Erosion and Abrasion - Are These Destroying Your Teeth?

Erosion and Arbrasion

Abrasion and erosion damage teeth in similar ways but they are separate conditions with different causes, and different measures are required to combat them.

Abrasion is the physical wearing away of enamel, the tooth’s protective outer coating. It can be caused by incorrect brushing technique, toothpicks or removable appliances such as partial dentures or retainers rubbing against the tooth surface. Abrasion defects are usually v-shaped notches near the gum.

Erosion is caused by acids dissolving areas of enamel. These acids can come from fizzy drinks, citrus fruit, fruit juice and a variety of foods. Stomach acids can also cause considerable erosion in cases of persistent vomiting – such as in acid reflux and the eating disorder, bulimia. Erosion defects are usually smooth, scooped-out areas on the tooth surface.

If the enamel has been penetrated by either abrasion or erosion, the tooth will usually become sensitive to temperature and/or sweet things.

Deep defects can also lead to food stagnation and plaque accumulation. These in turn can cause gum disease and tooth decay.

Prevention.

You can prevent abrasion – and, unlike tooth decay, you can stop it progressing it if it’s already present:

1. Don’t scrub your teeth horizontally with a manual toothbrush. An electric brush will do a better job of cleaning your teeth and its oscillating or vibrating action will avoid enamel damage.

2. If you do use a manual brush, don’t press too hard – especially on the side opposite to the hand in which you hold your brush. Right handed people tend to cause more abrasion on the left. Left handed people wear away their teeth on the right. And don’t use a brush with hard bristles.

3. Use interdental cleaners (floss, interdental brushes, sticks) properly. If in doubt, ask the hygienist to show you. Like so many things, it’s easy when you know how – and bloody difficult if you don’t.

4. Have removable appliances such as dentures and retainers checked regularly. Everybody is different so your dentist will suggest how often would be optimal for you.

You can also prevent erosion – and, if it’s already present, stop it getting worse:

1. Keep acidic food and drinks to a minimum.

2. If possible, limit acidic food and drinks to mealtimes. Certainly don’t spread them out throughout the day.

3. Rinse your mouth with water after you’ve had something acidic – BUT DO NOT brush your teeth for half an hour. Acid softens the surface layers of the enamel so it’s more easily rubbed away until it remineralizes from your saliva. In other words, don’t add abrasion to erosion.

4. Be aware that sports drinks have additives to speed up their absorption by the digestive system. These additives make the drinks more effective at rehydrating the body and maintaining nutrient balance, but they also make them more acidic.

If Treatment is needed, it is in 2 parts (3 parts if extra work is required to restore the appearance) and is similar for both abrasion and erosion.

1. Identify the cause of the problem (horizontal brushing, toffee etc.) and change it – I’m always amazed by the number of people who think that treatment will cure everything without any input from them. If something you’re doing is causing you harm, you have to change it. Otherwise, any treatment you get will fail – and that doesn’t just apply to your mouth. Sorry to be so blunt but it’s an unavoidable fact.

2. Treat sensitivity. In mild cases, regular use of a sensitive formula toothpaste may be all that is necessary. Or a desensitising sealant may need to be applied. If the defect is deep or is becoming a stagnation area, it may have to be filled to restore the original contour of the tooth.

3. If appearance is an issue, a cosmetic restoration may be required in the form of a composite filling or a veneer – depending on the degree of damage.

Dental abrasion and acid erosion can cause severe damage to teeth but they are easily avoided if you know how. And now you do.

Tom Nolan is a dentist with over 30 years’ experience.

If you found this article useful, you should check out his book

Watch Your Mouth – An Owner’s Manual.

Also available as a download. This book is packed with practical advice and will tell you everything you need to know to keep your mouth healthy, trouble-free and beautiful for the rest of your life.

You can get in touch via Tom's practice: The Dentist in Town.


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