How To Treat
Tooth Erosion

Are you wondering how to treat tooth erosion? Does tooth erosion really exist? Or is it just a phrase that advertising companies have cooked up to frighten you into buying particular toothpastes?

Most dentists use the term "teeth erosion" in a completely different way to the toothpaste adverts. Have you seen the television advertisements showing a small light shining through a front tooth, and a voice-over telling you how this proves that you have tooth erosion?

I think that those adverts are rather misleading.

The tooth they show is actually perfectly normal. If you shine a strong light through anyone's front teeth, you can see the light shining through them! Teeth are translucent. They transmit light, as well as reflect some and absorb some.

How To Treat
Tooth Erosion

Erosion is usually caused by something acidic. It's where a tooth has been worn down, BUT NOT by rubbing on another tooth (attrition), or by rubbing on something else hard like a really hard toothbrush (abrasion).

So it's NOT caused by grinding or clenching your teeth at night. And also not by scrubbing your teeth with a hard brush. These things may make the effects of erosion worse, but erosion itself is caused by acids in your mouth.

How do I know if I have tooth erosion?

You may notice two things;

First, that your teeth seem to be worn down at the biting edges or biting surfaces. This can be caused by grinding your teeth alone, but is more noticeable if you are getting a lot of acids in your mouth too.

close-up view of worn down upper front teeth

tooth erosion

The picture above shows badly worn down biting edges on the visible teeth, especially the lower teeth.

Second, you might notice that the neck of some teeth (near the gum) seems to be worn away, and maybe a little yellower than the rest of the tooth. This is where the enamel has become thinner or else has disappeared from the necks of the teeth. This can also look and feel like small "notches" in the teeth that you can get a fingernail into.

Close-up view of cervical erosion on upper front teeth.

Enamel erosion at the necks of the teeth next to the gum edges

Is enamel erosion important?

It can be, if it goes on for a long time. In the early stages it can cause sensitivity to cold drinks, acidic foods and sometimes sweet things. As the enamel surface gets more eroded, you can start to see the different yellower color of the next layer of the tooth (the dentine), and this may become a cosmetic concern. Finally, after a lot of tooth erosion, the tooth may become weaker.

What are the exact causes, and what can I do about it?

There are several possible sources of excess acid in your mouth. Here are the main ones, the most common sources are listed first:

Coke

Sodas and soft drinks, such as Coke, Pepsi, Dr Pepper, Mountain Dew, Seven-Up, etc. Even the sugar-free versions are loaded with acid. Drinking these sodas occasionally is OK, but if you're drinking them regularly every day, then you are at increased risk of getting acid erosion on your teeth. ALSO, sports drinks such as Gatorade are acidic.

But it's not just the "artificial" drinks - natural fruit juices are also acidic. Again, a glass of orange juice in the morning is fine, but if you are sipping juice the whole day long, your teeth are being bathed in acid for hours at a time.

Stomach acids. This comes in two flavors; first, acid reflux. You may feel like you get indigestion a lot, and can taste acid in your mouth. Doctors call it gastro-oesophygeal reflux. Apart from being unpleasant, the stomach acids can damage your teeth over time.

Second, bulemia. If you suffer from bulemia, and make yourself throw up after eating, then again your teeth are getting hit by stomach acids. The only difference here is that the inner surfaces of the teeth suffer more than the visible outer surfaces.

How To Treat Enamel Erosion

The very first step is to reduce whatever has been causing the enamel erosion in the first place.

The first thing to do is cut down on acidic drinks. That means all sodas. If you drink a lot of fruit juice, try diluting it 50% with plain water. The best thing is simply to switch to water, period.

Then look at what you are eating. If you eat a lot of fruit, try to cut down, and limit it to once a day. Do not suck lemons or orange skins! Try switching to different types of vegetables.

Finally, to reduce the effects of tooth erosion, use a high-fluoride toothpaste, such as Colgate Gel-Kam, and remember to NOT rinse out with water after brushing; just spit out any excess toothpaste, and leave the rest.

How To Treat Tooth Erosion

Bearing in mind that tooth erosion involves the loss of tooth enamel, the treatment must be focused on replacing the lost enamel. But we can't grow new tooth enamel and stick it back onto the affected tooth!

There are really only TWO options when it comes to replacing the enamel lost due to tooth erosion;

1. Composite bonding

2. Veneers or crowns.

Composite bonding involves covering the affected areas with tooth-colored filling material that is bonded to the tooth. This is very conservative because it does not require any tooth substance to be drilled away. At most, the enamel area bordering the area of erosion my be lightly polished to roughen the enamel, giving a stronger bond.

Veneers or crowns are more aggressive procedures, as they require the removal of some tooth substance. Veneers can be very thin and only need slight removal of tooth enamel. However crowns (or 'caps') require the drilling down of the tooth to make room for a full cap of porcelain.

Which method is best?

As always, IT DEPENDS.

Composite bonding does not involve any drilling or shots. The results can be very good, but may become a little stained over a few years, depending on how much coffee, red wine and cigarettes you consume!

Veneers are the next step, and can look extremely good. They will not pick up staining unless you are a heavy smoker. But, they are not as strong as crowns. If you have a heavy bite or you grind your teeth at night, they may crack or break.

Crowns can also look fantastic, and they are much stronger than veneers. They will not stain over time, but the downside is that the teeth involved need to be drilled down a bit to make room for the caps. This is the permanent removal of tooth substance, and this cannot be reversed. Once you have a crown on a tooth, it will always need a crown.

The advertising industry has frightened a lot of my patients with pictures of so-called "acid" tooth erosion, but for most people it's not a problem.

Tooth erosion tends to occur more in people who are trying to have a healthy diet, but go overboard on the fruit juice! My advice is to dilute all fruit juices by 50% with plain water, and to use a high-fluoride toothpaste to brush with afterwards.

If you are interested in treating enamel erosion, make an appointment with your dentist for a consultation and find out your options!