What is tooth erosion?
Cavities (dental caries) are caused by bacteria in the mouth. These oral bacteria produce acid from sugars and other carbohydrates (such as those found in pasta, potatoes and bread). This acid causes dental caries. Tooth erosion is the wearing away of tooth enamel by acids from food and drink or from the stomach. Eating habits have changed dramatically in recent years. For example, soft drinks and sports drinks are being consumed more frequently and in greater quantities. This results in tooth erosion. Here you can read how to prevent tooth erosion.
What is tooth erosion?
Tooth erosion is the dissolution of tooth enamel due to acid attack. It is an insidious process that is not easy to recognise. That is why prevention is of the utmost importance. If tooth erosion is not treated, the acids can dissolve the tooth enamel and then even the exposed dentine.
What does tooth erosion look like?
Tooth erosion in an 8-year-old child
Usually, you only notice tooth erosion at an advanced stage, for example when you experience discomfort while eating or drinking. By then, the tooth enamel has often already disappeared. You can only recognise tooth erosion when the appearance of the teeth changes. The front teeth become shorter, thinner and more translucent, or develop ragged edges. The teeth become (locally) increasingly yellow or develop dark spots. This is because the enamel becomes thinner and the underlying yellow dentine shines through more and more. Pits may form in the cusps of the molars. At a later stage, the cusps of the molars may even disappear completely. This means you are chewing on the dentine, which causes pain and sensitivity. Erosion does not affect fillings in teeth and molars. As a result, the fillings may protrude above the tooth surface.
How does tooth erosion occur?
Soft drinks and sports drinks are being consumed more frequently and in greater quantities.
Tooth erosion is mainly caused by acids from food. These acids dissolve your teeth. It is not just about how much acidic food and drink you consume. The more often you do so and the longer you keep acidic products in your mouth, the greater the risk of tooth erosion. The way you eat and drink also has an influence. For example, do you wait to swallow until the drink has lost its fizz? Or do you swish a drink around in your mouth to enjoy the taste? This means that the acid stays in your mouth for longer. Stomach acid can also cause tooth erosion. Vomiting and regurgitation cause stomach acid to enter the mouth. The more often this happens, the more severe the erosion will be. Stomach disorders can cause regurgitation and vomiting. However, people who vomit frequently due to an extreme desire to lose weight (anorexia nervosa) or people who binge eat and then deliberately vomit (bulimia nervosa) can also suffer from severe tooth erosion.
What is the role of saliva in tooth erosion?
Saliva protects your teeth against tooth erosion. It neutralises the acids in food and drinks. Some medicines or certain illnesses can inhibit your saliva production. This can make you more susceptible to erosion.
What causes tooth erosion?
Almost all drinks are acidic!
All acidic foods can be harmful.
1. Soft drinks and fruit juices
Soft drinks get their fresh taste from added phosphoric acid (for example in cola), citric acid or malic acid (in all kinds of soft drinks and sports drinks). You cannot taste the sour flavour because of the added sugar or sweetener. Sugar suppresses the sour taste, but does not neutralise the acid. Of course, you know that most soft drinks are bad for your teeth. But not everyone knows that fruit juices are even more acidic. So they are even worse for your teeth. Most sports and mixed drinks and most red and white wines are also acidic. The harmful effects of the drink have everything to do with its acidity. The more acidic the drink, the more harmful it is to your teeth. But it is not the acidity of the drink alone that determines whether damage is done to your teeth. The damage also depends on your drinking behaviour:
- the number of times per day that acidic drinks are consumed
- the time you hold an acidic drink in your mouth
- the way of drinking (rinsing the soft drink through the mouth until the ‘fizz’ is almost gone or swishing it around the mouth for the taste)
Bear in mind that almost all drinks are acidic! Water, coffee (without sugar) and plain tea (without sugar) and milk are exceptions.
