Dental Erosion That’s Not Caused by Cavities; How Does It Happen?

A Conclusive Study Based on Interviews with Monarch Dental San Antonio, Concordia Dental & Katsur Dental Professionals

Erosion! Your dentist has diagnosed initial dental erosion. But how is that possible? You don’t eat sugary foods and you practice good tooth brushing techniques? And now you have to see about cheap dental implants because your doctor says you suffer from erosion.

Because we know that so many of us have questions with regards to cavities and dental erosion, especially when it is not cavity related, we decided to turn to our network of professional doctors to get answers. Thanks to professionals like those available at Monarch Dental San Antonio, Concordia Dental and Katsur Dental, we learned the following.


Dental erosion can be a natural occurrence,say the experts at Monarch Dental San Antonio. It is possible to have enamel erosion without it coming from the bacteria that causes caries. There are basically two types of dental erosion. The first is the type is caused by bacteria, which is the process we know causes cavities. This is generally caused by poor oral health care, consuming sugary foods and not visiting your dentist regularly.

But what if you do brush your teeth three times a day, you floss as you are supposed to, and you visit your dentist regularly? Still, you might experience dental erosion say experts at MDSA. The enamel on your teeth is wearing down. This is known as dental erosion. It happens when your tooth enamel, the hardest part of your tooth is exposed to non-bacterial acids. When this happens your teeth are experiencing mineral loss from the surface of the tooth.

Both cavities and dental erosion cause the need for cheap dental implants if the problem is not attended and treatment is not implemented.


“Wow!” you think. “That’s kind of scary. What does that mean. What is dental erosion? Does that mean my teeth are getting smaller?” Actually,according to experts at Concordia Dental, if you visit your dentist regularly and practice good oral hygiene, it just means you need to be careful, visit your dentist regularly, understand what dental erosion is, learn how to control it, and start treatment.

Dental erosion is an oral health issue that occurs worldwide, and in some countries is becoming more frequent, say the experts at Concordia. It happens when tooth enamel, the hardest part of your tooth and the part that everyone sees, is exposed to non-bacterial acids. Early signs of dental erosion are shallow and localized dimpling on the molars and incisors, and overall erosion of tooth enamel and dentin (the part that lies under the enamel.) The key to stopping it is early intervention which means implementing measures; these reduce the direct contact your teeth have with acids and the resistance of the tooth enamel. It is early intervention that can help you avoid the expense of cheap dental implants.

The manifestation and management of this type of dental erosion is fundamentally different from the type of erosion that causes cavities, because this erosion is not caused by bad bacteria as it is in regular cavities. Lets explain the difference a little better.

Cavities – are caused by the byproduct left by bacteria that feeds off of sugars and starches in your mouth. This byproduct is a type of acid that creates holes and cracks in the tooth enamel. You can prevent this type of acid byproduct by brushing your teeth correctly and  visiting your dentist regularly.

Dental Erosion – is caused by natural and medical occurrences in your body. It is the ingestion of food and medical acids that your body cannot balance out correctly through the secretion of saliva. “This happens in some people,” suggest experts at Katsur Dental

Both types of enamel erosion are preventable and manageable but in different ways say the doctors at KD.

So, we thought we would delve a little deeper into the explanation of dental erossion. We know you already understand how to prevent cavities, so instead, let’s learn about dental erosion and the reasons why your dentist may say you are at risk.


What Is It?

Dental erosion doesn’t start as an enamel lesion, but rather, it is  a surface-softening that wears down the enamel and is resistant to re-mineralization through the more conventional treatments. The doctors at MDSA helped us to comprehend that this has nothing to do with the way normal cavities occur. And the problem is made worse as it spreads throughout the tooth enamel and dentin of all your teeth. This hard tissue loss can also be a result of other types of tooth wear such as abrasion.

The erosion is caused by tooth surface softening and increases with tooth to tooth contact you make when chewing. If this condition is not managed by your dental professional through effective intervention, it can result in the loss of a substantial amount of enamel and to the exposure of the dentin which leads to dentin sensitivity and tooth esthetic issues.

The erosion occurs when teeth are in direct and sustained contact with acidic substances. This causes demineralization of dental enamel because the pH levels have reached a critical level of 5.5.7. These acids get into your mouth in one of three ways;

  1. Through bacteria
  2. Ingested extrinsic acids through diet
  3. Through acids that come from backflow of gastric content.

Acids of bacterial origin – is the erosion we all are familiar with as it causes cavities.

Diet Ingested Extrinsic Acids – cause dental erosion in some people and this is caused primarily by diet and saliva flow rate and the saliva buffering capacity in the mouth.  Some people have low saliva flow rate and poor buffering capacity which allows for prolonged retention of acids in the mouth.

Acidic Foods Can Be the Cause Dental Erosion

Sodas are Bad For you and it is a serious problem, say experts at Dental Implants Atlanta. Soft drinks, carbonated beverages, fruit juices and sports drinks are acidic beverages. The pH effects of these beverages has been extensively studies and shows that dental erosion  occurs in the form of enamel and dentin tissue loss in people that drink a lot of soft drinks and fruit juices.

Acidic Foods are Also Culprits in The Erosion Process

Acidic foods and dietary ingredients Besides acidic drinks, many solid and semisolid foodstuffs are also acidic in nature. Although researchers do  not fully understand the erosive effects of  acidic foodstuffs, they believe that  frequent ingestion of these types of foods may also contribute to dental erosion. Individual eating habits may be the most important factor affecting the erosive potential of acidic foods. Frequent consumption of citrus fruits could significantly increase the risk for dental erosion.

Medications Can also Be Acidic

Even medications can be the cause say the doctors at Dental Implants Atlanta. Other sources of extrinsic acids come from  Acidic medications such as those containing vitamin C34, 35 and aspirin36, 37. These over-the-counter medications  may cause erosion when used in a manner resulting in sustained contact between tooth surfaces and the medication. Habitual use of mood-enhancing drugs such as ecstasy can also increase the risk for erosive tooth wear.

People Working in Certain Professions Can Also Be Exposed to Dental Erosion

Certain environmental and occupational factors contribute to dental erosion, especially in selected populations. This may affect swimmers, workers in an environment with acidic industrial vapors and professional wine tasters.


Intrinsic Acids Cause Dental Erosion

Intrinsic Acids are those that come from the inside of our body. The source of intrinsic acids in the mouth is mostly from the backflow of the gastric contents through the esophageal tract. Gastric juice consists mainly of hydrochloric acid, produced by the parietal cells in the stomach. The presence of this highly acidic gastric juice may lead to dental erosion. Gastro-esophageal reflux disease (GERD), bulimia and rumination are the main conditions associated with the backflow of gastric juice to the mouth.

It is Common in People Who Suffer from Bulimia

Dental erosion in bulimic patients is most likely associated with oral retention of regurgitated gastric contents. The dietary habits of bulimic patients may include binging on high-energy foods and foods with high erosive potential, which may further erode teeth.

The Importance of Saliva Flow in the Elimination of Acids in the Mouth

When acidic substances enter the mouth, salivary glands increase the secretion of saliva; the flow accelerates to clear the acids from the oral cavity. Since human saliva contains bicarbonates and urea, it rapidly neutralizes the acidic remnants and returns the oral pH to normal – which is known as the buffering capacity of saliva, an important mechanism for oral pH regulation. But flow rate can differ in each person depending on many different factors.  For instance, people who suffer from autoimmune diseases such as Sjögren’s syndrome can have lower flow rates. People on certain medications like antidepressants or antipsychotics could have lower saliva production.  Even aging affects saliva production. When saliva flow rate is reduced, its clearance and buffering capacity will be negatively impacted, resulting in abnormal acid retention in the mouth, which, in turn, may contribute to dental erosion. Saliva flow rate and buffering capacity are therefore important factors that can help the body eliminate acids naturally and prevent dental erosion.


How Does Your Dentist Diagnose Dental Erosion Accurately?

Accurate diagnosis of erosion and erosive tooth wear is crucial suggest the doctors at Dental Implants Atlanta. It begins with an in-depth assessment of risk factors for erosion and of medical and dental histories. Visual inspection of tooth surfaces and wear patterns provides direct evidence of dental erosion. Since dental hard tissue loss associated with erosion is not reversible, and a severely worn dentition represents a great challenge to dentists and patients, it is important that your dental professional recognize the risk factors early, preferably before any sign of erosive tooth wear is present.

