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Acid Reflux Disease and Tooth Erosion

Tooth erosion occurs when tooth enamel wears away due to an acid attack. The tooth enamel is considered the hardest tissue in the body, even though it is very thin. When there’s loss of tooth enamel, then there is tooth erosion. Often, this leads to pains and sensitivity to hot and cold food. There may be reactions to every biting and chewing. 

The enamel protects the dentin layer of the tooth. Dentin has microscopic tubules that cannot protect the teeth against heat or cold, or bacteria in the absence of the enamel layer. In other words, when the dentin layer erodes, the inner part of the tooth gets exposed. 

Most foods and drinks have chemical levels, and some are safer than others. The enamel helps the mouth to contain the effects of unfriendly acids. When the acids become extreme, they damage the enamel and gradually wear it off the teeth. 

Also Read: Enamel Shaping: How To Whiten Your Teeth Without Surgery

Acid reflux as a cause of tooth erosion

If you suffer from tooth erosion, your dentist will consider acid reflux as its first possible cause. The reason is that 24% of children with acid reflux disease suffer from tooth erosion, while that number is as high as 32.5% in the case of adult patients.

According to the Journal of Pediatric Gastroenterology and Nutrition, “Acid Rather Than Nonacid Reflux Burden Is a Predictor of Tooth Erosion.”

Gut and Liver, an international journal of gastroenterology, also believes there is a positive correlation between acid reflux and tooth erosion. Authors of a research paper published in this journal in 2013 state that erosion begins by affecting the tooth enamel slightly before pushing the entire tooth into danger.

Good to Remember: Beyond aesthetic consequences and associated oral health issues, severe erosive activity can lead to exposed dentin, hypersensitivity, and eventual loss of affected teeth. (American Dental Association)

Tooth Erosion Symptoms

Tooth erosion or enamel erosion can have detrimental effects on the teeth. Identifying it at the earliest stages may help curb further damage.

Enamel erosion may show one or more of the following symptoms:

  • Cracks and chips in the tooth
  • Rough edges on your teeth
  • Teeth discoloration from white to yellow
  • Gum recession 
  • Noticeable spots on your teeth
  • Teeth edges become transparent
  • Tooth pain from biting or chewing
  • Increased sensitivity to foods and drinks 
  • Painful reactions to brushing
  • Tooth decay

How does acid reach your teeth to cause erosion?

Patients suffering from gastroesophageal reflux disease, hiatus hernia, and anorexia nervosa can have dental acid erosion. These diseases are more prone to cause vomiting. Vomits bring powerful stomach acids to the mouth, gradually eroding the teeth. 

Also, patients with bulimia are prone to dental acid erosion. Since this is an intentional act of making yourself sick, you may vomit more than usual. This, in turn, affects your teeth as the acids in vomit are very strong and may cause enamel erosion. 

If you suffer from alcohol addiction, then you will most likely develop tooth erosion also. Heavy consumption of alcohol and alcoholic drinks causes a hangover, a symptom of which is throwing up.

Also Read: Smile Makeover: Procedures, Costs, and Benefits

Which beverage cause more tooth erosion, Red Bull or Diet Coke?

According to a study conducted at the University of Iowa, Gatorade causes more tooth erosion than Red Bull and Coke, which, by turn, cause more erosion than 100% apple juice and Diet Coke.

A similar study conducted at the University of Medicine and Pharmacy in Romania concluded that sports and energy drinks reduce the calcium level and phosphorous ions concentrations in enamel.

What are the extrinsic origin and intrinsic origins of dental erosion?

Dental erosion can happen because of acid in a patient’s mouth. The extrinsic origin of that acid is when the acid comes from the acidified food that the patient consumes. On the other hand, the intrinsic origin of the acid means the acid comes to the mouth of the patient from inside the patient. If the patient suffers from acid reflux or bulimia, or if they consume excessive alcohol, they may throw up, thus bringing their teeth in contact with acids.

Which acid in acid reflux patients causes tooth erosion?

According to the Archives of Oral Biology, it is the presence of hydrochloric acid in the reflux content that causes tooth erosion. Reflux can happen several times a day, thus pushing the substances in the stomach back to the patient’s mouth. Reflux usually happens when the muscles at the lower end of the esophagus relax at the wrong time.

Reflux content, however, may contain different bile acids, including cholic acid and chenodeoxycholic acid. Their concentration may vary. They may damage the inner lining of the esophagus, if not the enamel layer of your teeth.

Which part of the tooth is first affected by acid reflux?

The palatal surface of the tooth may first be affected by acid reflux in tooth erosion patients. The palatal surface is the part of the tooth closest to the tongue. The acid, however, may damage other tooth surfaces provided it remains in the mouth longer and in high concentration.

Can a tooth’s enamel surface be remineralized after consuming acidified food or drinks?

A healthy tooth’s enamel surface may show signs of damage after a person consumes acidic food or drink. For example, if a tooth comes in contact with an acidic drink repeatedly for about half an hour, the remineralization of the enamel of that tooth may require as many as 24 hours to return to the pre-contact state. However, the damaged enamel may begin to heal after 2 to 4 hours.

Good to Remember: Beverages popular in the United States can produce dental erosion. (Nutrition Research)

Who will most likely suffer from tooth erosion due to acid reflux?

According to research, people belonging to the following risk groups could suffer from acid reflux most:

  • People with eating disorders. That includes both anorexia and bulimia.
  • Those suffering from gastroesophageal reflux disease.
  • Those that are into alcohol abuse.

If you belong to one of the following groups, it is likely that you will have dental erosion:

  • You are into soft or sports drinks.
  • You are a vegetarian.
  • Do you eat raw food diet? You may have tooth erosion.
  • Occupationally you are exposed to acid.
  • Regular medications may induce acid reflux and hence tooth erosion.
  • Certain food supplements can also increase the chance of tooth erosion for you.

On what does the severity of tooth erosion depend?

The severity of tooth erosion depends on the nutrition intake, the composition of saliva, the physical wellness of the patient, and how fast and well the patient’s body can absorb the acid. The composition of the tooth, flow rate into it, and the anatomy of the enamel are also contributing factors to tooth erosion.

At the same time, the pellicle formation on the surface of the enamel may also be a factor in this regard. The pellicle is a thin protein film that covers the teeth right after brushing them.

Can I lose my tooth due to enamel erosion?

There are enough reasons to fear enamel erosion, but it should not lead to tooth loss. However, if enamel erosion is not treated, it could lead to more dangerous dental problems like cavities and abscesses that can cause tooth loss. Since the erosion of your enamel will be evident, chances of preventing tooth loss are very likely, provided you see a dentist.


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