Have you been told by your dentist that your teeth are at risk of erosion or that you’ve been grinding your teeth? Below may be useful information about the various causes of tooth wear.

What is tooth wear?

  • Tooth wear is the irreversible loss of tooth structure. The resulting structural loss is unsightly, impairs the function of teeth and is often painful. The damage can also be difficult and costly to repair.
  • There are three types of tooth wear: abrasion, attrition and dental erosion. These can sometimes occur in combination and can be difficult to determine the sole type of wear.
    • Abrasion: physical wear of the teeth caused by something other than tooth to tooth contact, e.g. overzealous tooth brushing, repeated use of a toothpick, or a habit of holding/using something between the teeth (nail biting, holding hair pins or sewing pins)
    • Attrition: loss of tooth structure due to tooth to tooth contact, such as tooth grinding.
    • Abfraction: loss of tooth structure due to overloaded force on the teeth, from grinding and clenching.
    • Dental erosion: dissolving of tooth structure due to the repeated presence of acids in the mouth.
Dental erosion

Dental erosion is the thinning of tooth structure due to dissolving enamel.

What does dental erosion look like? The first signs of dental erosion include:

  • Teeth appearing yellow: due to darker coloured tooth structure showing through the thinning enamel.
  • Teeth appearing glazed and smooth – due to the tooth surface being worn away.
  • Teeth appearing to be shorter.
  • Fillings sitting higher than the surrounding tooth surface.
  • Chewing surfaces of the teeth showing smooth, concave craters.
  • Sensitive teeth.

What causes dental erosion?

  • The cause of dental erosion is acid attack.
  • Many drinks including soft drinks, energy drinks, sports drinks, alcohol and fruit juices contain acids. Most of these drinks also have a high sugar content which contributes to tooth decay.
  • A diet high in acidic food and drinks can cause tooth wear. The lower the pH of a product, the more acidic it is. Any food or drink with a pH lower than 5.0 may cause tooth wear and tooth sensitivity.

 

The pH of some common foods and drinks
Milk pH 6.9
Flavoured milk pH 6.7
Tap water pH 6.0
Cheddar cheese pH 5.9
Coffee pH 5.0
Beer pH 4.5
Orange juice pH 3.5
Apple juice pH 3.4
Grapefruit pH 3.3
Pickles pH 3.2
Sports energy drinks pH 3.0
Common soft drinks and carbonated water pH 2.5-2.7
Red wine pH 2.5
Lemon juice pH 2.2
Vinegar pH 2.0

Other factors that contribute to tooth erosion:

  • A dry mouth – which increases the risk of damage from an acid attack
  • Stomach acid coming in contact with the teeth due to chronic regurgitation, reflux or vomiting (e.g. bulimia, morning sickness, peptic ulcer)

What should I do to minimise the risk of dental erosion?

  • Eat a well-balanced diet, and reduce the amount of acidic and sugary foods and drinks. Try to limit snacking.
  • Eat foods that act as a buffer by neutralising saliva pH more quickly (e.g. dairy products contain a protein called casein which protects teeth from acid).
  • Avoid holding or ‘swishing’ acidic drinks around the mouth as this minimises exposure of the drink to the teeth.
  • Chew sugar free gum to stimulate saliva flow and wash acids away.
  • Drink plenty of water frequently throughout the day, especially if exercising. Fluoridated water is ideal.
  • Avoid caffeinated beverages, as caffeine causes dehydration.
  • Do not brush immediately after eating or drinking acidic or sugary foods or drinks, as the tooth enamel will be softened and could be ‘brushed off’.

What should I do to minimise the risk of the other causes of dental wear?

  • To reduce your risk of abrasion, abfraction and attrition ensure that you are brushing your teeth gently twice a day with a soft toothbrush, and flossing daily.
  • Tooth clenching and grinding are common and are associated with stress, nicotine, caffeine, health conditions particularly snoring and sleep apnoea, and stimulatory-drugs particularly narcotics.
  • Stress-management and relaxation can be beneficial, and you may benefit from a protective guard for the teeth made by your dentist, to be worn at night

If you think your teeth are affected by any of the above concerns, please give us a call for a consult with one of our dentists.