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How to Prevent Dental Erosion?

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How to Prevent Dental Erosion?

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Dental erosion is the wearing away of the tooth structure by acids. This article discusses in detail the causes and management of dental erosion.

Medically reviewed by

Dr. P. C. Pavithra Pattu

Published At February 10, 2015
Reviewed AtApril 28, 2023

What Is Dental Erosion?

The gradual dissolution of dental hard tissue by acids is termed dental erosion. It is an irreversible loss of tooth structure. It does not involve bacteria. The dissolution of mineralized tooth structure occurs when acids come in contact with tooth structure.

What Is the Difference Between Erosion, Abrasion, and Attrition?

  • Erosion - Chemical wear of the tooth structure by extrinsic or intrinsic acids.

  • Abrasion - Physical wear of the tooth structure due to extrinsic mechanical processes, for example, tooth wear due to inadvertent brushing habits.

  • Attrition - Physical wear of the tooth structure due to intrinsic mechanical processes like excessive or abnormal forces from the opposite tooth.

What Causes Erosion?

  • Mostly, the extrinsic acids causing dental erosion are contributed by acidic medications and dietary components such as acidic beverages and foods (for example, colas, juices, soda, and alcohol below pH 4).

  • Backflow of gastric juice from the stomach occurs in diseases such as gastroesophageal reflux disease (GERD), bulimia, and rumination (regurgitation), thereby leading to dental erosion.

  • Teeth with diminished acid resistance, including developmental deficiencies and hypomineralization as in dental fluorosis, are more prone to dental erosion by acids.

  • The buffering capacity of saliva neutralizes the acids, thereby preventing erosion. But, in the case of reduced salivary flow rate, there is inadequate buffering action of saliva leading to dental erosion.

What Are the Changes in the Tooth Structure Caused by Erosion?

  • Occlusal Surfaces- These are the biting or grinding surfaces of the back (posterior) teeth. These surfaces show shallow and localized dimpling and exposed dentin (inner layer of the tooth). Loss of occlusal morphology is also seen in advanced stages.

  • Labial Surfaces- These are smooth and flat surfaces of the front teeth seen while talking and smiling. Shallow enamel defects are seen on these surfaces.

  • Palatal and Lingual Surfaces- These are the inner side of the upper and lower teeth where the tongue touches, at-rest position. Broad-based lesions and exposed dentin are seen. Flattening and loss of contour of the teeth occur in advanced stages.

  • Incisal Edges- Tips of the upper and lower front teeth are called the incisal edges. Incisal grooving of the affected tooth is seen.

The other clinical appearance of erosion include -

  • Broad concavities within smooth surface enamel.

  • Increased incisal translucency.

  • Wear on non-occluding surfaces.

  • Raised amalgam restorations.

  • The clear, non-tarnished appearance of amalgams.

  • Loss of surface characteristics of enamel in young children.

  • Preservation of enamel cuffs in the gingival crevice is common.

  • Hypersensitivity.

  • Pulp exposure in deciduous teeth.

  • Cupping of occlusal surfaces, that is incisal grooving, with dentin exposure.

Are There Any Medical Problems That Can Cause Dental Erosion?

  • Bulimia is a medical condition where the patients want themselves to be sick so that they can lose weight. This can damage the tooth enamel because of the high levels of acid in the vomit.

  • Acids produced by the stomach come into the mouth (known as gastro-oesophageal reflux).

  • Dental erosion is also found in people suffering from,

    • Hiatus hernia, where a region of the stomach is squeezed up to the chest through an opening present in the diaphragm.

    • Oesophageal problems.

    • Alcoholics.

What Is the Prevalence and Incidence of Tooth Erosion?

High prevalence is observed in children, and a high incidence is seen in adolescents.

What Are the Risk Factors of Dental Erosion?

  • Taking citrus fruits more than twice daily.

  • Consumption of soft drinks four to six times a week.

  • Eating disorder.

  • Bruxism habit.

  • More often intake of sports drinks.

  • More often, intake of apple vinegar.

  • Vomiting.

  • Excessive attrition.

  • Symptoms or history of gastrointestinal reflux disease.

How to Prevent Dental Erosion?

  • Avoid or at least reduce the dietary intake of acidic beverages.

  • Adopt drinking methods that limit acid contact with teeth (use a straw, gulp down, and do not swish around).

  • Avoid misuse of acidic medication, including vitamin C.

  • Use proper protection to minimize occupational hazards.

  • Clinical interventions such as treating underlying medical conditions like GERD, bulimia, etc. Get treated for reduced salivation. Increase the acid resistance of teeth through fluoride therapy (varnish, mouthwash, topical gel, toothpaste).

  • Have fizzy drinks, pops, and sodas, just at mealtimes, as it helps to reduce the number of acid attacks on the teeth.

  • Do not hold the drink in the mouth or swish it around the mouth as it can cause long contact with the teeth.

  • Always end a meal with milk or cheese, as it can help cancel out the acid.

  • Chew a piece of sugar-free gum after eating as it will help to produce more saliva to help cancel out the acids present in the mouth after eating.

  • Wait at least an hour after drinking or eating anything acidic before brushing the teeth, as it gives the teeth time to rebuild the mineral content again.

  • Brush the teeth at night and at least one other time during the day with a small-headed brush with soft bristles and fluoridated toothpaste.

  • Children up to three years should use toothpaste with a fluoride level of at least 1000 ppm (parts per million). Children above three years should use toothpaste from 1300 ppm to 1500 ppm.

  • Spit out the foam after brushing, and do not rinse the mouth so that the fluoride stays in the teeth for a longer period.

