Most people are familiar with the risks of tooth decay, but not everyone is familiar with tooth erosion. In tooth erosion, the enamel of your teeth is removed by an acidic attack, similar to tooth decay. Unlike tooth decay, which tends to affect specific teeth at isolated regions, tooth erosion affects many or even all of your teeth at once, causing global damage that often can’t be treated with treating just one or two teeth. It may require full mouth reconstruction to fix.

Of course, before we start treating your teeth, we want to identify the cause of your tooth erosion and stop it so that your teeth and gums don’t suffer more damage. And although tooth restorations are more resistant to acid damage, they can also be damaged if we don’t identify and control your erosion.

woman drinking soda through a straw

What is the Tooth Enamel?

The enamel is the top and most outer layer of your tooth and is also the hardest layer of the tooth as well as the hardest material in the human body. The enamel is translucent and serves the purpose of protecting the other layers of your teeth from daily use like chewing, crunching, grinding, and biting. Although it works as a shield, it can still become damaged. When it does, the other layers of your teeth won’t have as much protection and risk a higher chance of damage. One of most common ways the enamel becomes damaged is from erosion.

Erosion from Acidic Foods and Drinks

Most of the acidic damage to your teeth is caused by acidic foods and drinks, which might be described as extrinsic sources of acid. Of course, the most common and damaging acidic drink is coke, which contains many acids, and may be more acidic than pure lemon juice. The addition of sugars and the tendency to sip at these beverages constantly increases their potency for removing your protective tooth enamel.

You might give up your soda habit and think you’re avoiding acid, but that’s far from the case. We’ve already talked about sparkling water as being potentially damaging, but likely OK, but there are many other drinks that are also highly acidic. Fruit juices can be very acidic, and even diluting lemon juice in water won’t eliminate its acidity. Energy drinks are often very acidic. Sports drinks can be damaging because they’re acidic, they contain sugars, and you may be drinking them when your mouth is dried out from exercise, making it harder for your body to restore a neutral pH.

And don’t forget acidic foods. Some fruits and vegetables are very acidic, and they tend to get more so when they’re preserved. Acid helps to preserve the food and prevent bacteria from growing, so it’s encouraged. Food with vinegar or citric acid can be damaging to your teeth, which is why they’re not recommended for teeth whitening.

Acidic damage from beverages tends to be seen in the front of the mouth. You’ll notice that your front teeth are highly discolored. At first, this discoloration might respond to teeth whitening, but as the erosion worsens, you will notice that your teeth still look stained. This is the dark-colored dentin showing through your thinned tooth enamel. You might notice the enamel erosion on front teeth the most. To protect your teeth, cut down on these acidic foods and follow them with a glass of water. Using a straw for acidic drinks can also reduce the damage by limiting the direct contact between your teeth and the beverage. However, if the beverage is in your mouth, it’s going to contact your teeth, leading to erosion.

Erosion from Stomach Acids

But acidic attacks can also come from within the body. Stomach acid is very damaging to your teeth. If you have GERD (gastroesophageal reflux disease), your stomach acid bubbles up into your throat and mouth. This tends to erode the teeth in the back of the mouth more than the front, although it can potentially damage all your teeth when the GERD is more severe.

Vomiting also exposes your teeth to tooth damage. This is a very brief but intense exposure to stomach acids. Occasional vomiting is unlikely to cause serious damage, but if you experience regular vomiting because of alcohol dependency, chronic stomach disorders, or a purgative eating disorder like bulimia nervosa, you might see significant tooth erosion. Vomiting causes more intense erosion of the front teeth but starting with the backs and sides of the teeth. It may initially be less visible to you, but we can readily detect it and let you know what we see.

One danger of this type of erosion is that it tends to attack the less visible parts of the tooth first. Instead of highly visible damage to your front teeth, the first symptoms of the problem you notice might be tooth sensitivity. Tooth sensitivity should always be taken as a warning sign of potentially serious oral health problems, such as gum disease, cavities, or tooth erosion. Always report sensitivity when you visit our office.

Other times, people become aware of the amount of damage caused by these conditions when they need treatment for serious tooth problems. This might include the need for reconstructive dentistry or root canal therapy for infected teeth.

Erosion Enablers

The acidic attack is never the only source of damage to your teeth, and there are many other sources of damage that can work synergistically with an acid attack to increase the amount of damage done to your teeth.

Dry mouth, for example, isn’t inherently damaging to your teeth, but it can make acidic erosion worse. When your mouth is dry, it’s harder for your body to restore a normal pH, as we talked about with sports drinks. But dry mouth can also be caused by aging, medication, and dehydration. If you tend to get dry mouth a lot, drink more fluids, talk to your doctor about medications, and consider a saliva replacement.

Tooth grinding also makes erosion worse. Not only are you grinding away some of the enamel on the tops of your teeth, but you’re also stressing the entire tooth, which can cause the tooth to flex. When the tooth flexes, tiny cracks appear in the enamel. This allows acid to penetrate more deeply and increases the speed at which enamel is damaged or lost. Surprisingly, this type of erosion tends to appear at the base of the tooth. Grinding and clenching can occur from stress at work, or because of a TMJ disorder.

Tooth decay can also exploit thinned enamel to become more serious more rapidly. Oral bacteria produce acid when they consume sugars and other carbohydrates from your food. Enamel is vulnerable to acidic attack, but under the enamel, the dentin is even more vulnerable. When there is less enamel to protect your teeth, oral bacteria can penetrate to this softer layer more quickly, which makes your cavities grow and lead to an infected tooth even faster.

Tooth Erosion Treatment

Once we know why your teeth are eroding and taken steps to slow or stop it, we can talk about repairing the damage with tooth erosion treatment. Often, enamel erosion repair requires dental crowns to protect the eroded teeth from further damage, either because of more acid or because of stress on the weakened teeth. The number of dental crowns you need depends on the type and severity of your erosion. Sometimes, a tooth is so heavily damaged that it may need a root canal or it may even have to be removed and replaced with a dental implant. We can provide you with reconstructive dentistry to address your erosion.

Erosion doesn’t just damage your teeth, either. If you have experienced receding gums as a result of an acidic attack, Chao Pinhole ® gum rejuvenation can help restore your gums to a healthy position.

To learn how we can restore your smile to its healthy, beautiful former self, please call (910) 392-6060 today for an appointment with Wilmington, NC cosmetic dentist Dr. Michael Kuzma.