Acid Wear - Dental Erosion

Dissolving teeth

Acid wear is fast becoming a very big concern in dentistry.

Like anything else in nature, teeth are susceptible to their environment. Ever heard that Cola can dissolve a tooth? Well the truth is there is a lot more than Cola or any other carbonated drinks that can damage teeth.

What is acid wear?

Acid wear is a type of erosion. The acid causes the tooth structure to demineralise. This essentially means that the tooth is dissolving. Acid wear is a chronic issue, meaning it occurs over an extended period of time and repeated exposure causes loss of tooth structure.

Where does the acid come from?

Acid causing dental erosion can be divided into two categories based on the source.

External

External wear means any acid that comes from outside the body. This means anything that you consume. Examples include:

-          Carbonated/Fizzy Drinks eg. Mineral Water, Soft Drinks, Energy Drinks, Beer

-          Sports Drinks and Pre-workouts eg. Gatorade

-          Wine

-          Fruit and Juices

-          Vinaigrettes and some salad dressings

-          Vitamin C tablets (chewable)

Various foods and drinks have varying levels of acidity. This is known as the pH level. The pH level ranges from 0-14, low pH means it is acidic and high pH means it is basic. A pH of 7 is neutral. Soft drinks for example have a pH ranging from 2.0-4.0. Just as a comparison, battery acid’s pH is 1 while water is usually ~pH7 (neutral).

Teeth are strong enough to withstand some acidity but only to a certain threshold. When the pH of the oral environment drops below ~5.5 teeth can start to erode.

Internal

Internal wear means the acid originates from within the body. Commonly this is due to gastric reflux (GORD – Gastro-Oesophageal Reflux Disorder). This is when the barriers between the stomach and the oesophagus, that normally keep stomach acid within the stomach, lax and allow reflux into the oesophagus. Stomach acid ranges from pH1.5-3.5 and can cause a lot of damage to teeth over time.

Pregnant women are also particularly susceptible to acid wear due to morning sickness.

What damage can it do?

Acid wear can cause generalised damage to all teeth within the mouth. Not only does it cause direct damage to the teeth in the form of erosion but it increases the risk of decay significantly. Once teeth wear and there is a loss of tooth structure, that tooth structure will never return. When the wear becomes significant enough it can cause further nerve problems within the tooth. Acid exposure can also pose problems when it comes to restoring teeth.

What can I do to prevent it?

Majority of acid wear is caused by extrinsic factors ie. diet. Diet is a major factor and simply reducing your acid intake already helps.

Other strategies to reduce the impact of acid wear:

-          Substitute with water or dilute with water

-          Rinse with water after having something acidic

-          DO NOT brush for at least 1 hour after something acidic/an acidic episode

-          Topical application of toothpaste or GC ToothMousse with your finger, spit-don’t-rinse

-          Eat cheese afterwards

-          See your GP if you think you may have symptoms of gastric reflux

Can it be fixed?

Once tooth structure is lost it will not form again. This means for areas where the acid has caused significant wear the only option is to restore it with a filling.

The acidic environment can cause accelerated wear of fillings as well, so it is very important to get the acid exposure under control before restoring these areas.

 Acid wear white fillings

 The acid wear as evident along the gum line in this case was moderate and we were able to identify the cause as dietary and restore the teeth before further damage was done. The fillings not only fill in the gaps but they protect the tooth structure underneath from further wear.

Acid wear is a chronic problem and many people are not aware of the damage that has been done or is occurring. Regular checks and cleans are important to detect these issues early so that the tooth structure can be protected.

After all:

Prevention is always Best.

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