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Most people don’t spend a great deal of time thinking about their teeth.

Life throws up sufficient curveballs to keep us otherwise occupied, so that’s understandable.

The problem is, however, that there may well be a silent epidemic affecting your teeth, to which you are totally unaware.

Dental erosion – the loss of tooth enamel caused by acids – is a severe problem that can wreak havoc on your oral health if left untreated.

Enamel is a translucent, protective coating that covers the crowns of your teeth – the visible portion above the gum line. Dental erosion can occur on all tooth surfaces: front, back, and sides. The severity and extent of dental erosion depend on how long your teeth are exposed to acid and how often you consume acidic foods and drinks. 

There are four stages of dental erosion: incipient, moderate, advanced, and severe. Severe dental erosion results in the exposure of the inner layers of your teeth, which can lead to increased sensitivity and pain.

Several things can cause dental erosion, including: 

• Acidic foods and drinks: Foods and beverages with a high acid content can wear away at the enamel on your teeth. Common culprits include citrus fruits, tomatoes, sodas, and vinegar.
• Dry mouth: A dry mouth doesn’t have enough saliva to protect your teeth from acidic foods and drinks. Certain medications or medical conditions can cause this.
• Teeth grinding: Teeth grinding (bruxism) can wear away at the enamel on your teeth over time.
• Heartburn and acid reflux: Gastroesophageal reflux disease (GERD) occurs when stomach acid flows back into the oesophagus, irritating the tissues. This can cause a burning sensation in the throat or chest, known as heartburn.
• Certain medical conditions: Some medical conditions can increase the risk of dental erosion. These include anorexia nervosa, bulimia nervosa, and cystic fibrosis.
• Heavy-handed brushing with a firm toothbrush and abrasive toothpaste will wear away your teeth at the gum line.
• Non-fluoride toothpaste will eventually catch up with you.

This short video provides an illustration of tooth wear in action:

We asked Dr Clifford Yudelman from OptiSmile about how dental erosion flies dangerously under the radar:

“Over the 16 years I practiced in California, I saw patients with great teeth and no cavities, deteriorate in a matter of months, not years, when they stopped using fluoride toothpaste and went onto some fad diet of the day. In those days, it was the “grapefruit diet”, no fluoride, and lots of grapefruit every day – a perfect storm.”

By now, you might be freaking out and wondering if you’re headed that way so let’s run through the most visible symptoms of dental erosion.

Changes in the colour of your teeth from loss of tooth surface and thinning lead to the transparency of your teeth. They may look shortened or misshapen and flattened biting surfaces with small round ditched where you used to have cusps as a teenager.

Cracked or fractured teeth always need yet another filling, or the dentist starts talking about crowns on your teeth. The symptom that should set alarm bells is increased general sensitivity to cold temperatures and cold air on your teeth.

The best way to treat dental erosion is to prevent it from happening in the first place by reducing the frequency of consumption of acidic foods and drinks. You can still consume these but be aware of how long the acid is in contact with your teeth and how often.

See your doctor if you have acid reflux, dry mouth, or any other medical conditions mentioned. 

There are several ways that dental erosion can be treated, depending on the severity of the problem:

• Topical fluoride treatments: Topical fluoride treatments help to strengthen tooth enamel and reduce sensitivity caused by dental erosion. These treatments are available in gels, rinses, and varnishes applied directly to the teeth. OptiSmile recommends Tooth Mousse with calcium and phosphate to build up the enamel. This is only available from a dental practice and can’t be found in pharmacies.
• Composite bonding: Bonding involves applying a composite resin material to the affected tooth or teeth. This material hardens and bonds with the tooth, protecting it from further damage. Dr Yudelman is following world trends with the latest method for this process. The bonding is applied using a computer-designed 3D printed mould and injected into the mould over your teeth.
• Veneers: Veneers are thin ceramic shells attached to the teeth’ front surface. Veneers are claimed to provide protection from further damage and give your teeth a cosmetic boost. However, we have previously discussed how this option is always a last resort because more tooth needs to be drilled away to place veneers.
• Crowns: Crowns are placed over damaged teeth to protect them from further damage and are typically recommended for people who have advanced cases of dental erosion. In some cases, multiple crowns may be necessary.

Dr Yudelman stresses that OptiSmile tries to reduce the drilling away of enamel, meaning fewer crowns and veneers. Composite bonding has become so advanced now that it’s rapidly becoming the standard of care for erosion treatment even in severe cases.

If erosion has caused your bite to collapse, a short course of Invisalign clear braces can regain the lost space and give the dentist enough room to build your teeth back up rather than drilling them down into little stumps and glueing on crowns. 

In extreme cases, extraction may be necessary if too much tooth structure has been lost to dental erosion.

By taking the aforementioned step, you can help reduce your risk of developing dental erosion. If you already have dental erosion, there are treatments available that can help lessen the symptoms and slow the progression of the disease.

OptiSmile in Sea Point, Cape Town has four dentists, an Invisalign specialist, a prosthodontist, and a hygienist who work as a team to help you with dental erosion or any other dental issues you may have.

Chatting with the professionals on hand to plot your treatment plan is the starting point. From there, you’re on the path to restoring your winning smile.