2. Foodstuffs
All acidic foods, no matter how healthy, can be harmful to your teeth. You should be particularly careful with acidic fruits. These include citrus fruits, blackberries and berries, apples, grapes, kiwis and mangoes, as well as products made from them (apple syrup, jam, fruit juice). All foods that have been acidified with vinegar or citric acid, for example, cause tooth erosion when consumed frequently. Think of salad dressing or mayonnaise, for example. Many people suck on vitamin C tablets instead of swallowing them straight away. This can be disastrous for your teeth. Vitamin C products are already slightly acidic in themselves and are also flavoured with added sweeteners and citric acid.
How can you prevent tooth erosion?
Water, coffee (without sugar) and plain tea (without sugar) and milk are not acidic.
Do not consume acidic products one hour before brushing your teeth.
To prevent or limit erosion, you can take a number of measures:
Nutrition
- Limit your consumption of acidic drinks and foods. As an alternative, drink water, milk, coffee (without sugar) or plain tea (without sugar) if possible, i.e. no fruit or herbal teas.
- Keep acidic products in your mouth for as short a time as possible. So do not swish the drink around in your mouth. Do not suck on sour sweets or other acidic products either.
- Limit the number of times you eat or drink. Have three meals a day and no more than four snacks in between. Eat acidic fruit no more than once or twice a day. If you drink with your meal, this counts as one occasion.
Brushing teeth
- Brush your teeth twice a day. Use a soft toothbrush and fluoride toothpaste. Clean the spaces between your teeth once a day with interdental brushes, dental floss or toothpicks.
- Do not eat or drink acidic products one hour before brushing your teeth. The surface of teeth becomes softer due to the effect of acid. If you brush your teeth immediately after eating or drinking acidic products, you can easily brush away the enamel layer.
How often can I eat or drink something acidic per day?
Limit the number of times you eat or drink. Have three meals a day and no more than four snacks in between. Eat acidic fruit no more than once or twice a day. If you drink with your meal, this counts as one occasion.
Is there anything I can do to strengthen my tooth enamel?
Fluoride strengthens tooth enamel and makes it less soluble in acid. Fluoride slows down the dissolution of tooth enamel. Therefore, brush your teeth twice a day with fluoride toothpaste.
Should I brush my teeth before or after breakfast?
It is best to brush your teeth after breakfast. Do you consume acidic products for breakfast? If so, wait before brushing your teeth. Use a soft toothbrush and do not brush too hard.
Are young people more prone to tooth erosion than adults?
Young people drink soft drinks, sports drinks, other mixed drinks and fruit juices much more frequently and in greater quantities. In addition, their eating habits have changed dramatically. As a result, young people in particular are more susceptible to tooth erosion.
Are diet drinks better for my teeth than regular soft drinks?
Diet drinks do not contain sugar, but tooth-friendly sweeteners. However, they contain just as much acid as regular soft drinks. They are therefore just as harmful to tooth enamel. However, the risk of cavities (caries) is lower when you drink diet drinks.
Buttermilk and yoghurt (drinks) are also acidic. Why are they not harmful to my teeth?
Buttermilk and yoghurt have a high calcium and phosphate content. This means that tooth erosion hardly occurs. But beware of yoghurt drinks that contain sugar. These can cause cavities.
What is the best drink to give my child?
Your child may drink water and plain tea (without sugar) without restriction. Alternatively, you may give them milk. Limit the amount of fruit juices and acidic soft drinks, or dilute them with water.
I take medication. Does this increase my risk of tooth erosion?
Many medicines have the side effect of inhibiting saliva production. This can cause you to suffer from a dry mouth. The natural protection provided by saliva is reduced by the use of many medicines. If you then eat or drink a lot of acidic products, the risk of tooth erosion is even greater. You should therefore discuss this with your dentist or dental hygienist.
Does erosion also affect the colour of my teeth?
When the enamel layer wears away, you can see the dentine through the enamel. Dentine has a light yellow colour. This makes the teeth look darker.
Want to know more?
Then download the free GezondeMond app. The app is available for Android and tablets, available via Google Play. The app for iPhone and iPad can be found in the iTunes App Store..
© Ivory Cross
