Acidic beverages have become so common in our lives that we can always find a bottle of them no matter what city or country we are in. you can find people drinking soft drinks everywhere. (Pixabay)
Acidic beverages have become so common in our lives that we can always find a bottle of them no matter what city or country we are in. you can find people drinking soft drinks everywhere. (Pixabay) 
Dentistry

Dental Erosion-Chemical Loss Of Mineralized Teeth

Dr. Ankit kadarge

Dental erosion is also known as acid erosion. It is the loss of dental hard tissue caused by intrinsic or extrinsic acid and not by bacterial production. Consuming lots of acidic beverages leads to erosion of teeth, which in turn causes changes in the structure of teeth and opens the door for food accumulation and bacterial activity that leads to cavities or dental caries.

What is the cause of Dental Erosion?

Dental erosion is caused by prolonged direct contact between acidic substances and tooth surfaces.

Acidic beverages and foods: The most common reason for dental erosion is acidic foods and drinks. For example, Fruit juices, particularly orange and apple juice, sports drinks, wine, beer, and carbonated beverages (such as colas or lemonades) all have low pH levels and can cause tooth erosion and it also depends on the frequency, rather than the total amount of acidic juices or foods consumed, is thought to be the more important factor in dental erosion.

Sugars and acids (citric acids and phosphoric acids) that are present in acidic beverages have the capacity to be both acidogenic and cariogenic, resulting in dental caries and perhaps even the erosion of enamel. (Unsplash)

General circumstances: People who suffer from bulimia or gastroesophageal reflux disease (GERD) are more likely to experience dental erosion because gastric acid from the stomach comes into contact with the teeth and also Vomiting regularly erodes tooth enamel and can lead to cavities.

Other factors:

  • A variety of medications, including vitamin C, aspirin, and antihistamines

  • Dry mouth or low salivary flow (also known as xerostomia), in this condition saliva's buffering capacity, is absent to counterbalance the acidic environment.

  • Genetic or inherited diseases

Enamel is a non-regenerative hard tissue of our body and a precious one too. But our daily habits cause irreversible damage to our tooth enamel. The solution is simple: get rid of carbonated drinks and save enamel.
Dr. Chintan shetty, BDS

What are the signs of dental erosion?

Sensitivity: Eating hot, cold, or sweet foods may cause increased sensitivity in the early stages of enamel erosion and teeth to become extremely sensitive in later stages. The enamel erodes, exposing the sensitive dentin and increasing its sensitivity.

Consuming lots of acidic beverages leads to erosion of teeth and this can affect people of any age. (Unsplash)

Discoloration: Enamel is a white substance. Dentin is a yellow sensitive tissue located beneath the enamel. If our teeth colour begins to yellow, it could be due to enamel loss, with the earliest colour change occurring on the cutting edges of the incisors as they become transparent. The enamel erodes and more dentin is exposed as the condition progress. This will discolour the teeth.

Shape Changes: 

  • Teeth may develop a broadly rounded concavity, and the gaps between teeth may widen on the surface of the teeth, indentations may appear. As the enamel erodes, the edges of teeth become rougher and more irregular and teeth begin to crack and become coarse in the later stages of dental erosion. You may notice that your teeth are thinner or smaller than usual and also, the lower portion of your front teeth may appear transparent rather than opaque. Either of these conditions indicates dental erosion.

  • Although dental erosion frequently coexists with attrition and abrasion, it has some distinguishing features in terms of location, appearance, and morphology. Usually the palatal aspect of the upper incisors and the occlusal surface of the lower first molars are the most commonly affected areas. Smooth and flat facets on facial or palatal surfaces, as well as shallow and localized dimpling on occlusal surfaces, are common early signs of erosion and If no action is taken, erosive wear will worsen, resulting in deep cupping lesions with exposed dentin and eventual loss of occlusal morphology.

Fun­-Fact: The Portuguese star Cristiano Ronaldo was not delighted to see two Coca-Cola bottles in front of him during the UEFA Euro 2020 pre-match news conference. He then pushed the bottles out of the camera’s way and encouraged people to drink water instead.

Be smart like the G.O.A.T. quench your thirst with the right choice. (Unsplash)

Clinical Interventions for Dental Erosion.

  • Apply fluoride varnish to tooth surfaces susceptible to erosion: A fluoride-containing protective film will reduce direct contact between tooth surfaces and acids while also delivering fluoride to strengthen the enamel surfaces.

  • Treat any underlying diseases caused by the presence of intrinsic acids intraorally, such as GERD, bulimia, or regurgitation. When an intrinsic cause of erosion is suspected, it is often necessary to establish close consultation with the patient's physicians.

  • When a low saliva flow rate is identified as a risk factor for erosion in a specific patient, steps should be taken to improve saliva flow. This may include discussions with the doctors about adjusting medications that cause dry mouth, as well as referrals for evaluation and treatment of autoimmune diseases like Sjogren's syndrome and treat the conditions that cause salivary hypofunction.

Management and Prevention for Dental Erosion.

  • If effective intervention is not initiated at an early stage, the eventual result of dental erosion is severe and causes loss of dental hard tissues, which harms function and aesthetics and also persistent pain due to dentin sensitivity and pulp pathology may further reduce the quality of life in patients with extensive dentin exposure.

  • Restorative treatment is available for severe erosive tooth wear. To restore the aesthetics and function of the teeth, composite resins and ceramics can be used for partial and full coverage restorations. However, if the restored teeth are subjected to severe erosive challenges, the restorations may fail over time due to marginal deterioration and continued loss of surrounding dental hard tissues. As a result, preventive measures for dental erosion are important not only for early intervention and primary prevention of erosive tooth wear but also for secondary prevention of erosion around restorations.

We can reduce tooth erosion and dental caries by following tips:

  • Do not brush soon after eating acidic foods or drinking beverages. Instead, give an hour to naturally clean teeth by washing away bits of food debris and preventing a prolonged acid attack on tooth enamel.

  • Limit or avoid the consumption of acidic beverages like soft drinks. If you do indulge, Choose low-erosive soft drinks and use a straw.

  • After acidic meals or beverages, rinse your mouth with water, drink milk, or snack on cheese right afterward. These can help neutralize acids.

  • Saliva helps to keep acids under control by buffering action. So chew sugarless gum with the ADA Seal of Acceptance to maintain your saliva level.

  • Use fluoride or remineralizing toothpaste and brush twice daily.

Conclusion:

In conclusion, excessive intake of acidic beverages could cause complex dental consequences, including dental erosion and caries. Although the diseases differ in histological appearance, the two concurrent conditions could harm dental hard tissues. Therefore, it is necessary to educate patient’s about the detrimental effects of excessive soft drink consumption.

References:

Leslie A. Ehlen, Teresa A. Marshall, Fang Qian, James S. Wefel, and John J. Warren et al. Acidic beverages increase the risk of in vitro tooth erosion. Nutr Res. 2008; 28(5): 299–303.

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