Acid Erosion

Have you ever been told by your dentist your teeth show an evidence of acid erosion? But you wonder what acid erosion is?

I see acid erosion in my patients every day and I do get worried as this is an irreversible problem. 

 

WHAT IS ACID EROSION?

Acid erosion is a type of tooth wear caused by an acid softening the surface of the tooth. It is irreversible.

The outer coating of the tooth, enamel, is a hard mineralised tissue which protects our teeth. When tooth enamel is exposed to acids (from food, drinks, or stomach), it temporarily softens and loses some of its mineral content (demineralisation). 

Saliva containing minerals will help to restore the mouth balance and neutralise the acidity and harden the enamel, but this is a slow process. Because the recovery process is slow, if the acid attack happens frequently, the tooth does not have a chance to repair.

 

THE EFFECTS OF ACID EROSION

You may be not aware that acid erosion is happening until it has reached an advanced stage. Here are the most common signs of acid erosion:

sensitivity - as the inner layer of the tooth (dentine) becomes exposed as a result of enamel wear, occasional sensitivity may be experienced when consuming hot, cold  or sweet foods and drinks

transparency - front teeth may appear slightly transparent near the biting edges

discolouration - teeth may appear yellow as the exposed dentine shows through. With time, they may lose their shine and become dull. 

 

WHAT CAUSES ACID EROSION?

Frequent consumption of foods and drinks with a hight acid content can cause enamel erosion.

Various fruits, juices, squashes, smoothies, wine, some fruit teas, can be highly acidic and therefore may potentially have a damaging effect on the teeth. Acidic foods should not and often cannot be avoided; however care needs to be taken as to HOW you eat and drink. For example, swishing drinks may have damaging effect on tooth enamel because holding and retaining acidic items prolongs the contact of the acid with the tooth, but drinking with a straw can help prevent the damage.

The frequency of consuming acidic foods plays a huge role; for example: if you have one orange a day and you cut it in small pieces, that is fine; but if you have oranges five times a day and you bite into them with your front teeth, this may damage your teeth.


The most common acidic foods and drinks are:

  • acidic drinks: orange, grapefruit, lemon, blackcurrant
  • carbonated drinks including sparkling water
  • cider
  • white wine
  • sport drinks
  • acidic fresh fruit consumed with high frequency (lemon, oranges, grapefruit)
  • chewable or soluble vitamin C, aspirin, some iron preparations
  • some fruit teas
  • pickles

examples of acidic drinks

Acid erosion can be also caused by the contents of the stomach reaching the mouth, for example in people suffering form acid reflux

Another cause is being sick often - during pregnancy, or when you have problems with eating. 

 

HOW TO PREVENT ACID EROSION?

Modern diet is often rich in fruits, vegetables and fruit juices. However, acidic foods should certainly not be avoided altogether. Eating fresh fruit and vegetable is an essential part of a healthy balanced diet, rich in vitamins and antioxidants. 

You can take small steps to minimise the risk of acid erosion. First, I would encourage you to answer the flowing questions: 

  1. how many times a day do you eat or drink something acidic?
  2. how many times a day do you eat acidic fruit or vegetable?
  3. how many times do you drink fruit or vegetable juice?
  4. how many times a day do you drink soft or carbonated drinks?

You can take the quiz on the Sensodyne website here.

If your answers give you together three or more times a day, then you are at risk of acid erosion. 

 

HELP !

Early intervention and prevention is key. There may be many causes of acid erosion, but generally the following advice will help you avoid the damage to your teeth:

  • reduce the frequency of carbonated drinks intake, such as soft drinks or sparkling water
  • have your fruit juice with a straw. fruit juice should make only one of your 5 or more portions of fruit and veg a day
  • do not retain acidic foods and drinks in your mouth, including wine or beer
  • try not to brush immediately after eating or drinking; leave brushing of teeth for at least thirty minutes after having something acidic, ideally one hour; if you have orange juice for breakfast, brush your teeth before breakfast. you can use fluoride mouthwash after eating
  • do not give up healthy food in your diet, particularly fresh fruit, but do take a fresh look at how you eat it; for example, cut your apples and oranges in small pieces, drink juice with a straw
  • chew sugar free gum after meals or use fluoride mouthwash
  • brush your teeth with fluoride toothpaste, after brushing just spit out and do not rinse 
  • try to substitute carbonated drinks, juice drinks or squashes with water or milk
  • try to reduce sport drinks intake
  • have something alkaline (opposite to acidic) when you drink wine, for example cheese or nuts
  • if you are sick, try not to brush your teeth immediately, use fluoride mouthwash instead
  • have regular dental checkups and talk to your dental professional about any concerns

have your juice with a straw



Hope this post has helped you to find out more about acid erosion. If you have any questions, leave a comment below or visit any of the following websites, which I have also used as a resource:

Acid Erosion by GlaxoSmithKline 

The Acid Truth by Pronamel 


Illustrations by Rachael Yap

Photos by Justyna Kamecka