Dental Erosion Risk Factors in Bullet Points

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Eating fruits and berries frequently will put you at risk of dental erosion.

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

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Compilation of Excuses

After being so serious for a while it is time to lighten up for a moment.

People are funny creatures. You can tell all sorts of tales of them and their funny ways. This time I will tell you about people’s creativity when they put a blame on so many other things than their own indolence when it comes to oral hygiene routines.

I’ve collected a list of the answers we get to two of the very common questions we ask. Let’s see if you recognise yourself?

So Are You Using Your Electric Toothbrush?

  • lost in a house move
  • it’s still in an unpacked box after a house move (moved a year ago)
  • it’s still in an unopened box after buying it a year ago
  • out of battery and haven’t got around to charge it
  • it’s malfunctioning
  • can’t find brush heads from the shops
  • I don’t have a plug-in in the toilet
  • it makes me feel dizzy
  • it’s too vigorous.. I’m nervous about loosing a filling
  • dropped it and it broke
  • the manual toothbrush is quicker
  • the manual toothbrush is easier to use
  • it takes too long
  • it’s too noisy.. I’m afraid of waking up the kids/wife/neighbour/partner
  • I don’t like the feeling in my head
  • it tickles too much
  • it makes my gums bleed
  • it hurts
  • the bristles feel too hard
  • don’t have batteries in the house (battery operated electric toothbrush)

How About Are You Cleaning Between The Teeth?

  • too difficult
  • too tired
  • floss gets stuck/shreds
  • my gums bleed
  • I lost a filling once
  • it hurts
  • my teeth are so close together that the floss/interdental brush/toothpick is impossible to use
  • I use a mouthwash instead
  • I use the water pick
  • I rinse with water after every meal
  • I use chewing gum
  • my gaps between the teeth are so wide that nothing gets stuck there
  • I push the bristles of the toothbrush between the teeth
  • I use a toothpaste that says it cleans between the teeth
  • I run out of floss/interdental brushes/toothpick (last year) and never got round to buy new ones
  • can’t be bothered
  • it makes the gaps between my teeth wider
  • I don’t have time for it
  • don’t know which one to use
  • is it harmful?
  • is it needed? I never see anything coming out when I floss
  • are you?

Linnanmäki, Finland.

Feel free to add more excuses on the comment box!