Summary

  • Dental erosion occurs when the surface of your teeth is dissolved by exposure to acid.
  • Dental erosion is preventable with proper diet, oral hygiene and regular dental care.
  • Treatment of dental erosion may require dental care. Ask your dentist for advice.
 
Dental erosion is the loss of the surface of your teeth due to acids you eat or drink, or acids coming up from your stomach. These acids can dissolve the crystals that make up your teeth, leading to tooth surface loss. These acids can also soften the tooth surface, making it easier for them to be worn away by abrasion or tooth grinding. This is known as acid wear. 

Stomach acids can cause dental erosion

The stomach contains many strong acids that are used to digest food. Vomiting and reflux can cause these stomach acids to enter your mouth.

Stomach acids are very strong and can cause substantial damage to the teeth. For example, people with bulimia, morning sickness or reflux (which can sometimes occur without you knowing) may experience this problem.

Dietary sources of acid can cause dental erosion

Many things that we eat and drink are acidic. One of the reasons for this is that acidic things taste nice. Common foods and drinks that contain high levels of acid, include:

  • soft drinks (sugar-free and sugar-containing)
  • sports drinks
  • energy drinks
  • citrus fruits (lemons, limes, oranges)
  • lemon-flavoured drinks or teas
  • fruit-flavoured lollies
  • most fruit juices
  • most cordials
  • vitamin waters
  • vitamin C tablets
  • vinegar
  • wine
  • pre-mixed alcoholic drinks.

Food acids are often added to processed foods and drinks. If you check the ingredient list of foods and drinks, you can see if food acids have been added. The ingredients are listed in order of their amount in the food, with the most being listed first. The closer any food acids are to the start of the list, the more acid the product will have in it. 

In particular, watch out for food acids 330 (citric acid) and 331 (sodium citrate), which are especially bad for teeth. For further information speak to your dental professional.

Symptoms of dental erosion

One sign of dental erosion is the loss of the surface of the tooth, leading to a smooth, shiny appearance. Dental erosion can also make any exposed tooth root (dentine) sensitive to hot, cold or sweet foods and drinks. 

When there is advanced dental erosion, the enamel may wear away to reveal the underlying dentine; these areas look like yellow depressions on the tooth surface (see below). Fillings may start to become more prominent if the surrounding tooth surface is dissolving away due to erosion.

BHC-Dental-Erosion

Photo: Dr Nathan Cochrane

Complications of dental erosion

Dental erosion, if untreated, can lead to the progressive loss of the surface of the tooth. The loss of tooth structure can require complex and lengthy treatment involving fillings, veneers, crowns and potentially root canal treatment. 

When the signs of dental erosion are detected, it is very important to determine the cause and modify it. 

 

Prevention of dental erosion

Dental erosion can be prevented by limiting contact of acids with the teeth. Some tips include: 

  • Eat a healthy, well-balanced diet.
  • Drink fluoridated water rather than soft drink or juice.
  • Eat fruit rather than drinking fruit juice.
  • Reduce how often you eat or drink anything acidic.
  • Use a straw if you are drinking something acidic.
  • Seek medical treatment for management of reflux or vomiting.
  • Do not chew vitamin C tablets. If necessary, take vitamin C supplements that are swallowed whole.
  • Use sugar-free chewing gum after meals to promote saliva flow. Saliva is very important for protecting your teeth from erosion.
  • Consider using dental products containing ‘stannous fluoride’ [Tin (II) fluoride]. Recent studies suggest stannous fluoride is effective in reducing tooth erosion. 

Following exposure to strong acids, you can help to neutralise the acid by: 

  • rinsing with water or a fluoride mouth rinse
  • rinsing your mouth with a sodium bicarbonate (baking soda) mouth rinse (one teaspoon of sodium bicarbonate in a glass of water)
  • consuming dairy products.

Tips to minimise tooth wear include: 

  • Use a soft-bristled tooth brush with fluoridated toothpaste.
  • Avoid using abrasive toothpastes (some whitening toothpastes are more abrasive).
  • Do not brush your teeth immediately after consuming something acidic.
  • Wear a custom made dental splint if you grind your teeth at night.

Saliva can help reduce dental erosion

Saliva is a powerful natural defence against erosion. Saliva can wash acids out of your mouth into the stomach, it can neutralise acid, and it can repair the early stages of tooth softening by repairing tooth mineral. However, it cannot restore the lost tooth surface. A reduced flow of saliva (dry mouth) can increase your risk of dental erosion. 

Stay well hydrated, as this improves your saliva. Remember that dehydration can reduce the amount of saliva you make, so drink lots of fluoridated water.

If you have a constant dry mouth, you may be at increased risk of dental erosion and you should consult your dental professional to identify the cause. 

Causes of reduced saliva

Causes of reduced saliva (or dry mouth syndrome) may include: 

  • medications – some can affect your salivary glands and reduce the amount of saliva that they can make, leading to a dry mouth
  • dehydration – working in a dry environment and not rehydrating often enough can lead to a decrease in saliva production. Also, excessive intake of caffeine found in coffee, tea, chocolate and cola drinks can reduce fluid levels in the body and reduce saliva
  • some specific diseases or conditions can affect the saliva glands, such as Sjogren's syndrome. 

 

Treatment for dental erosion

The lost surface of the tooth may need to be replaced with filling materials or crowns. It is important to visit your dental professional regularly so that they can identify dental erosion early, determine the cause, and then work with you to develop strategies to prevent further dental erosion and tooth wear. 

Where to get help

  • Your dentist or oral health professional
  • Your public oral health service
  • Dental Health Services Victoria community dental clinics. Tel. (03) 9341 1000
  • The Royal Dental Hospital Melbourne:
    • General dental enquiries Tel. (03) 9341 1000 or 1800 833 039 (from rural Victoria) Monday to Friday, 8:30 am to 4.30 pm
    • Emergency service Tel. 1300 360 054 Monday to Friday 8.00 am to 8.30 pm, weekends and public holidays 8.30 am to 8.00 pm
  • Australian Dental Association Tel. (03) 8825 4600
 
References
  • Schlueter N, Hardt M, Lussi A, et al. 2009, ‘Tin‐containing fluoride solutions as anti‐erosive agents in enamel: An in vitro tin‐uptake, tissue‐loss, and scanning electron micrograph study’, European Journal of Oral Sciences, vol. 117, no. 4, pp. 427–434.

More information

Mouth and teeth

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This page has been produced in consultation with and approved by: Australian Dental Association Victorian Branch

Last updated: March 2017

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.