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Erosion

Dental erosion is a major problem in today’s society. Erosion is the loss of tooth structure due to acid damage. It initially affects tooth enamel and, if unchecked, may proceed to the underlying dentine. Erosion is usually caused by acidic foods and drinks with a pH below 5.0-5.7. Much evidence exists linking increased erosion with the consumption of soft drinks such as:

• Fruit drinks and juices such as lemon juices with high a concentration of citric acid. Drinks like smoothies are also very harmful in having a low pH combined with a large availability of fruit sugars which are quickly and easily digestible by bacteria in the mouth to release harmful acids.
• Carbonated drinks such as colas (in which the carbonic acid is not the cause of erosion, but citric and phosphoric acid). Energy and sports drinks, much like smoothies, are also loaded with acids and sugars.
• Wine has been shown to erode teeth, with the pH of wine as low as 3.0-3.8.
• Other possible sources of erosive acids are from excessive exposure to chlorinated swimming pool water.
• Frequent regurgitation of stomach acids results in erosion. This can happen inadvertently to people who suffer from excessive stomach acidity. Alternatively it is a common characteristic in the mouths of people with bulimia since vomiting results in exposure of the oral cavity to gastric acids. 

Dental erosion often changes the appearance and sensitivity of teeth; the tips of the upper front central teeth may become more transparent. Alternatively, the body of the teeth may become more yellowish as the surface enamel is removed over time, allowing the underlying dentine to show through. As this happens, the teeth may become more temperature and/or sweet sensitive due to the nature of the exposed dentine. The teeth may also change shape as the damage continues.

The damage is not limited to the front teeth; a phenomenon known as “cupping” can be observed on molar teeth, in which the tips of the cusps of the teeth start to exhibit little concavities. The teeth can start to develop cracks and an increased tendency towards breaking as they weaken.

As bacteria can’t actively damage enamel, except through acid damage, it provides a very valuable protection against decay. As the enamel becomes thinner, so does the layer of protection over the more vulnerable dentine; the propensity for developing tooth decay is therefore increased.

Abrasion

Abrasion damage is most commonly seen on the teeth at the gum edge as a concavity in the tooth, and can be as a result of overaggressive tooth brushing; it is most often also seen in conjunction with gum recession. In this, the gum of the tooth moves down the tooth, making them appear longer. The neck of the tooth that is exposed is made of dentine. This is softer than enamel, and therefore more prone to abrasion as well as decay. It is also more sensitive, and areas of recession can be more reactive to extremes of temperature, sweet, and even touch. Whilst gum recession can be caused by aggressive brushing, another common causative factor is bruxism (teeth clenching and grinding); this can also be a frequent contributor to  cavities at the gum edge (abfraction cavities) and bone loss around teeth.

Abrasion cavities can be filled with tooth coloured fillings, although this is not always the best option. We are able to help you identify and stop the causative factors of abrasion, as well as monitor the severity to ensure that the problem is not worsening. We also have options available to help desensitise abrasion areas, as well as strengthen the remaining tooth structure. The appropriate electric toothbrush is also commonly helpful to reduce the damaging effect of over-brushing, and our hygienists are able to advise how best the clean your mouth without sustaining further harm.