Tooth Erosion: Symptoms, Causes, Treatment, Cost and Side Effects

Tooth erosion is the wearing out of teeth over time due to their dissolution with acids. These acids can be in the form of fruit juices, tea, coffee, cigarettes, red wine, soft drinks with excess of citric and phosphoric acids, dry mouth, acid reflux, certain medications like antihistamines and aspirin, sugar rich diet and sometimes environmental factors causing stress, friction, corrosion. The enamel which is the hard translucent covering of the tooth protects the tooth from the external agents. The reasons why the tooth surface gets eroded are attrition in which the teeth clench or grind against each other like that in bruxism, abrasion occurs wherein the tooth surface suffers physical wear and tear due to several reasons like improper flossing, brushing the teeth with excessive force, biting fingernails, pens or bottle caps and regularly chewing tobacco. Abfraction is the another reason of tooth enamel’s erosion due to fractures of tooth and corrosion of teeth that occurs mainly due to certain medication, very acidic foods, GERD and alcoholism. The symptoms of tooth erosion are painful sensitivity to sweet, hot and cold foods, cracking and chipping making the teeth look unsightly and cupping or cutting indentations on teeth. Treatment of tooth erosion cannot reverse the enamel growth on the tooth. The treatment options are mainly management of teeth so that they are no more unsightly and also are prevented from further erosion.

Tooth erosion is the wearing away of the topmost layer of the tooth i.e enamel. It is caused due to the action of acids from food or drinks which come in contact with the teeth surface. Symptoms associated with it mainly include:

• Sensitivity: There is a feeling of tooth sensitivity to certain kinds of food items including sweet as well as too hot or cold food items. This may be moderate to severely painful.
• Discoloration: Due to erosion of the teeth, dentin gets exposed. It gives the tooth its own shade which may be yellow, grey, or brownish.
• Cracking and chipping of tooth surface: As the enamel erodes, it gets chipped off and cracks, leading to sharp, irregular, and jagged tooth edges.
• Smooth and shiny tooth surface: Tooth when appearing as smooth and shiny surfaces, indicates a mineral loss.
• Cupping: The tooth surface shows indentations at the point of biting or chewing.

Summary: Tooth erosion is a common oral health issue accompanied by wearing away of the enamel. Important symptoms associated with it include pain and sensitivity, discoloration of the tooth, cracking or chipping of enamel, etc.

Tooth erosion involves loss of tooth surface or wearing away of enamel due to the action of acids. It is accompanied by chipping or cracking of the enamel. It may be caused due to the following:

• Excessive consumption of soft drinks: Soft drinks contain phosphoric and citric acids, which act on the tooth surface causing enamel loss.
• High sugary diet: Sugary food items provide a favorable environment for the thriving of bacteria, which secrete acid in the mouth. These acids act on the tooth surface.
• Sour candies: These are rich in acid, causing adverse reactions to the enamel surface.
• Fruit drinks: Acids present in these are erosive in action.
• Dry mouth: Low saliva in the mouth promotes an acidic environment, causing the wearing away of the enamel.
• Acid reflux: Acid in the stomach reaches the mouth due to backward esophageal reflux, leading to the action of acids on the tooth surface.
• Environmental Factors: These include factors like friction, stress, corrosion, wear and tear, etc. which are responsible for causing mechanical wearing away of the tooth.

Summary: Tooth erosion is caused due to the chemical action of acids on the tooth surface. The condition arises as a result of the consumption of certain food items which are responsible for creating an acidic environment around the tooth.

The diagnosis of tooth erosion is followed by a proper treatment plan and is done under the supervision of a dentist. Important steps involved in it are:

• Asking about the chief complaints: The patient is asked about the tooth pain and sensitivity. This involves asking about the onset and nature of both symptoms.
• Oral examination: A detailed examination of the oral cavity is needed for a proper diagnosis.
• Probing: In this step, teeth are probed using dental instruments to check for any cavity.
• Radiographic examination: It involves analyzing dental X-rays to check the extent of decay or cavities.

Summary: The diagnosis of tooth erosion is an important step based upon which a proper treatment strategy is decided. Important steps involved are taking a history of present illness, oral examination, probing, and radiographic analysis.

Tooth erosion can be treated using several techniques like bonding and veneer. Bonding can be used if the condition of teeth is not very bad. In the bonding technique a resin which is of tooth colour is applied on the teeth. Bonding quite effectively covers the eroded teeth and the faded colour of the teeth. This procedure also protects the teeth from future erosion and discoloration. In case the condition is very bad then the treatment can be done by placing veneers on the teeth. Veneer is a thin sheet that is prepared after taking images of the teeth. The veneer is then attached to the teeth with the help of cement. Before applying the cement the colour of the cement is chosen according to the teeth’s actual colour. The other preventive and management procedures done for the treatment are avoiding acidic foods like excessive tea or coffee consumption, modification of the pH of food to be taken in, using sodium fluoride solution as a remineralising agent either in the form of a tablet or a lozenge or mouthwash, application of varnishes or fluoride gels to increase the hardness of the enamel and make the enamel resistant to erosion and softening.

