Understanding Tooth Erosion: Causes, Symptoms, and Treatment
Do your teeth feel weak or appear worn down? If so, you may be suffering from dental erosion. Dental erosion occurs when acids break down the outside layer of the tooth, dental enamel, and expose the underlying layer known as the dentin. Dentin is naturally yellow in color and much weaker in strength than dental enamel.
Although dental enamel, the outer layer of teeth, is considered the strongest substance in the body, it is still subject to damage caused by acids in the mouth. When acids breakdown dental enamel, this is known as tooth enamel erosion or teeth corrosion. Intrinsic erosion is caused by regurgitation of stomach acids from conditions such as acid reflux, anorexia, or bulimia. On the other hand, extrinsic erosion is caused by dietary acids, such as the consumption of sugars, sodas, citric fruits, excessive alcohol use and other items that are highly acidic.
How Saliva Impact Tooth Erosion?
Saliva plays a major role in oral health. In this section we will discuss the benefits of saliva.
Saliva can lower your risk of developing tooth erosion. Saliva helps neutralize the acidic beverages and foods we consume by increasing the pH of the mouth. Saliva also contains important minerals that help keep teeth strong and healthy. When individuals lack adequate amounts of saliva, such as those with dry mouth or conditions that impact the salivary glands such as Sjogren syndrome, they are more susceptible to experience tooth decay and dental enamel erosion.
Types of Enamel Erosion
Enamel erosion can be classified into several different types. This includes chemical erosion, attrition, abfraction, dietary erosion, and gastric erosion.
Chemical erosion refers to the chemical breakdown of teeth via acids not caused by oral bacteria. Chemical erosion can progressively weaken the teeth and lead to irreversible enamel loss. Common causes of chemical erosion include regurgitation of stomach acids and acids from dietary habits.
Attrition occurs when there is friction between your teeth. This is commonly caused by teeth grinding (bruxism) or clenching, which can wear down tooth enamel. This can make your teeth more susceptible to fracture and tooth decay.
Abfraction refers to the loss of dental enamel caused by excess stress and pressure. This often is noticeable near the gumline and appears as discolored V-shaped notches. Common causes of abfraction lesions are stress from biting, chewing, teeth grinding, and clenching.
Dietary erosion is caused by the ingestion of acidic foods and beverages. The acids from what we consume in our diet can lead to loss of tooth structure. Highly acidic items that commonly cause dietary erosion are citrus fruits, carbonated sodas, and sugary foods and beverages.
Gastric erosion is the loss of dental enamel caused by stomach acids. One of the most common examples of gastric erosion is acid reflux, which involves the flow of stomach acids into the oral cavity. Excessive vomiting can also cause gastric erosion.
Stages of Enamel Erosion
There are two enamel erosion stages. As the acids break down tooth enamel, the second layer of your teeth known as the dentin can become impacted.
Dental erosion initially only affects enamel, the outermost layer of the tooth. However, overtime, the tooth enamel wears away and reduces the strength of your teeth. This causes the tooth to appear thinner and translucent.
The second layer of your teeth, known as dentin, can become affected by acids as the enamel becomes penetrated. The dentin is a much weaker substance than enamel, which allows demineralization to occur in dentin at a much faster rate. Exposure of the dentin can also lead to tooth sensitivity and tooth discoloration.
What are the Symptoms of Tooth Enamel Erosion?
There are numerous symptoms of tooth enamel erosion to keep an eye out for. If you notice you have any of the enamel erosion symptoms mentioned below, be sure to inform your dental professionals for guidance and treatment.
- Discoloration of the Teeth - Tooth discoloration is a common result of tooth enamel erosion, which occurs as the white enamel layer thins out and uncovers the yellow dentin layer.
- Pain or Discomfort in Teeth - Teeth can become sensitive and trigger pain especially when eating or when pressure is applied to the teeth.
- Stained Teeth - Teeth impacted by dental enamel erosion will appear stained or yellow as the dentin layer becomes exposed.
- Sensitive Teeth - Dental erosion can lead to tooth sensitivity, especially when being exposed to different temperatures.
- Rough edges on the Teeth - Acids can cause the teeth to appear worn down and create rough edges on the teeth.
- Shiny Spots on the Teeth - Shiny smooth spots may appear on the teeth as the tooth enamel becomes demineralized.
- Increased Risk of Tooth Decay - Tooth erosion weakens the teeth, which can make them more susceptible to tooth decay.
- Fractured Teeth - As the teeth become weakened by acids, they can crack or break easier.
What Causes Tooth Enamel Erosion?
It is important to find out what causes enamel erosion so that adequate treatment can be performed. There are several potential causes of tooth enamel erosion, which we will now discuss.
- Gastric Reflux (including GORD) - Conditions such as Gastroesophageal reflux disease (GERD) and chronic acid reflux can erode dental enamel.
- Frequent Vomiting - Frequent vomiting allows your teeth to be in contact with stomach acids that are corrosive to dental enamel.
- Dry Mouth Syndrome - Inadequate levels of saliva in the oral cavity seen in people with dry mouth can allow harmful acids to remain on the teeth and cause enamel wear.
- Bulimia - Eating disorders such as bulimia can increase your teeth’s exposure to stomach acids and cause enamel erosion.
- Stomach-Irritating Drugs like Chemotherapy - Chemotherapy drugs and other stomach irritating drugs can upset the gastrointestinal tract, increasing acid reflux, and exposing teeth to acids.
