What is Erosive Tooth Wear?

The term “erosive tooth wear” broadly describes various types of loss of tooth enamel. Significant erosive tooth wear occurs in about 30 percent of adults and is something that increases with age. Three general types of erosive tooth wear exist, and they have different causes.

Demineralization

The first type of erosive tooth wear, demineralization, is the loss of enamel caused through the action of acids on the teeth. While early and slight demineralization can be remineralized, continued and severe erosion caused by demineralization can lead to permanent loss of enamel.

Attrition

“Attrition” in a dental context refers to the loss of tooth enamel caused by the mechanical effects of tooth bearing against tooth; specifically, grinding or chewing.

Abrasion

Dental abrasion is the third type of enamel erosion and is similar to attrition. This is the loss of enamel caused by the mechanical effects of non-tooth materials on the teeth. Abrasion can begin quite young, as when the mamelons (points on the edges of new teeth) of young children wear away.

What Does Erosive Tooth Wear Look Like?

Erosive tooth wear appears differently in different parts of the mouth, at different stages in its progress, and depending on its cause.

When erosive tooth wear is caused by demineralization, it is most likely apparent in discolouration of the tooth surfaces, as the whiter enamel loses density and thickness and the more yellow-coloured dentin starts to show through. Such discolouration can appear anywhere in the mouth but is more likely to appear on the insides of teeth as those areas as generally most exposed to acids.

Attrition and abrasion appear as wear on specific surfaces of the teeth. When wear occurs on the anterior (front) teeth, it shows most as the cutting edges of the teeth being reduced in height and width; when wear occurs on the posterior (rear) teeth, it shows most as loss of enamel where molar meets molar and then later in a loss of crown height with dentin being exposed.

Erosive tooth wear is not the same thing as loss of enamel leading to dental caries (cavities) arising from the activity of bacteria in the mouth, although both demineralization and dental caries are linked to acids in the mouth. The difference is that demineralization arises from directly exposing the teeth to acids introduced into the mouth, whereas cavities are specific sites of enamel loss caused by acids created by the action of bacteria over time.

Prevention

Once you see the various types of erosive tooth wear, you will understand that their impacts might be reduced, but not entirely avoided. We cannot completely prevent exposing our teeth to some acids; we will inevitably chew and sometimes grind our teeth; and we will without doubt chew things that will abrade our teeth to some degree. It’s really a matter of minimizing these effects.

Prevention can be promoted by:

• using fluoride toothpastes and mouthwashes (the fluoride assists in preventing demineralization)
• using a soft bristled toothbrush to reduce abrasion
• limiting the frequency of brushings and using gentle, circular brushing to minimize abrasion
• using calcium-based products to remineralize tooth surfaces
• choosing low abrasion products
• minimizing the exposure of teeth to acidic food and drink
• briefly delaying tooth brushing after acidic food or drink to minimize abrasion when teeth are particularly soft
• using a dental mouth guard (or night guard) to guard against attrition from involuntary tooth grinding

Acidic sources

In preventing demineralization, it is important to avoid unnecessary exposure to sources of acidity in the mouth. Primary sources are:

• fruits, especially citrus fruits
• drinks containing citric acid (typically fruit juices)
• carbonated drinks (therefore carbolic acid)
• alcoholic drinks
• acidic foods
• acidic sweets
• some medications

Acidity in the mouth has other causes that should be minimized: dry mouth, acid reflux, vomiting, poor mouth hygiene, and the time duration of exposure to any acidic influences. Obviously these sources of acidity cannot be eliminated, but they can be monitored and reduced.

Restoration

In cases of significant erosion, numerous repairs can be effected. Composite resins (tooth coloured fillings), crowns, and dental onlays (veneers) are all available.

Contact Sherway Gardens Dental Centre with any questions you might have about erosive tooth wear and how to deal with it.