Tooth enamel is the hardest substance in the body. This bony, dense material needs to be strong in order to protect the sensitive living nerves and tissue deep inside the teeth during chewing. Enamel also keeps out bacteria and other pathogens that cause infection and inflammation in the tooth’s living tissue, known as the pulp. Although tooth enamel is extremely durable, it is subject to damage and deterioration caused by bacterial tooth decay and acid erosion. Enamel erosion is a serious dental condition that impacts over half of American adults and one-third of children in the United States, according to the National Institute of Health.
Enamel erosion starts out slowly, and most patients do not know they’re suffering from the condition until serious symptoms develop. These symptoms range from painful sensitivity when eating foods of hot or cold temperature, as well as crunchy or overly sweet foods. Some patients with enamel erosion also experience pain when brushing their teeth. Other symptoms of enamel erosion include cracks and fractures of the teeth, ad increased risk of tooth decay. Some patients with enamel erosion experience a yellowing of the teeth, as the hard, white out enamel thins and shows the yellow dentin underneath.
The number one cause of enamel erosion is a diet that is high in acid. Foods high in acid include citrus fruit and fruit juices, tomatoes and tomato products, coffee, tea and sodas. Other causes of an acidic environment in the mouth are foods that many people do not think about, such as carbohydrate laden foods like chips and pasta. These foods are high in sugar, which feed bacteria in the mouth. A byproduct of the bacteria reacting to sugar is the creation of acid. This acid damages the enamel by causing cavities and tooth decay.
“One of the main culprits of acid erosion is soda,” said Dr. Stefania Caracioni, D.D.S, L.V.I.F.
Caracioni is a Topeka, Kansas, dentist and discusses enamel erosion with her patients.
“Soda is high in acid and in phosphorus, which leaches calcium from the bones and teeth,” she said.
Drinking soda all day long continues to expose the teeth to acid, so Caracioni stresses that soda consumption should be minimized, and patients should brush their teeth soon after consumption.
“Diet sodas are not any safer,” said Caracioni. “Diet sodas with alternative sweeteners have been found to be just as damaging as to tooth enamel as regular sodas. For best protection, patients should drink regular tap water.”
Caracioni suggests regular tap water because most public water drinking systems have been treated with fluoride, a naturally occurring element found to fortify teeth against acid erosion.
“Skip bottled water as it lacks the necessary fluoride for teeth health,” said Caracioni.
Other causes of enamel erosion include xerostomia, or dry mouth and the use of some medications that dry out the mouth. This is because saliva is critical for maintaining the pH balance of the mouth, and helps to protect the teeth from eroding acid. Patients that have gastroesophageal reflux disease, or GERD, also experience a higher rate of acid erosion, as stomach acid frequently rises to the mouth and impacts teeth.
Tooth grinding also leads to enamel erosion says Caracioni.
“The pressure of tooth grinding will wear down the teeth over time,” Caracioni said. “Patients who grind their teeth should discuss their habit with their dentist and be fitted with a nighttime mouth guard to protect their teeth.”
Once lost, tooth enamel cannot be restored. Patients with enamel erosion may need to have their teeth bonded, if their case is severe. During bonding, the teeth are coated with a resin to help strengthen and protect the teeth. Other patients may need dental crowns to protect exposed, sensitive tissue. Patients with symptoms of enamel erosion should make an appointment with their dentist and discuss treatment options.