Acid erosion on teeth can lead to a variety of symptoms that should be evaluated by a dentist. As the outer layer of your teeth wears away, you may experience tooth sensitivity. This sensitivity often leads to pain when you consume hot or cold foods and drinks.
A BRIEF HISTORY:
The problem has probably always been present but it is only very recently that it has been identified as a dental health problem.
WHAT CAUSES ACID EROSION IN TEETH:
The main cause of acid erosion is acids from acidic foods in our diet such as citrus fruits, fruit juices (citric acid), colas (carbonic acid), and energy drinks.Even some wines have a pH as low as 3.0 - 4.0 (anything below pH 5.0 is considered a problem).
A second cause can be acid from the stomach brought into the mouth through acid regurgitation in disorders like gastro-esophageal reflux disease ( GERD) or eating disorders like bulimia and anorexia nervosa.
EARLY SIGNS AND SYMPTOMS:
- Sensitivity - As acids dissolve away the patient's enamel the patient may notice some sensitivity to hot, cold, and sweets as the enamel disappears and the underlying dentin is exposed. This is often seen on the outsides of the teeth first.
- Color Change - As the enamel gets thinner we notice two distinct color changes. The incisal edges become more translucent as the enamel gets thinner. At the gum line the teeth get yellower as the white enamel gets thinner and the yellow dentin starts to show through.
- Change in Shape - The shape of the teeth may even change as enamel is lost. Also spaces may open in-between teeth.
- Wear - Teeth which have weakened enamel due to acid erosion will wear more quickly. If a patient has acid erosion coupled with bruxism the may wear away very quickly.
- Dental Restorations - May appear higher than the surrounding tooth structure. This is because the enamel dissolves away but the restorations do not.
- Divots May Appear - On the tops of the 1st, 2nd, and 3rd molars and notches ( called Abfractions) may appear at the gum line.
PREVENTION AND MANAGEMENT:
- Avoid Acidic Foods - (listed above) avoid snacking continuously throughout the day most especially on these sweet and acidic foods.
- Avoid Brushing Right Away - postpone brushing for awhile after eating these acidic foods as the enamel will be a bit more prone to abrasion at this time.
- Toothpastes - pastes which are specially formulated to help remineralize these areas are available and should be used. Pastes like Crest Pro-Enamel and fluoride containing rinses can be helpful.
- Bruxism - if you think that you are also a bruxer take measures to bring this problem under control. Purchase a night guard to prevent excessive wear on the acid weakened teeth.
GASTRO-ESOPHAGEAL REFKUX DISORDER (GERD):
The main symptoms of GERD are heartburn which is often worse when lying down or sleeping. A metallic or acidic taste in your mouth can be a common symptom. In the mouth eroded areas may appear especially on the tops of the lower molars or at the gum line.
- Causes - acidic foods, alcohol, over-eating (late in the day especially), smoking, obesity, and stress.
- Food Triggers - dairy products, chocolate, spicy foods, caffeinated beverages, and tomato based products.
BROADENING THE SEARCH:
Often dentists are asked to investigate the cause of many symptoms in the mouth including pain, bad tastes, and sensitivity. If a thorough investigation convinces the dentist that the problem is not of a usual dental origin the dentist will broaden the search into the surrounding areas. This generally includes the ear, nose, and throat areas. Infections in the sinuses can cause referred pain that feels like toothache. Infections from the nasal passages and sinuses can spread into the mouth causing discomfort and unpleasant tastes.
Similarly acids introduced into the mouth from acid reflux can cause sensitivity and unpleasant acidic or metallic tastes.