Tooth Wear : Acid Erosion

Acid Erosion occurs when teeth are exposed to acid, either dietary or within the body regularly over time.  Enamel, which covers the surface of your teeth, becomes thinner and more translucent, eventually wearing away altogether.  Enamel has a crystal structure so strong healthy enamel looks light in colour, enamel covers a layer of dentine which holds a lot of water so it looks a bit darker, as more and more of this dentine shows through thinning enamel the teeth can appear darker than they should be.  Like all tooth wear, one acid erosion has started and the enamel has become thinner its difficult to reverse this process, but we can definitely put some plans in place to try and stop the teeth wearing away any further.  This particular type of tooth wear is usually a back seat driver in all of the other tooth wear we’ve discussed above, especially attrition.  This is because thinner enamel will wear away faster, so by helping to prevent acid erosion it will have a positive effect on reducing the other kinds of tooth wear we usually see as well.

Stomach acid has caused enamel to wear away on the surfaces of the teeth closest to the palate.

But what is acid?? Basically there can be two types, acid that come from the body and acid that comes from our diet this acid dissolves our enamel over time so the fewer encounters our teeth can have with acid the better.

Enamel covering back molars has been worn away due to acid reflux.

The first type, acid from our bodies, covers vomiting and acid reflux, both of which you should seek advice about from your GP.  Here stomach acid washes over the surface of your teeth and if this happens frequently enough this will cause acid wear around the back of your upper front teeth and your molar teeth.  Usually solving the source of the problem is the best way to deal with this whether this treating the problem with some acid reflux medication - which should always be prescribed by your doctor or some more sensitive treatment as advised by your doctor re eating disorders or alcoholism. 

Also if you’re pregnant and experiencing a lot of morning sickness you might have some acid erosion to show for it at the end. 

The best advice if you suffer from any of the above is not to brush your teeth directly after a bout of acid reflux or vomiting, which is probably the first thing you would like to do so I sympathise.  Ideally you should wait at least 30 minutes before brushing your teeth but in the mean time freshen your breath with an alcohol free fluoride mouthwash if this would make you feel a bit better.  Avoiding eating late at night can also help.

The second kind of acid challenge our teeth face is from dietary acid.  Acidic foods and drinks is a really broad category but the usual suspects are:

• Fizzy Drinks

• Alcoholic Drinks

• Fruit

• Fizzy/Sour Sweets

• Fruit added to drinks eg hot water with lemon

• Pickles/Dressings

• Tomato based foods

You’ll see that lots of these foods are actually healthy, particularly fruit.  We ABSOLUTELY 100% want you to continue eating fruit (and vegetables) at least 5 portions each and every day, but the issue my friends is snacking and grazing on these foods. Again, here comes the science bit…

So, lets break this down. 

Sucrose Rinse = Sugary Drink

Demineralisation = Enamel starts to get soft

Remineralisation = Enamel hardens up again

pH 5.5 = The point where enamel gets soft and starts to wear away

If you are continually having acidic foods, or foods generally, your teeth don’t spend enough time in the remineralisation zone so constantly having acidic foods and drinks will cause your enamel to become soft and wear away faster.  This is why we should stick to having acidic foods and drinks at meal times to give our teeth time to recover before the next acid attack.  Your teeth would like you to avoid snacking and only drink milk or water in between meals, please and thank you.

But here is the real rub with acid erosion, not only is it a big problem in itself, it makes other types of tooth wear happen more and faster.  If your enamel is already soft and you start clenching or grinding your teeth as we’ve seen in attrition, if you haven’t I’ll link it here, we are going to loose tooth surface extremely quickly.  Similarly with over brushing, a softer demineralised surface will be brushed away faster than a tooth surface that’s been given time to recover after an acid attack.  So my advice for ALL tooth wear patients is careful with acidic foods and drinks, fine to have them but have them at a meal time because it is the frequency that we have acidic foods and drinks which pushes the fast forward button on all kinds of tooth wear.

But what can we do if our teeth are already showing signs of acid erosion?  Aside from cutting down on acidic foods and drinks as we’ve just mentioned we can protect and try to re-mineralise the surface of our teeth with toothpaste.  My favourite re-mineralising toothpaste for loss of enamel right now is by Spotlight Oral Care called Toothpaste for Rebuilding Teeth - I think they were having a ‘Ronseal’ moment.  This vegan toothpaste has been designed by Irish dentists and it has been clinically formulated to remineralise and replenish lost enamel.  Now it is on the pricer side and it can be slightly harder to get (although it should be stocked in most Boots stores in Ireland) so if you find that’s the case you can always try good old Sensodyne Pro Enamel*.  This particular Sensodyne actively strengthens weakened enamel while helping to maintain healthy teeth and gums.  Having strong enamel will also help your teeth look whiter and brighter, its a win win.

Thankyou so much for reading my blog! I really appreciate it :), remember acid erosion usually occurs alongside other types of tooth wear so check out my blogs on attrition, recession and over brushing if you can.

*gifted products