Tooth wear

Tooth wear is the irreversible loss of tooth structure, which is often painful, unsightly and impairs the function of teeth. The damage can also be costly and difficult to repair. There are 3 types of tooth wear: abrasion, attrition and erosion. It is sometimes difficult to determine the type of tooth wear present because different types often occur together.

  • Abrasion: physical wear of the teeth caused by something other than tooth-to-tooth contact e.g. overzealous or inappropriate toothbrushing, repeated use of a toothpick or placing hair pins between the teeth.
  • Attrition: loss of tooth structure from tooth-to-tooth contact, such as grinding of teeth.
  • Dental erosion: dissolving of tooth enamel due to the presence of acids in the mouth.

Signs and symptoms of dental erosion

The first signs of dental erosion include:

  • teeth appearing yellow due to darker coloured tissue showing through thinning tooth enamel
  • teeth appearing glazed and smooth due to the tooth surface being worn away
  • teeth appearing to become shorter
  • fillings sitting higher than the surrounding tooth surface
  • chewing surfaces of the teeth showing smooth, concave craters, and/or
  • sensitive teeth.

Causes of dental erosion

The cause of dental erosion is acid attack. Many drinks including soft drinks, energy drinks, sports drinks, alcohol and fruit juices contain acids. Most of these drinks also have a high sugar content that can cause the teeth to decay.

A diet high in acidic food and drinks can cause tooth wear. The lower the pH of a product, the more acidic it is. Any food or drink with a pH lower than five may cause tooth wear and tooth sensitivity.

The pH of some common foods and drinks are indicated below:

Milk pH 6.9
Flavoured milk pH 6.7
Tap water pH 6.0
Cheddar cheese pH 5.9
CoffeepH 5.0
BeerpH 4.5
Orange juicepH 3.5
Apple juicepH 3.4
GrapefruitpH 3.3
PicklespH 3.2
Sports energy drinkspH 3.0
Common soft drinkpH 2.7
ColapH 2.5
Red winepH 2.5
Lemon juicepH 2.2
VinegarpH 2.0

Other factors that contribute to erosion include:

  • a dry mouth, which increases the risk of damage from acid attack, and/or
  • stomach acid coming in contact with teeth due to vomiting from conditions such as bulimia, morning sickness and gastric reflux.

Preventing dental erosion

  • Eat a well balanced diet, and reduce the amount of acidic and sugary foods and drinks. Try to limit snacking.
  • Eat foods that act as a buffer by neutralising saliva pH more quickly (e.g. dairy products contain a protein called casein which protects teeth from acid).
  • Avoid holding or 'swishing' acidic drinks around the mouth as this increases the likelihood of tooth decay and tooth wear.
  • When drinking, use a straw whenever possible as this minimises exposure of the drink to your teeth.
  • Chew sugar free gum to stimulate saliva flow and wash acids away.
  • Drink plenty of water frequently throughout the day, especially if exercising. If available, drink fluoridated water.
  • Avoid caffeinated beverages, as caffeine causes dehydration.
  • Do not brush immediately after eating or drinking acidic or sugary foods or drinks as tooth enamel will be softened and could be 'brushed off'.

Help and assistance

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