Tooth wear, no matter what its cause, is a significant problem in our society. Over the last 5-10 years of my time in practice, I have seen a dramatic increase in tooth wear.
Of course, some of it can be blamed on grinding. But there is another cause of wear that many people do not know about. Erosive or chemical wear has become a big problem.
It has even been seen in kids as young as 5-6 years old. It’s a problem that we really need to get a handle on. Allow me to explain what erosive tooth wear is.
WHAT IS EROSIVE TOOTH WEAR?
Erosive tooth wear occurs because of a chemical process that breaks the tooth enamel down. There are two contributing factors to this type of wear.
One can have one of these contributing factors or the two combined. Obviously, the two combined types occurring in the same person cause far bigger problems than either one alone. Let’s discuss the two contributing factors.
INTRINSIC OR INTERNAL CAUSES
1. Gastric acids that come up into your mouth because of conditions such as gastric reflux or GERD. It is important to figure out if you suffer from this because the sooner it is treated appropriately, the sooner the destruction will cease.
2. Eating disorders are another cause of erosive wear. People who suffer from disorders such as anorexia or bulimia struggle with this because of vomiting. And chronic vomiting can cause them to have issues with dry mouth, which increases the susceptibility to erosion.
EXTRINSIC OR OUTSIDE OF THE MOUTH CAUSES
1. Dietary habits like ingesting carbonated drinks (which include soda, energy drinks, seltzer waters), tea, coffee, citrus juice, some wines, and sports drinks. These drinks have a very low pH, making them very acidic. Many people ingest more than one of these types of drinks a day; orange juice and coffee for breakfast, iced tea for lunch, sports drink at the gym, energy drink or soda midday to wake up, wine in the evening at a party.
That is a lot of acid in one day, and that’s just ONE day! Sports drinks and energy drinks seem to be the most acidic. Some foods are also acidic and should be eaten in moderation, such as apples, oranges, grapefruits, tomatoes, and lemons to name a few.
2. Dry mouth/reduced saliva flow is a major contributor to erosion. The saliva helps protect the enamel from destruction, and when it is decreased it cannot do its job. Many of the medications needed to help treat other conditions, unfortunately, have a side effect of dry mouth. Oral rinses or moisturizers are a way to help improve this situation, but one must be careful to make sure they are a neutral pH.
Chemical erosion is a problem we must be aware of, and do what we can to minimize its occurrence. Costly restoration of the teeth could follow after having erosion for many years. It is much easier to try to avoid it than to treat it.
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