Risk factors for dental erosion include:

  • Frequent use of acidic dietary products, especially soft drinks, fruit juices and acidic foods
  • GERD, rumination, regurgitation and frequent involuntary vomiting
  • Prolonged use of chewable acidic medications, especially vitamin C and aspirin
  • People in occupations involving hazards that include direct contact with acidic substances, e.g., wine makers and tasters, swimmers, and battery workers
  • Sustained use of recreational drugs such as ecstasy
  • Low saliva flow rate and inadequate saliva buffering capacity Patients with any of the above factors are at risk of developing dental erosion.

Early intervention for the prevention of dental erosion is an effective strategy that prevents further erosion rather than any attempt to restore lost dental hard tissue due to erosion. Evaluation your dietary habits  and talking to your doctor is helpful in  assessing the erosive potential of acidic foodstuffs.

You also want to  review your current medications and take note of the way you take them as this is  also helpful in finding drugs that cause low saliva flow and that may cause erosion if ingested inappropriately. Both stimulated and nonstimulated saliva flow rates can be assessed in dental offices by simply measuring the amount of saliva collected in a 5- or 10-minute period. Patients with a non-stimulated saliva flow rate of less than 0.12 ml/min may be considered as having low saliva flow.

Without intervention, erosive wear will progress, leading to deep cupping lesions with exposed dentin and eventual loss of teeth. In patients with extensive dentin exposure, transient and persistent pain due to dentin sensitivity and pulp pathology may further reduce quality of life.


Repairing Teeth That Have Suffered from Dental Erosion

Your dental professional can restore severe erosive tooth wear by using composite resins and ceramics for partial and full tooth coverage. This restores the function and the beauty of your teeth.  However, if the restored teeth continue to be subjected to severe erosive challenges, the restorations may fail. This is why it is important to take preventative  measures for dental erosion.


How to Prevent Further Erosion?

Effective strategies for prevention of dental erosion may be formulated like this:

  1. Avoid or reduce direct contact with acids through behavioral and clinical interventions.
  2. Increase acid resistance of dental hard tissues by ensuring that your Dentist uses fluoride therapy.
  3. Increase resistance to food acids by taking calcium and phosphates.
  4. Reduce tooth abrasion with proper proper toothbrushing instructions.
  5. Reduce your intake of acidic beverages and foods: If you do drink sugary, acidic drinks use a straw to avoid contact with teeth.
  6. Rinsing with water or drinking milk immediately following the drinking of acidic beverages will accelerate the clearance of acids and help return the oral pH to neutral.
  7. Avoid misuse of acidic medications, including vitamin C: Chewing this type of medication or using such pills as lozenges increases risk for dental erosion. Acidic medications should be swallowed, if possible.
  8. Use proper protection to avoid occupational hazards: Masks, mouth guards and neutralizing agents should be used to reduce contact with acidic vapors and fluids.

Thing your Doctor Can Help With:

In the early stages of tooth enamel erosion there are certain things your doctor can do to minimize the process.

  1. Your dentist may suggest the application of a fluoride varnish to tooth surfaces susceptible to erosion. This is a protective film that contains containing fluoride and reduces direct contact between tooth surfaces and acids.
  2. He may suggest medical treatment for underlying diseases associated with the presence of intrinsic acids intraorally: This includes GERD, bulimia, regurgitation and rumination.
  3. Treat conditions causing salivary hypofunction: When low saliva flow rate is established as a factor for erosion in a specific patient. He will take measures to improve saliva flow, if possible.
  4. He may suggest treatment to increase acid resistance through fluoride therapy It has been shown that fluoride could minimize the erosive effects of soft drinks when applied as a varnish, a mouthwash, a topical gel or a dentifrice.



Dental erosion can occur even when you take oral care precautionary measures say all the doctors we interviewed. But it is common, say the professionals at Concordia Dental. It is usually a result of aging, lower levels of saliva secretion and the ingestion of acidic foods. It is a condition that you can minimize and repair. However, early detection are key in controlling the condition and preventing it from eroding teeth minimizing esthetic tooth repair measures.

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