While intrinsic erosion from gastric reflux or bulimia presents a danger in some patients, many patients suffer from extrinsic erosion brought on by drinking and eating highly acidic food and drinks, common in diets today. Patients may be eating a “healthy” diet and still endangering their enamel. A pH level of 6.6 in the oral cavity is enough to soften tooth surfaces, while a pH of 5.5 will demineralize enamel and dentin. A diet heavy in fruit and vegetables such as apples (pH of 3.5 to 3.9), oranges (2.8 to 4.0), and tomatoes (3.7 to 4.7) can soften both enamel and dentin as well as exposed cementum. Heavy coffee drinkers are exposing their tooth structure to pH values of 2.4 to 3.3. Consuming sports drinks may reduce the pH in their oral cavity to 2.3 to 4.4. Beer and wine also lower pH values to similar levels. Brushing after every meal while enamel is soft can cause abrasion and reduce tooth structure. Teeth can become sensitive over time, and constant erosion can leave dentin exposed. Frequent whitening can increase sensitivity as well, and patients need to be counseled on when to “touch up” and if fluoride is necessary to help protect vulnerable areas. Diagnosis of acid erosion can be included as part of initial patient consultations about diet and lifestyle. Acid erosion can cause teeth to lose luster while becoming smooth with rounded edges. The color may be darker due to loss of enamel, and dentin becoming visible. The incisors may become translucent, and teeth may exhibit more cracks than normal. Acid erosion is nonreversible and can cause long-term damage. Patients need to be aware of how their diet can be causing gradual loss of enamel, and should be instructed on what products are available to help with remineralization.
(Source: Dimensions of Dental Hygiene, April 2008)
