Dental Erosion
Loss of tooth enamel from acid wear
Quick Facts
- Type: Dental (oral health) condition
- Cause: Acid, not bacteria, wearing enamel
- Common sources: Acidic drinks, reflux, frequent vomiting
- Key sign: Sensitive, smooth, or thinning teeth
Overview
Dental erosion is the gradual loss of tooth enamel, the hard outer layer of the teeth, caused by acid wearing it away. Unlike tooth decay, which is driven by acid produced by bacteria in plaque, erosion is caused by acid that comes directly into contact with the teeth, such as from acidic foods and drinks or stomach acid.
Enamel does not grow back once it is lost, so erosion is permanent and can expose the softer, more sensitive layer of tooth underneath. Over time this leads to sensitivity, changes in the appearance of the teeth, and a higher risk of damage. The good news is that erosion can usually be slowed or stopped by identifying and reducing the source of acid.
Symptoms
Erosion develops slowly, and early signs can be subtle.
- Increased sensitivity to hot, cold, or sweet foods and drinks
- Teeth that look smoother, shinier, or more translucent
- Yellowing as the darker layer beneath the enamel shows through
- Rounded or thinning tooth edges
- Small dents or cupping on the chewing surfaces
- In advanced cases, cracks, chips, or changes in how the teeth fit together
Sensitivity is often the first noticeable symptom and a reason to seek a dental assessment.
Causes
Dental erosion is caused by acid contacting the teeth. Sources include:
- Dietary acids: Frequent fizzy drinks, fruit juices, sports drinks, citrus fruits, and other acidic foods and beverages.
- Stomach acid: Acid reaching the mouth from acid reflux (GERD) or from frequent vomiting, including in eating disorders.
- Dry mouth: Reduced saliva, which normally helps neutralize acid, increases the risk.
- Certain medications and conditions: Some that increase acid or reduce saliva.
Risk Factors
- Frequent consumption of acidic drinks and foods
- Sipping acidic drinks slowly over long periods
- Acid reflux or heartburn
- Frequent vomiting, including from eating disorders or pregnancy
- Dry mouth from medications or other causes
- Brushing teeth immediately after acidic foods or vomiting
Diagnosis
A dentist usually diagnoses erosion during an examination.
- Dental examination: Looking for the smooth, worn, or thinning enamel typical of erosion.
- History: Reviewing diet, drinking habits, reflux symptoms, and any vomiting.
- Monitoring over time: Comparing the teeth at follow-up visits to track progression.
Identifying the underlying source of acid is an important part of the assessment, sometimes involving questions about reflux or referral to a doctor.
Treatment
Treatment focuses on stopping further erosion and protecting or restoring the teeth.
- Reducing acid exposure: Cutting back on acidic foods and drinks and managing reflux or vomiting.
- Strengthening enamel: Fluoride toothpaste, treatments, and products that help protect remaining enamel.
- Treating sensitivity: Desensitizing toothpaste or dental products.
- Restoring damaged teeth: Fillings, bonding, veneers, or crowns for significant wear.
- Managing underlying conditions: Treating acid reflux or seeking help for an eating disorder.
Because lost enamel cannot regrow, early action to remove the cause is the most effective approach.
Prevention
- Limit acidic drinks and foods, and avoid sipping them slowly over long periods
- Drink acidic beverages with meals and use a straw to reduce contact with teeth
- Rinse with water after acidic foods, drinks, or vomiting
- Wait about an hour before brushing after acid exposure to avoid wearing softened enamel
- Use fluoride toothpaste and stay well hydrated
- Treat reflux and seek help for frequent vomiting
When to See a Dentist or Doctor
See a dentist if you notice ongoing tooth sensitivity, teeth that look worn, smooth, or discolored, or changes in the shape of your teeth. Also see a doctor if erosion may be linked to:
- Frequent heartburn or acid reflux
- Repeated vomiting
- An eating disorder, which needs supportive medical and mental health care
Addressing the underlying cause protects both your teeth and your overall health.
Frequently Asked Questions
What is the difference between dental erosion and tooth decay?
Tooth decay (cavities) is caused by acid that bacteria in plaque produce, while dental erosion is caused by acid contacting the teeth directly, such as from acidic drinks or stomach acid. Both wear away enamel, but they have different sources and prevention strategies.
What causes dental erosion?
Common causes include frequent acidic foods and drinks like fizzy beverages, juices, and citrus, as well as stomach acid from reflux or frequent vomiting. Dry mouth raises the risk because saliva normally helps neutralize acid.
Can eroded tooth enamel grow back?
No. Once enamel is lost it does not grow back, so erosion is permanent. This is why preventing further loss by reducing acid exposure, and protecting or restoring the teeth, is so important. A dentist can advise on the best options.
How can I protect my teeth from erosion?
Limit acidic foods and drinks, use a straw and have them with meals, rinse with water afterward, and wait about an hour before brushing after acid exposure. Use fluoride toothpaste, stay hydrated, and treat reflux or frequent vomiting.
Should I brush right after vomiting or acidic drinks?
It is better to wait about an hour. Acid temporarily softens enamel, and brushing immediately can wear it away faster. Rinsing with water in the meantime helps clear the acid until it is safe to brush.
References
- American Dental Association (ADA). Tooth erosion.
- MedlinePlus, U.S. National Library of Medicine. Tooth disorders.
- Mayo Clinic. GERD and dental erosion.
- National Institute of Dental and Craniofacial Research (NIDCR). Tooth decay and oral health.