When people think of things that can destroy teeth, most will only think of cavities. While cavities do account for a great majority of tooth damage, they are not the only problem against which we need to protect our teeth. Enamel erosion is a great destroyer of teeth, leading to sensitivity, an increase in wrinkles (really!), and the need for expensive dental restorations . . . all without a single cavity present in the mouth.
Enamel is the hardest structure in the human body. It is harder than the underlying dentin in teeth and harder than all of our bones. Enamel’s “kryptonite” is acid. Bacteria cause cavities through the production of acid. Acid is the only thing that can weaken and soften this hardest structure in the body. While bacteria use this acid to penetrate into the tooth, causing a cavity, you can have acid damage without the presence of bacteria. This occurs when the pH inside our mouths goes below a pH of 5.5.
Erosion is the process of a gradual dissolving of tooth enamel in the presence of an acidic environment. The outer coating of enamel on the teeth becomes thinner and weaker over time. It also becomes more translucent, showing through the underlying yellow dentin. Enamel erosion makes teeth look yellower and smaller. Because one of enamel’s roles is to act as an insulator of the nerve tissue within the tooth, when it thins and weakens, you lose the insulation effect. This makes teeth sensitive to cold foods and drinks.
Eroded enamel is also weaker and less capable of fighting off the attacks of cavity-causing bacteria. So while erosion is not the same as decay, it does place your teeth at a higher risk for decay. It provides a much thinner shell for bacteria to penetrate, making it easier for them to cause cavities.
Enamel erosion is always the result of an acidic pH in the mouth. This lowered pH can have three different sources.
Saliva is naturally alkaline (or basic) in pH, and it counteracts the acid attacks of bacteria. It helps maintain a neutral pH inside the mouth, in addition to its many other important purposes. When someone does not have an adequate amount of saliva, the resulting dry mouth has an acidic pH. Studies show that enamel begins to demineralize (soften) at a pH of 5.5. When the mouth is dry, it places you closer to that dangerous threshold.
Many of the foods and drinks we ingest are acidic, and depending on the method in which we eat and drink them, they could cause serious damage to the teeth. Unfortunately, almost every beverage outside of plain water is acidic. This includes sodas, sports drinks, fruit juices, coffee, tea, wine and beer. Even sparkling water is acidic, with the potential to erode tooth enamel. Foods that contain citrus fruits and tomatoes are acidic in pH, too. Because we stimulate saliva production when we chew, acidic foods are less dangerous than acidic drinks.
The risk for erosion increases with the length of time you expose your teeth to acidic drinks. Sipping a soda or sports drink over several hours can keep the pH of the inside of your mouth at or below the threshold for enamel damage. The actual volume you drink is less important than the length of time you spending drinking it.
A major cause of enamel erosion is the backflow of stomach acid into the oral cavity through severe acid reflex or GERD. Stomach acid has a very low pH (it is a very strong acid) and can quickly cause severe erosion of the tooth enamel. We also see erosion from stomach acid when someone vomits frequently. A telltale sign of bulimia is severe enamel erosion on the backside of the upper front teeth.
Stomach acid is not safe for the tissues of the oral cavity. Please do not ignore any of these serious medical conditions allowing stomach acid into the mouth. The effects on the teeth can be disastrous.
In order to prevent enamel erosion, you must address any of the causes listed above. We will give specific tips within each category.
Millions of Americans suffer from dry mouth as a side effect of prescription medications. The lack of saliva in a dry mouth leads to an increased risk for erosion, cavities, gum disease, and mouth ulcers. You can fight dry mouth by using various products.
To stimulate natural saliva production during the day, we recommend chewing sugar-free gum, preferably with xylitol as the sweetener. You can use small sweetened patches that stick to the roof of the mouth to help stimulate saliva at night (Xylimelts).
In addition to stimulating natural saliva production, you can use salivary substitutes to help lubricate the inside of the mouth. Biotene’s dry mouth gel and spray are great products to carry with you and use throughout the day as needed.
Lastly, you should drink plenty of water. Your body cannot make saliva if you are dehydrated. Make sure you are staying well hydrated every day. Avoid drinks that contribute to dehydration like alcohol and caffeine.
In the effort to keep the inside of your mouth at a neutral pH, you should avoid acidic drinks and foods. This can seem almost impossible to do, so we will add this caveat: avoid them between meals. When you are eating a meal, your body produces the highest amounts of saliva to counteract the acid. Between meals, though, there is much less saliva present.
So the tactic that will protect your mouth best is avoiding acidic drinks and snacks between meals. If you do enjoy an acidic beverage, drink it quickly instead of sipping on it for extended periods of time.
Because stomach acid is so much stronger than the other causes listed here, this is the most important one to address. If you do suffer from acid reflux, GERD or frequent vomiting, we urge you to seek medical attention. You may need prescription medication to control GI problems, or you could need to seek therapy for any eating disorders.
Unfortunately, many people wait until after enamel erosion occurs to seek treatment for the underlying medical conditions that contributed to it. This leads to the need for expensive dental work. You can prevent the damage of enamel erosion by addressing your medical problems first.
Call your nearest Premier Dental of Ohio location today to schedule a consultation with one of our caring dentists. We can answer any question you have about enamel erosion, assess your unique situation and make customized recommendations for prevention.