is; this is best done by the dentist taking impressions of your teeth. The impression is cast in plaster and can be used to see if the amount of erosion is getting worse over a period of time.

For those affected by erosion it is important to:

  1. Limit acidic foods and drinks to meal times

  2. Reduce the number of times during the day that acidic foods and drinks are consumed

  3. Choose soft drinks which have no added sugar and have been shown to pose a negligible risk of tooth erosion

  4. Finish meals with a small piece of cheese or a drink of milk

  5. Delay brushing teeth immediately after having acidic foods or drinks.

It may be possible to improve the appearance of teeth that have been eroded with the use of adhesive filling materials, veneers or crowns. However, it is important that the cause of tooth erosion is identified first before this kind of dental treatment is undertaken.

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