Tooth erosion is the breakdown of tooth enamel by acids without the involvement of bacteria. This causes the teeth to become damaged and unable to repair themselves. Dental erosion is one of the 15 most common dental problems in the world.
Causes of tooth erosion
External causes (dietary and lifestyle factors)
Highly acidic foods and drinks:
Soft drinks (cola, energy drinks), fruit drinks (orange, lemon and apple juice). Acidic foods, fruit with a high acid content (citrus fruits with citric acid, pineapple). Foods containing vinegar (salad dressings, pickled vegetables), alcohol (wine).
Poor oral hygiene:
Brushing teeth immediately after consuming acidic foods can further erode the already damaged tooth enamel. Toothpaste with a high abrasion value (RDA value over 100) or brushing too hard can also be the cause.
Occupational exposure to acids:
People who work in the chemical industry or who often come into contact with acidic vapor (e.g. winemakers, chemists) are more likely to suffer tooth damage. Contact with chlorinated water can also affect tooth enamel.
Internal causes (physical factors)
Reflux disease (GERD) and eating disorders (bulimia, anorexia):
Stomach acid from frequent vomiting attacks the teeth. This means that people who vomit often often come into contact with acid. Women who suffer from severe nausea during pregnancy are particularly at risk.
Genetic factors, habits, and medications:
Some people have naturally thinner or softer tooth enamel. This can cause them to lose teeth more quickly. Bruxism cannot directly lead to tooth damage, but can cause teeth to wear down more quickly. Certain medications or chewable tablets containing vitamin C can damage tooth enamel.
Xerostomia (dry mouth):
If you don’t salivate enough, acids cannot be neutralized and erosion occurs. Possible causes include medication or not drinking enough. Stress, smoking and illnesses such as diabetes or radiation treatment can also contribute to this.
General symptoms of tooth erosion
The signs of tooth erosion are subtle at first, but become more obvious over time:
- Sensitivity: The teeth are more sensitive to cold, hot, sweet or acidic foods.
- Discoloration: As the enamel breaks down, the dentin underneath appears more yellow.
- Shiny or smooth tooth surface: Affected areas appear particularly smooth or shiny.
- Thinning teeth: The cutting edges of the front teeth can appear transparent.
- Change in tooth shape: The chewing surfaces appear flattened or hollowed out.
- Cracks and notches: Depressions or cracks develop, especially in the neck region of the tooth.
Course of tooth erosion – stages of enamel erosion
1) Early Stage (Beginning Erosion)
In the early stage of tooth erosion, the damage is small and often goes unnoticed. The hard outer layer (enamel) begins to lose essential minerals because of repeated exposure to acids. This process makes the enamel slightly softer and more vulnerable to further acid attacks.
This can make the tooth surface look a bit smoother than normal, which is a sign of early wear and tear. Although the tooth is still mostly intact, some people may feel a bit more sensitive to hot, cold, or sweet foods. This is because the enamel is getting thinner, which reduces its protective barrier.
2) Middle Stage (Progressive Erosion)
As the erosion gets worse, the enamel keeps getting thinner. At this point, you might see the underlying dentin, which is a softer, yellowish tissue beneath the enamel. This can make teeth look more transparent or duller than before.
As well as looking different, the teeth often become more sensitive to hot and cold and to touch. Your teeth may also become more rounded or flattened because of constant acid exposure. In some cases, small dents or cupping lesions can form on the biting surfaces of the teeth.
3) Advanced Stage (Severe Erosion)
At this stage, the enamel is worn down a lot and the dentin is left exposed. Dentin is naturally more yellow than enamel, so teeth can look much darker. The teeth may also show signs of wear and tear, such as dents, increased roughness, and weakening.
Another problem with advanced erosion is that teeth become more sensitive. Dentin contains microscopic tubules that allow external stimuli to reach the nerves inside the tooth. The compromise of the protection barrier significantly increases the risk of developing cavities and bacterial infections.
4) End Stage (Extreme Loss of Tooth Substance)
In the last stage, the loss of enamel and dentin is so bad that the teeth become unstable. The erosion can go deep into the tooth and expose the pulp (the part containing nerves and blood vessels). This can cause constant or severe pain, even if you’re not eating or drinking anything that could cause it.
At the end stage, the exposed dentin and nerves make the teeth highly susceptible to abscesses and decay. Therefore, at this stage, conservative treatments may not work, you might need dental implants in Turkey to replace the tooth structure.
Treatment of tooth erosion
- Fluoridation: Fluoride-containing toothpaste or special gels strengthen tooth enamel and increase resistance to acids. Fluoride varnish strengthens the teeth, while protective splints reduce the risk of mechanical wear (e.g. from teeth grinding).
- Change in diet: Avoid acidic drinks such as soft drinks. Use a straw when drinking acidic drinks to protect your teeth. Acidic foods should be combined with neutralizing foods, such as cheese or yogurt. Chewing gum without sugar can promote saliva production and thus improve the neutralization of acids.
- Optimizing oral hygiene: After consuming acids, rinse your mouth with water before brushing your teeth. Use a low-abrasion toothpaste and a soft toothbrush at least twice a day.
- Filling therapy: For minor damage, tooth-colored composites can be used. For severely affected front teeth, a ceramic veneer can be applied. Veneers in Turkey offer an optimal solution.