Acid Wear and Teeth

Dr. Jordan Appel came by the show to discuss acid wear and how we can save our teeth from it!

What is Acid Wear?
Loss of tooth structure by chemical dissolution without the involvement of bacteria. It is one of the types of tooth wear that is caused by acids softening and wearing away the tooth's surface. The acids can come from food and beverages you consume or from stomach, which are gastric acids. Acid wear is made worse if in conjunction with the other types of wear and the outcome isn't pretty! (Lab study -2500 years to remove 1mm with brushing alone...100 years with brushing and toothpaste...add an acid...only 2 years)

The majority of Canadian either don't know what acid wear is or they admit to knowing very little about it. The first key to prevention is awareness.

What are the signs of acid wear?
These signs are not inclusive to acid wear but it could be a sign that you are suffering from it:

- colour- the tooth appears yellow as the enamel becomes thinner
- translucency - the incisal edges become thinner causing the tooth to appear translucent
- structure - small cracks and minor fractures appear on weakening incisal surfaces, resulting from thinning of the tooth structure lustre and texture- tooth surface loses its lustre and texture (especially the front teeth) becoming smooth as the enamel wears away
- sensitivity- your teeth may become sensitive to hot and cold foods and beverages and the outdoor temperature

What causes acid wear?
As the name implies, it's the result of having acids on the teeth for too long causing the enamel to be worn away.

2 Types of Acids:
1. Intrinsic acids (for example, people suffering from gastric reflux where it is the acids from your stomach that caused the damage to your teeth or if you have an eating disorder like bulimia or anorexia, morning sickness during pregnancy)
2. Extrinsic acids - oftentimes, without realizing it, we are putting our teeth at risk when we consume these everyday foods and beverages that are acidic - phosphoric acid (coke), citric acid (OJ), carbonic acid (carbonated drinks)

Acidic foods should not necessarily be avoided, but care needs to be taken as to when and how often they are consumed. The more often they are consumed, the concentration of the acids and the exposure time will determine the harm dietary acidity can do to your teeth. Canadians may be surprised to learn of some foods and drinks that are acidic... such as bananas, grapes, and ice tea! The #1 acidic food for Canadians is vinaigrette dressings. The website has a guide that lists numerous foods and their acidic risk potential.

What happens to your teeth if acid wear is left untreated?
Firstly, in a recent survey, 93 percent of dentists and hygenists have seen patients in their practice who have acid wear. I believe we are seeing this condition more often because people are keeping their teeth longer due to improved oral hygiene, greater incidence of flouridated water and better restorative techniques meaning that teeth are subject to wear for a longer period of time.

If left untreated:
1. When there are larger areas of exposed dentine can be repaired by bonding white filling material to the tooth
2. A crown or cap can be fitted over the entire tooth if the acid wear has led to a large breakdown of tooth structure
3. A root canal treatment may be necessary to provide pain relief if the nerve in the tooth has been exposed by all the wear

In the advance stages of acid wear there is likely a need for expensive and complicated dentistry to restore teeth to normal function - and acid wear makes the tooth more susceptible to decay!

What can you do to protect your teeth from acid wear?
As there are different reasons why you may experience acid wear, talk to your dentist about your habits so that plan for preventive action can be determined. Here are some examples:

- Drinking directions - avoid habits such as sipping, swishing, or holding drinks in your mouth. Kids like to swish the carbonated drinks in their mouth to make it easier to swallow). There has been a 300 percent increase in soft drink consumption in the past 20 years) Drink with a straw when consuming acidic beverages, ensuring the flow is directed away from the teeth

- Toothbrush timing - avoid brushing immediately after eating acidic foods when the enamel is soft. Wait at least 1 hour to do so.

- Avoid chewing fruit for a prolonged period of time (i.e. eating one orange throughout the entire day) and avoid the popular act of grazing through out the day -include these acidic foods and drinks as part of a regular meal to dilute the acidity

- Use a fluoride mouthrinse, milk, or food such as cheese after having acidic foods

- Because saliva helps neutralize the acid, stimulate saliva flow with sugar-free gum or lozenge.

- Avoid chewable vitamin C and chewable aspirin... swallow the tablet whole

- Consider using modified acid beverages (eg. Orange juice with added calcium)

- Have regular check-ups with your dentist to see if your teeth have been affected by acid wear

- Toothpaste protection - use a toothpaste like Pronamel from Sensodyne.

Do I need to use a regular toothpaste along with it?
No, Pronamel from Sensodyne is a toothpaste that has been formulated to provide the total care of an everyday toothpaste (cavity protection, breath freshening, tartar control).

Can the affects of acid wear be reversed?
Tooth enamel is the protective 'armour' for your teeth - once it's gone, it's gone forever. That is why understanding the problem and taking steps to minimize the risk is so important.

For more on tooth sensitivity, check out Tooth Sensitivity 101!


Acid Wear and Teeth
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