People with reduced salivary flow are especially vulnerable to dental erosion.
Heartburn, chronic regurgitation, acid reflux, GERD (gastroesophageal reflux disease) – whatever you want to call it – reduces salivary flow and triggers vulnerability to dental erosion. Dehydration invariably occurs with this disease because scar tissue eventually narrows the esophagus, making swallowing uncomfortable.
Some patients may not be aware of their condition until it starts affecting their teeth, and a dentist will always refer these patients to an appropriate or interdisciplinary team. As an untreated condition, acid reflux can lead to complications of erosive esophagitis, stricture formation, and Barrett’s esophagus, which increase the risk of esophageal adenocarcinoma.
Sugar-free antacids and xylitol chewing gum are very useful in stimulating improved moisture. Xylitol particularly, inhibits the growth, metabolism, and polysaccharide production of Streptococci mutans – the oral bacteria most responsible for tooth decay and the breaking down of enamel.
The recommendation for patients with dental erosion is to chew a xylitol-based chewing gum for 5 minutes immediately after every meal, and also after any major acid events.
For some, prescribing pilocarpine may be considered; it’s used to treat dry mouth in radiotherapy patients and can be a constructive strategy for managing acid erosion. It’s necessary for dentists and medical practitioners to obtain baseline data before advising this type of treatment, because stimulated flow rates, salivary pH, and buffering capacity must be determined.
Patients having to deal with tooth erosion need new dental routines. Not using strongly abrasive toothpastes, and not brushing teeth immediately after an acid attack and instead rinsing with water, bicarb soda, and a fluoride mouthwash. Water eliminates most of the acid, bicarb soda neutralises any residual, and fluoride mouthwash help remineralise the etched tooth structure.
Teeth should also not be brushed for at least 30 minutes after eating or drinking, when enamel is softened and at its most delicate.
Acid reflux is not the only reason tooth enamel becomes compromised; demineralisation, when the mineral ions of enamel, dentin, cementum, and bone are leached also happens with the acidic by-product of plaque.
Demineralisation occurs when the surface acidity of the teeth falls below pH 5.5. Saliva has an average pH value of 6.7, easily reduced to damaging levels simply by the consumption of carbonated drinks and citrus juices.
Keep in mind that damaged tooth enamel will never replicate itself; weakened and softened enamel can only be somewhat improved by remineralising the teeth.
To minimise the irreversible damage to dental hard tissue, those at high risk of oral acidity are advised to always avoid potentially harmful foods and drinks – with soft drinks, sodas and sports drinks the major offender of tooth enamel erosion. Even sugar-free, and regardless of flavour, carbonation makes it acidic; along with the primary culprits of wine, alcohol in general, and citrus fruits and vegetables.
Peanut butter and popcorn also make the list of foods to avoid.
Highly concentrated fluoride rinses, gels, and varnishes increase resistance and lower the risk of further enamel and dentin erosion. Three monthly fluoride varnish applications by your dentist and daily use of prescription fluoride toothpaste is tantamount for restorative treatment.
Aside from the discoloration of enamel erosion, restorative treatment is needed when the structural integrity of affected teeth is jeopardised. Hypersensitivity, loss of tooth dimension, and the likelihood of pulpal exposure are symptoms to avoid: and why regular dental check-ups are so important.
The protective effects of laser application on demineralised enamel and dentin has gained attention in recent years where new smoothness is created by melting and solidifying the surface of the tooth.
The treatment of choice, however, is direct composite coatings; and porcelain veneers for more advanced cases.
These treatments seal the enamel, reestablish tooth contour, and provide a physical barrier to further acid exposure.
For patients with extreme enamel loss on more than two surfaces per tooth and tooth length, complex reconstruction with ceramic crowns and bridges is often inevitable.
All the stuff you’d rather not have happen.
So look after your health.
Ignoring issues or changes in digestion is asking for trouble, really; and that’s not so easy when your teeth are wearing away.
Note: All content and media on the Elevate Dental Richmond website and social media channels are created and published online for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice.