Dental Erosion Risk Factors in Bullet Points

There has been so much discussion about dental erosion recently that I wanted to gather all the latest information in one post. I have been in dental profession for over 20 years and even I still learn new things about dental erosion. So read this post to see if you knew these things as well.

I will update this post every time I learn something new that will cause dental erosion. I would be grateful if you could collaborate by commenting this post in case I have missed some risk factors.

The Risk Factors

• diet that does not contain dairy products
• vegetarian diet even if dairy products are used
• consumption of acidic beverages, especially when consumed between the meals (including all juices, sugar-free drinks, sparkling water, any drink with flavouring, alcohol and bubbles. As an example the pH of Coca-Cola is 2,5 = highly acidic)
• vitamin supplements in a form of a drink (including fizzy tablets)
• use of sport drinks
• dehydration
• dehydration + sport drinks = increased risk
• drinking tea apart from green tea and black tea
• consumption of erosive foods, increased risk if consuming erosive foods/drinks over 3 times per day (e.g. fruits, berries, vinegar, pickled food, herbal tea, cola, sparkling water, juice, flavoured water)
• eating sour candy
• frequent consumption of alcohol
• use of smokeless tobacco
• frequent use of salad dressings
• gastro-esophagel reflux disease (GERD)
• gastro-esophagel reflux disease combined with a use of a mouth guard (read this to find out how to protect your teeth if you use mouth guard)
• eating disorder (anorexia, bulimia)
• frequent vomiting (e.g. when pregnant)
• eating fruits between the meals (when fruits are eaten as a part of a meal = no risk)
• eating indian food frequently (indian spices, especially panipuri masala, are acidic)
• swishing acidic drink in mouth before swallowing
• sipping an acidic drink (e.g. herbal tea, cola, sparkling water, juice, flavoured water) over a long period of time
• brushing teeth after eating
• brushing teeth after drinking acidic drinks like wine, juice, sparkling water
• dry mouth (saliva protects the teeth, neutralises the acids)
• drinking herbal tea very hot (high temperature increases the erosive potential of a drink)
• consumption of pickled foods
• medication that dry the mouth as a side-effect (e.g. antihistamines, antidepressants)
• use of oral moisturizers with pH below 6.7 (see a table pH levels of commonly used oral moisturizers and dry mouth treatment products here)
• acidic mouthwashes e.g. Listerine Total Care rinse pH = 3.57
• anti-tartar toothpastes that has chelating agents – chelators bind or trap other chemicals such as calcium = they effectively remove calcium also from teeth.
• use of non-fluoride toothpaste
• liquid breakfast (including smoothies). There’s no saliva in mouth in the morning = nothing to neutralise acids. Chewable breakfast would make the saliva flow again after sleeping.
• certain illnesses that affect the saliva flow (e.g. Sjögren’s syndrome)
• drinking fruit juices instead of eating the real fruit – fruit juice has been proven to cause erosion 10 times more than the same fruit chewed.
• chewing gum with liquid center including sugar-free chewing gums (also xylitol). The liquid inside the chewing gum is acidic.
• sugar-free candy, especially fruit-flavoured ones (they contain high levels of food acid, particularly citric and phosphoric acid)
• dry mouth + sugar-free fruit-flavoured candy to stimulate saliva flow = increased risk of erosion
• asthma medication, especially if brushing after corticosteroids (e.g. Flixotide evohaler)

Edit 27.1.2019

• swimming in a gas-chlorinated swimming pool, especially especially at risk are the competitive swimmers
• fruit-flavoured sugar-free chewing gum

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