The StarPhoenix
An apple a day . . . Dental erosion caused by some healthy foods

EDMONTON -- Basically any food with an acidic pH, whether it's healthy or not, is still acidic, which means it can dissolve your tooth structure. In layman's terms this is called acid wear, in medical terminology it's known as dental erosion or acidic erosion.

Healthy foods that are culprits for dental erosion are anything citrus -- so oranges, orange juice, lemons, limes -- and things such as yogurt. Sports drinks and energy drinks are culprits as well, but aren't really health food.

People automatically think of things with sugar in them, so if something is sugar-free they think it's OK for their teeth, but it can still be quite acidic, especially a lot of diet pops.

Acidic foods and drinks are probably the least of our worries, though. Most dental erosion occurs from stomach problems such as gastroesophageal reflux disease or GERD, heartburn, which basically throws the pH level of battery acid on your teeth.

Most cases of the dental erosion I see are mild. In a month, I probably see at least one person where it's quite severe.
Erosion looks very different from normal dental wear which tends to be quite flat. Erosion tends to be a smooth lesion that's kind of cupped or concave. It's usually seen on the biting surfaces and on the sides of the teeth near the gum line. The areas are discoloured because once the outer layer of enamel wears away, it exposes the next layer, dentin, which is yellow.

Sensitivity is probably the biggest complaint people have because of dental erosion. In the dentin there are microscopic tubes containing fluid that connect to the nerve. Dentin is like the gatekeeper to the nerve and when it gets stimulated the fluid rushes in and hits the nerve.

Everybody's going to get acid exposure because we all eat. It's the frequency of how often it's happening that's the key.
So if you're going to eat citrus fruits, don't do it all day long. Nibbling on citrus fruits and drinking or sipping orange juice all day long means you're being exposed again and again and again. If you limit your exposure to once or twice a day, your end result is going to be a lot better.

If you're not a person with any other risk factors, then of course it's more important for you to eat healthily by eating those fruits and vegetables. However, if you have a lot of risk factors -- if you have a lot of stomach problems, drink a lot of pop and sports drinks and grind your teeth -- topping that off with orange juice every day is probably not a good idea.

If you have acid exposure, brushing and rinsing with water right after is the worse thing you can do, because you're spreading the acid around. What you need to do is neutralize the acid -- rinse with a baking soda solution, or eat something that has a high fat, high protein count. Wait about 30 minutes, then brush.

If people have fairly extensive erosion, it will usually require work with a specialist, and quite a bit of expensive dental work, to restore the teeth.

In terms of sensitivity, there are things you can do. Toothpastes for sensitive teeth are good, but as soon as you stop using them, the sensitivity comes back.

The only thing that can remineralize enamel and actually make your teeth stronger than they were originally is fluoride. In my practice, I assess people for risk.

If they're at low risk for decay or erosion, I don't usually recommend any additional fluoride. If they're at moderate risk, I'll recommend a home fluoride treatment. And, if they're at high risk, I'll usually make them custom dental trays that they actually wear to do a fluoride treatment at home every day.