Erosion: Are you wearing down your teeth

What is dental erosion?
How is erosion caused?
Why haven't I heard about erosion before?
Can erosion be fixed or stopped?

NEW research 2009: Cleaning your car can be bad for your teeth
A recent study in Sweden investigated the cause of tooth damage in workers who recondition cars. They found that workers all were exposed to an alkaline degreaser. These chemicals are not acidic, which is what is typically identified with tooth damage, but very alkaline. The alkaline degreasers are used in the food industry, among other things to clean professional kitchens, but are also common in car care industry and to remove vandalism painting.
The damaged teeth were more susceptible to decay and other damage.

What is dental erosion?
It is where we start loosing the tooth layers (particularly the outer enamel layer). This becomes a problem when we start to get teeth that

• Look too short
• Sensitivity occurs
• Nerves in the teeth die (require endodontic treatment)
• We are going to live longer than our teeth!

How is erosion caused?
This is an age - wear and tear problem. A particularly harsh diet (lots of non-refined food) could cause it. In Western society it is more likely to occur because of acids. These can be:  1. External acids (most commonly) or 2.Internal acids

1. External Acids ( introduce to your mouth)
   Dietary:  soft drinks, sports drinks, fruit juices, cordial, chewable vitamin c tablets, vinegar and pickles
   Industrial /occupational/lifestyle: wine assessment, acid vapors in industrial settings, improperly chlorinated swimming pools and spas
   Pharmaceutical: Vitamin C, frequent aspirin use, some iron tonics, some cough medicines, some mouth rinses, asthma medication
2. Internal Acids (within us) can also cause damage.
   There are many conditions that cause vomiting or regurgitation. E.g. Morning sickness, gastric reflux, hiatus hernia, bulimia, alcoholism

Why haven't I heard about it before?
For some people it is a problem but for many people it is not. Different things that are important in whether you have this as a problem are:

1. Saliva: people with dry mouths are at greater risk. Sports people need to be particular aware of dehydration. Distance swimmers and rowers need to be virulent.
2. Acid in your diet: Some acid foods don’t seem to be a problem because other aspects modify the erosive potential. Mature red wine is less erosive than young red or white wines and yogurt has a ph of about 4 but doesn’t show erosive effects in most people.Cooking methods can affect the erosion potential of foods.
3. Time and frequency of acid contact: The more frequent the acid contact and the greater the length of time then the greater the damage. If the acid effect is then followed by a mechanical effect the damage will be greater.e.g. brushing teeth after vomiting.

Can erosion be fixed or stopped? (random suggestions)

• Remove the acid from the diet
• Cheese or drinking water at the end of a meal helps restore the mouth.
• Try acid drinks through a straw to minimalise tooth contact. Avoid frequent consumption of acid drinks between meals.
• Use a bicarb rinse after vomiting.rinse mouth with water. Put toothpaste onto your tongue to fresh your mouth - brushing teeth that have just been exposed to acid will cause MORE tooth loss. Use a bicarb rinse.
• Find an alternative to chewing Vitamin C tablets.
• Seek treatment for gastric reflux
• Chew sugar free chewing gum to reduce a dry mouth.

Cooking method can affect erosion
Researchers at the University of Dundee have discovered that different methods of cooking vegetables can vary their effects on dental erosion. A new study led by Dr Graham Chadwick from the School of Dentistry, found that oven-roasted ratatouille was significantly more acidic than the traditional stewed version of the dish (Chadwick R G. Eur J Prosthodont Restor Dent 2006; 14: 28-31).
The research was based on reports that a vegetarian diet may give more risk of dental erosion due to the acidic nature of a large number foods involved, including fruit and vegetables. Ratatouille is a popular vegetarian dish made from tomatoes, onions, aubergines, courgettes and red and green peppers, and can be either stewed on a stove-top or oven roasted. The team looked to see whether the cooking method had any effect on its final acidity and therefore its potential for contributing to dental erosion.
Although ratatouille is always acidic, oven roasting was found to increase the acidity of the dish to the point where it was equivalent to some carbonated drinks. 'The finding that cooking method has an impact on the acidity of food is an interesting and useful tool for dentists when advising patients on ways to reduce their chances of dental erosion,' said Dr Chadwick.
The Dundee team also looked at whether the cooking method had an impact on individual vegetables and fruits. They found that there was no effect on the acidity of tomatoes or onions, but roasting resulted in more acidic aubergines, green peppers and courgettes. Red peppers were found to be more acidic when stewed.British Dental Journal (2006); 200, 545. doi: 10.1038/sj.bdj.4813650