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What is Tooth Erosion?

In the photo to the right you can see the yellow dentin showing on a first molar with severe tooth erosion.   All of the white enamel has been eroded away exposing the underlying yellow dentin.  These particular molars (first molars) typically erupt when a patient is about six years old and they are meant to last a lifetime.  So, keeping them healthy is very important!  Do you have tooth erosion?  You may not even be aware of this but the effects are permanent and should be diagnosed as soon as possible to prevent this irreversible trauma!

Severe erosion of first molar.

Severe erosion of first molar.

A quick search of the internet (I elected to copy some of the information that I found) will tell us that Tooth erosion or enamel erosion can be caused by the following:

  • Excessive soft drink consumption (high levels of phosphoric and citric acids)
  • Fruit drinks (some acids in fruit drinks are more erosive than battery acid)
  • Dry mouth or low salivary flow (xerostomia)
  • Diet (high in sugar and starches)
  • Acid reflux disease (GERD)
  • Gastrointestinal problems
  • Medications (aspirinantihistamines)
  • Genetics (inherited conditions)
  • Environmental factors (friction, wear and tear, stress, and corrosion)

What are some of the environmental causes of tooth surface erosion?

Friction, wear and tear, stress, and corrosion (or any combination of these actions) can cause erosion of the tooth surface. More clinical terms used to describe these mechanisms include:

  • Attrition. This is natural tooth-to-tooth friction that happens when you clench or grind your teeth such as with bruxism, which often occurs involuntary during sleep.
  • Abrasion. This is physical wear and tear of the tooth surface that happens with brushing teeth too hard, improper flossing, biting on hard objects (such as fingernails, bottle caps, or pens), or chewing tobacco.
  • Abfraction. This occurs from stress fractures in the tooth such as cracks from flexing or bending of the tooth.
  • Corrosion. This occurs chemically when acidic content hits the tooth surface such as with certain medications like aspirin or vitamin C tablets, highly acidic foods, GERD, and frequent vomiting from bulimia or alcoholism.
The contralateral molar in this patient also shows severe erosion.

The contralateral molar in this patient also shows severe erosion.

Enamel is the thin outer covering of the tooth. This tough shell is the hardest tissue in the human body. Enamel covers the crown which is the part of the tooth that’s visible outside of the gums.  Because the loss of enamel during tooth erosion usually occurs over a long period of time, there is often very little sensitivity in teeth with erosion.  The tooth actually has the ability to lay down more tooth structure from the inside protecting the nerve inside the tooth from painful stimuli.

Looking at the photo to the left, you can also see staining or decay within the enamel of the molar behind the molar with tooth erosion.  Sometimes tooth erosion will look like small pits in the enamel before the near total destruction of the enamel on the chewing surface of the tooth as seen here.

Enamel is translucent meaning that it allows some of the underlying color of the tooth to show through as light passes through it. The underlying portion of the tooth, the dentin, is the part that’s responsible for your tooth color — whether white, off white, yellow, or grey.  So when enamel is lost with tooth erosion, the darker dentin color of the tooth becomes more evident.

See bilateral erosion of the lower first molars.

See bilateral erosion of the lower first molars.

If you are concerned about whether you have tooth erosion, or if treatment is needed here, our office can help! Call our Grand Junction, Colorado office at (970) 242-3635 and we will do our best to answer your questions about this or any dental health concern!

Yours for better dental health,

Julie Gillis DDS, AAACD

Restoring Teeth, Restoring Smiles