- Asthma Medication from Inhalers - Asthma medications can contain ingredients, like sugar, which can increase your risk of tooth decay and dental erosion.
- Chewable Vitamin C Tablets - Some research has suggested that vitamin C tablets can create a more acidic oral environment, making your teeth more vulnerable to acid erosion.
- Mouth Rinses - Some mouth rinses, particularly those with alcohol, can be highly acidic and contribute to enamel erosion.
- Iron Supplements - Iron supplements may trigger acid reflux and thus increase your teeth’s exposure to harmful stomach acids.
- Cough Suppressants - Cough suppressants can contain acidic ingredients which can wear down tooth enamel.
- Citrus Fruits - Excess consumption of citrus fruit, like oranges, lemons, and limes, can erode tooth enamel.
- Vinegar - Vinegar is highly acidic, which if consume in excess can lead to dental enamel erosion.
- Fruit Juices - Fruit juices are often high in sugars and acids, which can make you more susceptible to tooth decay and enamel erosion.
- Soft Drinks (Sugary or Sugar-Free) - Sugary and sugar-free soft drinks like soda are highly acidic due to carbonation, which commonly contributes to enamel erosion.
- Wine - Wine and other alcoholic drinks can cause dry mouth, and are often highly acidic and sugary which can lead to enamel erosion.
What are the Tooth Enamel Erosion Treatments?
Enamel erosion treatment can vary depending on the cause. Your dental professional will perform a thorough examination and take into consideration your medical and dental history. They will determine the best treatment option for your specific case.
Dental sealant are thin coatings of protective dental restorative material to help prevent tooth enamel erosion. Sealants are typically applied on the chewing surfaces of the back teeth. They help prevent acid-producing oral bacteria and food particles from become trapped in within the grooves of the teeth.
Desensitizing agents often include ingredients that help reduce tooth sensitivity. These agents often work by blocking dentinal tubules, which contain nerve fibers that stimulate pain.
As mentioned, saliva is an important pH buffer that also provides teeth with beneficial minerals that keep your teeth strong. If you have inadequate amounts of saliva, your dental professional may recommend using saliva substitutes. There are many over-the-counter saliva substitutes that are commonly in the form of mouth sprays or gels.
Dental Crowns or Veneers
Dental crowns or veneers are great options to help fix damaged tooth enamel. They can help restore the function and appearance of your teeth. If you are missing a tooth, a dental bridge may be recommended to replace it.
Dental Tooth Extraction
In severe cases, it may be recommended to extract your tooth. This may be the case if there is not enough supporting tooth structure or if the tooth is infected beyond repair with any other treatment option. Your dental professionals will inform you of the many options available to replace your tooth after tooth extraction, such as with a dental bridge, implant, or denture.
Root Canal Treatment
Some individuals may require root canal treatment to remove dental infection and help restore the damaged tooth. A root canal involves removing oral bacteria and infection from within the tooth’s root, known as the dental pulp. The root is then sealed with a protective restorative material. Root canal treatment is often accompanied with a dental crown procedure to help protect the tooth from further damage.
Fluoride possesses many benefits for teeth. Fluoride is a mineral that has been proven by researchers to prevent tooth decay and tooth sensitivity. It has also been found to help remineralize teeth, strengthening your tooth enamel over time. Fluoride treatment is a great preventive care method that is placed by your dental professional in the form of a varnish, rinses, foams, or gels.
How to Prevent Enamel Erosion?
One of the best ways to treat enamel erosion is to prevent it from happening altogether. Luckily, there are several ways to prevent the erosion of tooth enamel or prevent it from becoming worse if it has already taken place. By following the examples of how to prevent enamel erosion mentioned below, you can help preserve the health of your teeth so that they last you a lifetime.
- Avoid Acidic Foods/drinks - One way to prevent enamel erosion is to avoid consuming highly acidic foods and drinks, such as sodas, citrus fruits and juices, coffee, and sour candies for instance.
- Use Straw For Acidity Foods - When consuming acidic beverages, use a straw to help reduce contact with your teeth.
- Limit Snacking - Limit frequent snacking throughout the day, which increases your exposure to acids and increases the likelihood of developing tooth decay.
- Chew Sugar-free Gum - Chewing sugar-free gum between meals can help stimulate saliva production, which naturally strengthens teeth with important minerals.
- Stay Hydrated - Stay hydrated with water throughout the day, which helps neutralize the pH of your mouth and rinse away oral debris and bacterial dental plaque.
- Use Fluoride Toothpaste - The American Dental Association (ADA) recommends using fluoride toothpaste, which provides several tooth-friendly benefits, such as strengthening the teeth with vital minerals and protecting against tooth decay.
- Do Gentle Brushing - It is recommended to use a soft toothbrush and brush gently to avoid damaging your tooth enamel.
- Consider Sealants - Speak with your dentist to see if sealants are a good option to help you prevent tooth erosion.
- Do Regular Dental Checkups - Schedule your regular dental checkups with our experienced team at Gentle Dental for all of your dental needs so that you can maintain good oral health.
Dental erosion can cause significant damage to your teeth, especially if left untreated. Acids caused by dietary habits or from conditions such as acid reflux, can cause irreversible tooth enamel loss. If you notice signs or symptoms of tooth enamel erosion, such as tooth discoloration, oral pain, teeth sensitivity, tooth decay, rough edges, or worn down or fractured teeth, it is important to seek help from your dental professionals immediately. Your dentist will discuss options for treating enamel erosion and help you get your smile back healthy and pain-free.