In its early stages tooth wear is often thought to be harmless. However as it progresses tooth wear can result in dentine hypersensitivity, loss of tooth shape and colour, and may require complex restorative intervention. Yet many people remain unaware of the consequences of tooth wear and the measures that can be taken to protect teeth from this slow and insidious process.
- Causes
A.Causes of tooth erosion due to extrinsic acids (from outside the body):
1. Teeth are lasting longer, Increased success by dentistry in the control of caries and periodontal diseases has extended the longevity of the natural dentition. Healthier unrestored teeth are exposed for longer to the gradual processes of everyday wear.
2. The modern diet paradox Modern diets are often rich in acids from a wide range of sources. Notably, many fruits, fruit juices, soft/pop drinks,vinegar-based salad dressingsand and wine have a low pH, sufficient to soften and demineralise enamel surfaces at approx pH 5.5 and below, and dentine at pH 6.5 and below, depending upon other factors such as titratable acidity, and calcium, phosphate and fluoride content. Large amounts of these beverages are not healthy for you for many reasons, so not only your teeth will benefit from reduced consumption, but also your nutrition status and your body's overall health. So-called "sports drinks" in particular contain large amounts of citric acid
Acid temporarily softens the surface of the enamel. It is a process normally mitigated by the natural action of saliva due to the presence of calcium, but frequent or prolonged acidic encounters leave less time for remineralisation to occur. In this weakened state, surface enamel is prone to wear from the abrasive action of toothpaste and tooth brushing.
3.Imbalanced eating patterns For example, not eating something that counterbalances the acidity of fruit, such as nuts, at the time of eating the fruit.
4.Snack foods ,Many of them are acidic.
5.Some medicines are acidic And therefore, erosive. They can cause dental erosion on direct contact with the teeth when the medication is chewed or held in the mouth prior to swallowing.
6.Environmental factors such as the chlorine and other chemicals in swimming pools can cause erosion over time.
7.Brushing habits, Don,t brush your teeth right after eating or drinking something acidic. Give your teeth some time. If you brush immediately after eating or drinking, you may cause tooth wear because the enamel is softened by the acid. After an hour or so, brush gently with a soft-bristled brush.
B.Causes of tooth erosion due to intrinsic acids (from inside the body):
1.Gastroesophageal reflux disease (GERD) or acid reflux, in which stomach acids come up into the oesophagus and mouth, can cause severe tooth erosion. Gastric acids are highly acidic with pH levels that can be less than 1.
2.Eating disorders Such as Bulimia or anorexia nervosa that cause frequent vomiting are also responsible for tooth enamel loss caused by the gastric acids.
Besides vomiting, persons who suffer from bulimia tend to consume larger quantities of fresh fruits and acidic beverages that worsen the problem.
3.Alcoholism could also cause vomiting related loss of tooth enamel.
4.Low salivary flow rate is a significant risk factor for dental erosion due to reduced pH buffering capacity (its ability to neutralize changes in mouth’s pH)
Signs and diagnosis
- Signs and diagnosis
Currently, dental erosion normally only reaches a diagnostic threshold when restorative dentistry is indicated. Improving recognition of the early signs and symptoms is crucial if effective preventative measures are to be taken.
A: Early signs
1. Sensitivity As dentine becomes exposed, an occasional slight twinge may be felt when consuming hot, cold or sweet foods and drinks
2. Discolouration Teeth can have a slight yellow appearance as the dentine shows through
3. Rounded Teeth A rounded 'sandblasted' look on the surface and edges of the teeth
B: Late stages
4. Transparency Front teeth may appear slightly transparent near their biting edges
5. Advanced Discolouration Teeth may show a darker yellow appearance which is the exposed dentine showing through
6. Cracks Small cracks and roughness may be present at the edges of the teeth
7. Severe Sensitivity As dentine continues to becomes exposed over time, teeth can suffer from severe dentine hypersensitivity
8. Cupping Small dents may appear on the chewing surface of the teeth , at this stage any fillings may appear to rise up
9.Pain or irritation in your mouth
10.Sharp tooth edges
At any stage of dental erosion, dentine hypersensitivity may occur. This could range from infrequent twinges during consumption of hot, cold or sweet foods, through to fairly continuous sensitivity readily provoked by the mildest of stimuli. Occasional sensitivity may well go unreported by the patient during routine examinations.
- Prevention
Intervention is key. Increased vigilance during routine examinations together with lifestyle advice can slow the progression of symptoms.
•Reduce or eliminate intake of carbonated drinks
•Cease retaining acidic foods and drinks inside the mouth
•Chew gum or suck a sugar-free lozenge to encourage saliva production and protect enamel, or eat a piece of cheese after an acidic meal
•Leave brushing of teeth for at least one hour after consuming acidic food or drink
•Brush with a soft toothbrush, using a low-abrasion, low-acidity, high-fluoride dentifrice
•Avoid fried or fatty foods if you have Acid reflux disease.
•Enjoy smaller, more frequent meals rather than eating large quantities at once.
•Take antacid tablets if needed, but don't over-use them.
•Drink plenty of water
•Do not smoke.
•Don't brush your teeth before eating or drinking something acidic? This probably doesn't happen too often, but if you do, you should stop. Brushing teeth immediately before drinking or eating something acidic brushes away the saliva that protects your enamel from acid.
•Don't brush your teeth too vigorously. It would seem like a good idea to brush hard, to scrub away all the remnants of food you've eaten. But brushing too vigorously can wear down and weaken a tooth's enamel. Instead, brush teeth gently, using circular strokes and a soft-bristled brush.
•Avoid grazing through the day. If you enjoy nibbling on food all day long, you may be endangering your teeth. The best solution is to ensure that the foods that you consume are either low in acidity or are combined with foods able to counteract the acidity and reduce your need for the acidic food. For example, consuming nuts with fruit or cheese with carrots may be one way to reduce the effects of acid wear. Nuts and dairy foods are considered helpful balancers to acidic foods.
• Rely on dental floss and toothpicks in between morning and evening brushing.
• Use a straw. Reduce the contact of juice and soda drinks with your teeth by drinking through a straw. This is only a minor help, so don't rely on it as a major solution!
- Things You'll Need
- Dental floss
- More water in your diet
- Neutral foods
Safe Whitening
Most commercial whitening products use peroxide-based solutions that whiten teeth without the erosion of enamel caused by acids.
What can you use as a natural way to whiten teeth? If used sparingly, baking soda. Although baking soda is abrasive and can cause wear on the enamel and roots of teeth, if used properly can help maintain a bright smile by removing accumulated surface stains on teeth. If you choose baking soda as a natural way to whiten teeth the following tips may help:
1. When brushing with baking soda, do not "scrub"! Brush gently to avoid wearing away the enamel and roots of your teeth.
2. To lessen the abrasiveness of baking soda and improve taste, first apply your normal toothpaste to your brush then dip into the baking soda.
3. The most effective way to remove stains involves making a slurry. Make the slurry by mixing a liquid with baking soda, then use an absorbent material such as a paper towel to "dab" the mixture and absorb the excess liquid, leaving you with a "paste". Using your favorite mouthwash improves the taste and provides other antimicrobial effects.
4. Limit the use of baking soda to one thorough brushing per month unless you have very heavy staining from coffee, tea, or smoking. Once per month is adequate for most people to maintain a whiter smile. Too much of a good thing will cost you in tooth sensitivity and enamel loss.
- Warning Do not ignore the signs of acid wear on teeth
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