Dental acid erosion

Dental erosion is the loss of tooth enamel caused by acid attack. Enamel is the hard, protective coating of the tooth, which protects the sensitive dentine underneath. When the enamel is worn away the dentine is exposed which can lead to pain and sensitivity.

Erosion usually shows up as hollows in the back teeth, thinning, or shortening of the front teeth and blunting of the sharp biting edges. Every time you eat or drink something acidic the enamel on your teeth becomes softer for a short while. The saliva slowly neutralizes the acid. However, until this happens your teeth will be more easily worn away, especially by brushing.

Causes of dental erosion

  • Carbonated/fizzy drinks, fruit juice, fruit squash, herbal tea, sports drinks.
  • Holding acidic drinks in the mouth, or swishing the drink in your mouth before swallowing.
  • Dry wines, lager, alcopops, mixers.
  • High alcohol intake, especially if this is linked to acid reflux or vomiting.
  • Pickles, vinegar, fresh fruits, yoghourt, spicy food.
  • Chewable or dissolvable vitamin C tablets.
  • Recreational drug use, especially where acidic drinks are consumed, while the user has a dry mouth as a result of the drug, and especially if the user also grinds the teeth at this time.
  • Acid vapours arising, for example, from batteries, fertilisers, chemical processing etc.
  • Acid in vapours from swimming pools (this can affect competitive swimmers).
  • Any medical condition causing vomiting.
  • Voluntary regurgitation of food from the stomach back into the mouth, before re-chewing and re-swallowing. (This is called rumination).
  • Stomach acid coming into the mouth due to hiatus hernia or reflux disease. (You may not know you have this; signs may include heartburn, indigestion, stomach pains, an acidic or metallic taste in the mouth, or they may be no symptoms at all. Silent reflux often occurs if you have a large meal and alcohol shortly before going to bed at night).

If you grind your teeth you may make the tooth wear worse.
If you have a dry mouth there will be less saliva in your mouth to neutralise the acids. Some people are more prone to acid erosion than others. Research suggests this is because some people have a higher mineral content in their saliva than others which is more effective at neutralising acids.

Advice for preventing further dental erosion

  • Limit acidic products. No more than two acidic drinks a day, ideally less if you are prone to erosion.
  • Drink acidic drinks quickly, rather than sipping them, and consider using a straw.
  • Have some cheese or milk, or sugar free gum after an acid attack, to help neutralise the acid.
  • Wait for an hour after an acid attack to brush your teeth, or brush your teeth before having the acid at breakfast.
  • Switch to vitamin C capsules if using chewable or dissolvable vitamin C.
  • Reduce alcohol intake.
  • Avoid large meals just before going to bed.
  • See your GP if you think you may have a relevant medical problem.