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 + 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)
- 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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