Dental Erosion: Causes, Symptoms & Treatment
Dental erosion is the chemical dissolution of tooth enamel caused by acids, without bacterial involvement. It can lead to tooth sensitivity and permanent tooth structure loss.
Things worth knowing about "Dental erosion"
Dental erosion is the chemical dissolution of tooth enamel caused by acids, without bacterial involvement. It can lead to tooth sensitivity and permanent tooth structure loss.
What is Dental Erosion?
Dental erosion refers to the progressive, irreversible loss of hard tooth tissue – primarily tooth enamel and the underlying dentine – caused by chemical acids. Unlike dental caries, dental erosion does not involve bacteria. Instead, acids directly dissolve the minerals in tooth enamel, leading to permanent structural damage over time.
Causes
The causes of dental erosion are typically divided into two categories: extrinsic (from outside the body) and intrinsic (from within the body) acid sources.
Extrinsic Causes
- Frequent consumption of acidic beverages such as soft drinks, fruit juices, energy drinks, and wine
- Regular intake of acidic foods such as citrus fruits, vinegar, and pickles
- Occupational acid exposure (e.g., in chemical industries)
- Certain medications with a low pH (e.g., effervescent vitamin C tablets, aspirin)
Intrinsic Causes
- Gastroesophageal reflux disease (GERD): Stomach acid reaches the oral cavity and attacks the teeth
- Bulimia nervosa: Frequent self-induced vomiting leads to repeated acid exposure of the teeth
- Chronic vomiting from other medical conditions
- Reduced saliva production (xerostomia), as saliva normally neutralises oral acids
Symptoms
In the early stages, dental erosion is often asymptomatic and is typically identified during a dental examination. As the condition progresses, the following symptoms may develop:
- Tooth sensitivity to cold, hot, sweet, or acidic stimuli
- Changes in tooth colour (yellowing due to exposed dentine)
- Rounding and smoothing of tooth surfaces
- Visible enamel defects and hollowing (known as cupping) on chewing surfaces
- Altered bite position in severe cases
- Increased risk of cavities due to weakened enamel
Diagnosis
Dental erosion is diagnosed by a dentist through a clinical examination. Typical features such as enamel loss, changes in tooth shape, and exposed dentine are assessed. To classify the severity, the internationally recognised BEWE Index (Basic Erosive Wear Examination) is commonly used. Dietary habits and medical history are also reviewed to identify the underlying cause.
Treatment
Treatment of dental erosion depends on the extent of damage and the underlying cause.
Prevention and Conservative Measures
- Reducing consumption of acidic foods and beverages
- Using a high-fluoride toothpaste to support enamel remineralisation
- Rinsing with fluoridated water after acid exposure
- Chewing sugar-free gum to stimulate saliva production
- Waiting at least 30–60 minutes before brushing teeth after acid exposure
- Using a straw when drinking acidic beverages
Treating the Underlying Condition
- For GERD: pharmacological treatment (e.g., proton pump inhibitors)
- For eating disorders: psychotherapy and medical support
Dental Restoration
- Composite resin fillings for moderate tooth structure loss
- Crowns and veneers for severe damage to tooth surfaces
- Occlusal splints to protect teeth in cases of concurrent bruxism (teeth grinding)
References
- Lussi A., Jaeggi T. - Erosion: Diagnosis and risk factors. Clin Oral Investig. 2008;12 Suppl 1:S5-13. PubMed.
- Bartlett D., Ganss C., Lussi A. - Basic Erosive Wear Examination (BEWE): a new scoring system for scientific and clinical needs. Clin Oral Investig. 2008;12 Suppl 1:S65-68.
- Shellis R.P., Addy M. - The interactions between attrition, abrasion and erosion in tooth wear. Monogr Oral Sci. 2014;25:32-45. Karger.
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