Did you know that tooth enamel is one of the strongest substances in the human body? Even with this strength, tooth enamel can become weakened over time due to a number of reasons. One common reason for weakened tooth enamel is dental erosion.
Before we can get too much into what dental erosion is, however, we first need to understand the basics of tooth enamel. Tooth enamel is the outer layer of your tooth that protects the underlying dentin and pulp layers. It is composed of a highly mineralized substance known as hydroxyapatite. Hydroxyapatite is calcium phosphate that has been crystallized, meaning that the calcium and phosphate molecules have a crystal lattice structure.
Since enamel is composed of 96% minerals, along with water and organic material, it is susceptible to a process known as demineralization. Demineralization is most commonly the result of cavities, however it can occur for various other reasons. When the enamel is lost for reasons besides tooth decay, this is known as dental erosion.
By far, the most common cause of dental erosion is acid. However, acid can be introduced into the mouth through different ways. The first and most common way is through our diet. There are many foods and beverages that are considered to be acidic, with some containing a higher concentration of acid than others. Some examples are berries, rhubarb, apples, citrus fruits and juices, and sodas with citric or phosphoric acid.
Another way that acid can be introduced into the mouth is through stomach acid. Although stomach acid normally remains contained within the stomach, certain digestive issues can cause it to move up the esophagus and into the mouth. This is highly common with acidic reflux disorders such as GERD, as well as medical conditions that may induce frequent vomiting. Since stomach acid is highly concentrated, the enamel will begin to erode if constantly exposed to it.
However, the body does have a natural way of managing the acid concentration in the mouth. Although saliva has many important functions, one of its main functions is to decrease and regulate the amount of acid in the mouth. This is one reason why normal saliva flow is so important. Unfortunately, there are individuals who have decreased saliva flow. This is known commonly as dry mouth and it is normally the result of a medical condition or side effects caused by certain medications.
Although acid is the primary cause of enamel erosion, another secondary cause is bruxism. Bruxism is the name given to the behaviors of teeth grinding and clenching. Both of these behaviors apply excessive amounts of constant force to the teeth. This constant enamel to enamel contact causes both sides to wear themselves down on the opposing teeth. Ultimately, this thins out the enamel and makes the teeth more susceptible to erosion from acids and tooth decay.
When dental erosion begins, it may not be immediately noticeable to anyone but an experienced general dentist. As the enamel continues to erode, however, it is expected to produce symptoms that are associated with tooth decay. Namely, these symptoms are: tooth sensitivity, discoloration, indentations on the enamel, and damage caused by weak enamel.
As you can see, tooth enamel can weaken over time for reasons other than tooth decay. Even though dental erosion is not as big of a problem as tooth decay, it can cause the same type of damage and symptoms, while also increasing the risk of decay. Enamel erosion is predominantly caused by acids found in foods, beverages, and the stomach, but it can also be the result of dry mouth or bruxism. Additionally, symptoms of erosion may or may not be present, so it is important to keep up with regular dental exams.
Dr. Roman Fedorciw has been in private practice in Cromwell since 1991. He is a member of the Academy of General Dentistry, American Academy of Cosmetic Dentistry and the American Dental Association. He is also a member of the Connecticut Dental Association and Middlesex County Dental Association. Dr. Fedorciw has been acknowledged by his peers as one of the “Top Dentists” in Hartford County by Hartford Magazine and in the state of Connecticut by Connecticut Magazine.