How Is Erosion Managed?

Identification of the etiology is the first step in the management of erosion. When excessive dietary intake of acidic foods or beverages is discovered, then patient education and counseling are important. When the patient has symptoms of GERD (gastroesophageal reflux disease), then he or she should be referred to a physician for complete evaluation and institution of therapy if indicated. A patient with salivary hypofunction may be given sugarless chewing gums or mints to increase the residual salivary flow.

In some cases, the etiological factors are not identifiable, and in other cases, the causative factor is difficult to control, such as alcoholism. Regardless of the cause, it is important to follow the preventive measures for erosion, and one of the important preventive measures is patient education. Much erosion prevention depends on the patient's compliance with dietary modifications, use of an occlusal splint, use of topical fluorides, etc.

What Is the Treatment for Eroded Teeth?

If a person experiences dental erosion, the dentist will suggest a few treatment techniques, tooth bonding being the first option. In this process, a tooth-colored resin is applied to the stained or damaged tooth. This procedure should be considered as an option if the enamel erosion causes discoloration of the anterior tooth. In severe cases, veneers are used to prevent further damage to the tooth. Root canal treatment (RCT) may be needed, followed by restoration of the tooth structure with a crown.

Conclusion:

Dental erosion is the loss of the anterior surface of the tooth, which is caused due to acid present in the food or drink, or the acid from the stomach. These acids wash away the enamel covering the tooth which results in damaging the tooth's structure. Dental erosion can occur at any age and can be treated by many various modes of treatment. The way to treat erosion is to prevent it from happening. The presence of enamel erosion can be prevented by maintaining good oral hygiene.

Frequently Asked Questions

1.

How To Treat Dental Erosion?

Two ways of treating dental erosion are:
- Tooth bonding, a cosmetic procedure, can be used in milder cases where the resin is tinted, matching the color of the teeth is applied over the affected enamel, and once set, it is bonded to the teeth following trimming and polishing.
- Crown can be placed on the damaged tooth in more severe cases to restore its function.

2.

Can a Dentist Fix Dental Erosion?

The dentist will suggest dental bonding if you are experiencing the earlier signs of enamel erosion. This is a relatively conservative restorative procedure. The dentist will place a tooth-colored resin on your teeth that will bond with your teeth and form a protective layer over the enamel before it began to erode. But in more severe cases, the dentist will suggest a veneer or a crown to your damaged teeth to prevent further decay or erosion.

3.

How Does a Dentist Fix Tooth Erosion at the Gum Line?

Tooth erosion commonly occurs at the gum line, leading to exposure of the root surface and the nerve endings of the teeth. For mild erosion with sensitivity, the dentist will suggest desensitizing toothpaste or a filling with tooth-colored material. Still, with exposure of nerve endings in severe cases, the dentist may recommend a veneer or a crown to fix it.

4.

Can Acid Erosion on Teeth Be Reversed?

Acids consumed from food items like citrus fruits, vinegar, or soft drinks can dissolve or erode the enamel off teeth by the washing or bathing action. The acid will cause the tooth surface to lose minerals from surface. We cannot reverse acid erosion, but people can take steps to protect their teeth against further progression. The portion of enamel lost cannot be replaced naturally, but it requires restorative dentistry.

5.

How Does Enamel Erosion Look Like?

In case of enamel erosion, the teeth may look yellow or especially shiny, with increased sensitivity to hot, cold, or sweet foods and roughness around the teeth' edges.

6.

What Can Be the Cause for the Erosion of Teeth?

- The leading cause of enamel erosion are acids found in the foods and liquids that are consumed.
- Regularly consumed foods and drinks with a pH below 5.7 may induce dental erosion.
- Improper brushing technique.
- The acid secreted in the stomach during the digestive process can dissolve any food, including bone and teeth.

7.

Can Coffee Be the Reason for Enamel Erosion?

Coffee is an acidic beverage that could help bacteria within the mouth to produce acids, leading to enamel erosion.

8.

How To Restore My Enamel Naturally?

To restore enamel naturally, you need to:
- Stop snacking.
- Avoid refined sugar and grains in your diet.
- Consume fat-soluble vitamins.
- Consume enough minerals.
- Support nutrient assimilation.

9.

What Type of Foods Can Cause Staining In the Teeth?

Acids can wear down the teeth while increasing the chances of stains setting in. The foods that can cause staining are:
- Coffee.
- Candies and sweets.
- Citrus fruits.
- Soft drinks.
- Tea.
- Berries.
- Red wine.
- Tomato sauce.
- Curry.
- Balsamic vinegar.

10.

Why Is Dental Erosion a Common Problem in Bulimics?

Studies show that between 47 and 93 percent of bulimia nervosa patients who vomit exhibit damage to tooth enamel. If you engage in self-induced vomiting, you should be aware that bringing acidic contents of your stomach into your mouth may cause erosion of the enamel surface of your teeth.

11.

How To Fix Acid Erosion on Teeth?

To fix acid erosion on teeth, you can use fluoride toothpaste and mouth rinse to replace the damage in milder cases or with dental fillings, veneers, or crowns in severe cases. To avoid further damage, you can:
- Drink plenty of water after consuming the acidic food or drink.
- Use a straw for drinking acidic beverages to reduce their contact with the teeth.
- Replace carbonated drinks with water, milk, or tea.
Source Article IclonSourcesSource Article Arrow
Dr. Nivedita Dalmia
Dr. Nivedita Dalmia

Dentistry

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attrition of teethfluorosishypomineralization of teethdental abrasiondental erosion
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