Any person whose teeth suffer extensive erosion due to which they look unsightly, cause pain and sensitivity are eligible for the treatment.

Only staining of teeth due to tea, coffee, wine, fruit juices and soft drinks do not make anybody eligible for treatment for tooth erosion.

Although tooth erosion is an irreversible process, it can be prevented by following certain measures. Some of them include:

• Avoiding consumption of acidic foods or beverages
• Use of straw while having acidic drinks
• Restricting consumption of snacks and packaged foods
• Taking sugar-free chewing gums in between meals so as to stimulate the saliva secretion
• Intake of plenty of water throughout the day, especially in conditions of dry mouth
• Use of toothpaste rich in fluoride content
• Using a soft toothbrush for proper cleaning of the teeth

Summary: The prevention of tooth erosion is possible through certain preventive measures. Those may include avoiding acidic foods and beverages as well as sugary diet, use of fluoride-rich toothpaste, intake of plenty fluids, avoiding packaged foods, etc.

No, there are no side effects of the treatment.

Post treatment guidelines for tooth erosion are avoiding too hot and too cold foods, smoking, alcohol and other acidic foods. It is also important that you brush the teeth at least twice daily.

Eroded teeth can never be reversed and the treatment with veneers and bonding can be done in a few days only.

The price of the treatment ranges from Rs. 1,000 to Rs. 30,000.

No, the results are not permanent.

Tooth erosion is caused by the acids present in foods. Hence, it is important to take care of the food items we are having so as to minimize the exposure of the teeth to an acidic environment. Some of the preferred foods may include:

• Fresh fruits and vegetables: These are rich in fibers which help to maintain proper cleanliness of the teeth and gums.
• Tea: This basically includes green as well as black teas. Polyphenols present in them either kill them or stop the growth of plaque bacteria.
• Chewing gums: Sugarless chewing gums are preferred. This increases the saliva formation in the mouth, which helps to cleanse the teeth.
• Fluoride-rich foods: Fluoride is needed for the teeth to maintain their strength. It also reduces the risks of tooth decay. Fluoridated water, dehydrated soups, powdered juices having no or less sugar, poultry products, seafood, powdered cereals, etc. are rich sources of fluoride.
• Milk and dairy products: These include cheese, plain yogurt, milk, etc. They provide sufficient calcium and phosphate to the teeth, restoring the mineral content. Cheese helps in saliva formation.

Summary: Tooth erosion is caused due to the chemical action of acid. The food items which are preferred in such conditions should be rich in fibers, minerals, and fluoride content. Other preferred foods include chewing gum, green tea or black tea, etc.

Based on research and studies, it has been found that more physical activities and exercises reduce the risks of periodontal disease, besides adding to better oral health conditions. People who are physically more active than the other ones are less likely to develop gum disease or other tooth-related problems.

Some of the exercises one can do even while brushing teeth to improve oral as well as overall health include the following:

• Wall sit
• Lunges
• Squats
• Sumo-squats
• Calf raises
• Jog in place
• Kegel exercises

Summary: Physical activities and exercises improve physical as well as oral health. They are considered to be effective in reducing the risks of tooth-related problems like periodontal or gum diseases, tooth erosion, etc.

Tooth erosion leads to the destruction of the mineral content of the tooth. It is necessary to detect such conditions early as being progressive, they may cause serious tooth problems starting just with cavities.

Complex dental procedures may be avoided with the prompt and on-time treatment of the tooth cavities. Some of the important ways to treat erosion include:

• Application of fluoride: Fluoride can help to restore the enamel if erosion or cavities are detected early. It is available in the form of gel, foam, toothpaste, varnish, etc., and effectively prevents tooth-related problems.
• Crowns: This is preferred when there is an extensive decay of the tooth. It consists of a custom-fitting covering which is placed over the tooth, replacing the natural crown.
• Fillings: These are used to restore tooth structure in case the cavity has reached an extensive stage. Available in the form of tooth-colored composite resins, porcelain, amalgam, etc., they help the tooth regain its lost strength.
• Root canal treatment: It is preferred when the cavity has reached the deeper soft tissues i.e pulp. This is the way to save severely infected teeth.
• Extraction of the tooth: Extraction is only preferred when the tooth cannot be saved with any of the methods like restoration, root canals, etc.

Summary: Tooth erosion is permanent and irreversible damage to the tooth structure. Certain dental procedures including fluoride application, crowns, and restorations, root canal treatment, etc. are preferred to treat such conditions.

The best alternatives to the treatment are preventing the teeth from erosion by avoiding acidic foods, too hot or too cold foods, alcohol etc.