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Enamel erosion, also called dental erosion or tooth erosion, occurs when acidic substances wear away tooth enamel (the outer layer of teeth).
Tooth erosion is a chemical process that exposes the more sensitive layers of a tooth, such as dentin. It does not involve bacteria.
In the U.S., enamel erosion is the second most common oral condition among adolescents. This is due to the frequent consumption of soft drinks, sports drinks, and fruit juices with low pH levels.6 Tooth decay (cavities) is the most common oral condition among adolescents.7
Enamel erosion can develop on both the back teeth (molars and premolars) and the front teeth (incisors and canines).
The most common types of enamel erosion include:
Common symptoms of early enamel erosion may include:
Common symptoms of advanced enamel erosion may include:
When an erosive substance (e.g., sugar or acidity) comes in contact with your tooth, the tooth’s surface will begin to dissolve.
The acids from this substance demineralize the enamel and the tissues beneath the tooth (also called dentin). This process leads to enamel erosion.
In the early stages, dental erosion only affects the enamel. Tooth enamel is the hard, mineralized surface covering your teeth.
The acids attack your tooth enamel and reduce the strength of your teeth. Over time, the outermost layer of your teeth begins to wear away.
Your teeth also become more translucent, and erosive lesions develop as the enamel thins out.
Dentin (the second layer of your teeth) has a different erosion process than enamel.
Enamel erosion causes a loss of surface tissue on the outer layer of teeth. Erosion also results in the demineralization of dentin and the permanent loss of tooth structure.
The small crystals in dentin dissolve quickly because they are more soluble than enamel crystals. When the dentin becomes exposed, tooth sensitivity and discoloration typically occur.
Enamel erosion can be caused by intrinsic or extrinsic factors.
These factors include:
Highly acidic, sugary substances can cause enamel erosion. These substances soften tooth enamel, which makes it easier for them to wear away by grinding (bruxism) or abrasion (erosion).
It is also important to avoid swishing or keeping acidic and abrasive substances in contact with your teeth. These foods and drinks include, but are not limited to:
All of these foods and drinks can also lead to cavity formation, especially when brushing and flossing are neglected.
Dental erosion is typically caused by sugars and substances with low pH levels (acidic foods and drinks).
Frequent vomiting, acid reflux, medical conditions, and improper oral hygiene practices can also lead to tooth erosion:
Dry mouth, also called xerostomia, is a non-life-threatening oral condition. It occurs when the salivary glands in the mouth do not produce enough saliva to keep the mouth wet.
Some proteins and antibacterial agents found in saliva kill bacteria and dilute acids. As saliva production decreases, acids in the mouth are not diluted, which results in erosion.
GERD is a more serious form of heartburn that occurs when your stomach acids come back up into your esophagus. The stomach contains gastric acid, small undigested food particles, pepsin, and bile acids.
Depending on the pH level of the stomach contents and if the contents reach the mouth, tooth erosion can occur.
The most common symptom of GERD is burning chest pain after eating spicy or acidic foods. The burning sensation may also become worse when lying down.
Many prescription drugs list nausea and vomiting as side effects, including opiates and chemotherapy medications. Other drugs that may induce vomiting in some people include aspirin and diuretics.
Medical conditions associated with vomiting can also cause enamel erosion. Common conditions include:
Bulimia nervosa, a life-threatening eating disorder characterized by a cycle of binging and self-induced vomiting, can also lead to erosive wear.
Long-term alcohol consumption can induce dental erosion. In addition to erosion, alcoholism is also associated with cavities. Bruxism and oral cancer are also common conditions associated with long-term alcohol use.
Enamel erosion associated with alcoholism can also be linked to frequent vomiting, regurgitation, or consuming alcoholic drinks high in acidity. The pH levels in most wines are low, which may result in erosion over time.
Vomiting during the first 12 weeks of pregnancy is very common. It is typically nothing to worry about unless oral hygiene is also neglected.
If vomiting is prolonged or occurs during multiple pregnancies, there is a higher chance dental erosion will develop.
Physical activity can decrease salivary flow and cause dehydration. This can increase the risk of enamel erosion when combined with highly acidic fruit and sports drinks. Intense workouts may also increase the possibility of gastroesophageal reflux.
There are different treatment options for dental erosion. However, if the dentin is already exposed, restorative dental treatment is necessary.
Dental erosion treatment options may include:
Tooth enamel is the hardest tissue in the body. Unfortunately, it’s not living tissue, so it can’t naturally regenerate. Once the enamel is eroded, it won’t grow back, even with a special toothpaste.
However, your teeth can be treated and remineralized.8
Remineralization is a natural process that keeps your teeth strong and healthy. The process takes calcium and phosphate minerals from your saliva and deposits them into your enamel.8
Over time, teeth will lose minerals due to the foods and drinks we consume; this is called demineralization. The main benefit of remineralization is that it can help prevent enamel erosion and dental infections.
Here are a few ways to remineralize teeth:
Erosion, by definition, means the enamel has already worn away. Unfortunately, any loss of enamel is irreversible.
To help prevent tooth erosion, common at-home oral care techniques include:
The cost of treatment depends on the type of restoration you need and how many teeth require treatment.
The prices below reflect the cost of standard dental erosion treatments without insurance:
Cavity Filling | $90-$300 (per tooth) |
Porcelain Veneer | $925-$2,500 (per tooth) |
Dental Crown | Up to $3,000 (per tooth) |
Dental Inlay | $650-$1,200 (per tooth) |
Dental Onlay | $650-$1,200 (per tooth) |
Enamel erosion is one of the most common oral conditions in America. There are different stages and types of erosion.
Enamel erosion can be caused by gastric acids (intrinsic) or external factors (extrinsic). Some different substances and conditions can cause enamel erosion.
There are treatment options for enamel erosion, but your enamel won’t grow back. However, it can be remineralized. The best way to prevent enamel erosion is by maintaining oral hygiene, avoiding certain foods/drinks, and visiting a dentist regularly.
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