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There are two common reasons tooth wear occurs: acid erosion and attrition. In this blog, I’ll be exploring what happens in both cases, and what you can do to protect your healthy and beautiful smile.
The primary cause of worn teeth is acid erosion. Acid from drinks and our stomachs slowly dissolves the enamel (the outer surface of the tooth) until it reaches the dentine (the yellow inner surface of the tooth).
The speed of the erosion depends on the frequency of acid contact with enamel. Enamel is the hardest substance in the human body, so it can take a long time for acid to wear it away. When it finally reaches the inner surface of the tooth, however, the rate of erosion progresses rapidly because the dentine is so soft.
Let’s explore the two main suspects culpable for acid erosion:
Up to 80 per cent of adults are at risk of enamel loss as a result of what they eat according to the American Dental Association,
In fact, a study on the relationship between food habits and tooth erosion was conducted on Malaysian University students. It was found that 68 per cent of participants had tooth erosion. Those subjects who had received information about healthy eating were less likely to have tooth erosion.
Some foods in our diets can be incredibly acidic. The pH scale measures acidity or alkalinity levels in a range from zero to 14. Substances that fall below a pH of seven are considered acidic, and those above seven are alkaline.
When we’re not eating and drinking, our saliva should be in the neutral range of 6.5 to 7.5 pH. This range is perfect for preventing enamel erosion and tooth decay.
There are certain foods that are common in our diets that can become a problem when consumed in excess.
The most popular offenders are:
These substances range from two to five on the pH scale. I know lemon water is quite trendy these days, but when consumed in excess it will cause issues over time!
When consuming foods with high levels of acidity, you should rinse your mouth with water and wait at least an hour before brushing your teeth. This gives your saliva a chance to wash away the acid and reharden your enamel.
Dental erosion as a result of stomach acid generally progresses more rapidly and can be more severe. This is because our stomach acid has a pH between one and two, which is incredibly acidic – much more so than the foods in our diet.
Stomach acids can enter the mouth for a multitude of reasons, most obviously vomiting, but also as a result of gastroesophageal reflux disease (otherwise known as acid reflux). This is when acid from the stomach leaks up the oesophagus due to weakened oesophageal muscles.
Patients with these conditions should be especially mindful of staying hydrated. Saliva is an excellent natural defence against tooth wear as it helps to clean the teeth of acid and allow the enamel to reharden. Many acid reflux medications can cause an incredibly dry mouth, so chewing sugar-free gum and drinking lots of water should help.
These include:
Acid erosion is difficult to identify before it becomes a problem unless you are being regularly monitored at a dental practice. This is yet another reason it is so important to visit your dentist on a regular basis – even if you don’t think there are any issues in your mouth.
Your dentist and hygienist will take digital scans of your teeth and compare them over time. This is the only real way of identifying tooth wear before it requires treatment.
With regards to stomach-related acid erosion, take note of regular heartburn which could be a sign of acid reflux. In these cases, I recommend visiting not only a GP, but also your dentist or hygienist to keep a close eye on your teeth. You may have heard stories from women who have experienced loss of tooth structure during pregnancies where they suffered with regular heartburn.
Dental attrition is caused by “tooth to tooth contact”, such as grinding or clenching teeth. The resulting friction causes enamel to wear down.
Many times, teeth grinding and jaw clenching are stress and anxiety induced. If you’re experiencing stress and anxiety to such an extent that your teeth are being affected, I recommend you consult a professional. After all, the healthiest and most beautiful smiles come from happy and confident people, and we all deserve to feel this way.
A 2011 study on the prevalence of dental attrition found that 80 per cent of participants (400 subjects out of a total of 500) showed signs of dental attrition up to the dentine.
If you’re struggling with attrition as a result of grinding your teeth or clenching your jaw and can’t seem to stop, I recommend investing in a hard acrylic mouth guard to protect your teeth during your sleep.
The rate of wear as a result of acid erosion is much faster than erosion by attrition.
The long-term consequences of tooth wear depend on a multitude of factors, including but not limited to a patient's genetics and the source of erosion. If no tooth wear protective measures are put in place, you might be putting yourself at risk of tooth ache, sensitivity, and even tooth loss. Once the erosion reaches the inner tooth, it could cause an infection in the nerve, which might require root canal treatments.
A consequence of tooth erosion that many patients fear the most, however, is simply an uneven smile. Teeth become shorter very gradually – over time you might not notice, but looking back at pictures might make you gasp at the difference!
Whilst this consequence is cosmetic, it can be a huge knock to your confidence. Confidence is a key ingredient in a healthy and beautiful smile, and that’s why I so often stress the importance of regular check ups with your dentist.
Reduction of stress, being mindful about your diet, and consulting a professional are great ways to protect your teeth.
Remember – simple is best! The best way to look after your teeth is simply to brush them for two minutes twice a day with a fluoride toothpaste. Enamel that has fluoride in it is stronger than enamel without fluoride.
No matter where your tooth wear comes from, a good dental practice should be completely non-judgemental. At London Dental Specialists, we are always here to help. Irrespective of the cause of your tooth erosion, there will be a solution and we can show you. Complete the form below so we can restore your smile to its former glory.
