Dental erosion is something you see in patients on a daily basis. Although it has multiple causes, many people aren't aware of the damage they do to their teeth. A dental hygienist's job is to inform them, and in the case of children to also inform their parents, on how this process erodes their teeth over time and to provide them with the tools to help prevent further loss of their tooth structure.
Dental erosion destroys the tooth's surface by a chemical dissolution process that is not bacterial in nature. The softened surface is also subject to wear by attrition and abrasion. Dental erosion can leave teeth looking shiny and glass-like initially, but eventually, patients' teeth can appear cupped with the eventual loss of occlusal morphology and even affect the patient's bite. This process begins when the normal pH level of saliva drops when exposed to internal or external acids, triggering demineralization. The exact pH level where demineralization begins can be tough to predict, however, as protective factors such as the presence of fluoride, calcium and phosphate can help protect enamel.
Patients may be familiar with the fact that erosion can result from consuming citrus fruits, acidic juices and regular sodas, yet they may be overlooking or unaware of a few lesser-known offenders. Here are five hidden causes of dental erosion you can pass on to your patients to preserve their healthy smiles.
Many people consume sugar-free beverages in an effort to cut calories. What some of your patients may not know is that diet soda is very acidic, with a pH as low as 3.2 according to RDH Magazine. The same is true of sugar-free energy and sports drinks. Ultimately, sipping on these beverages continuously can increase acid erosion because it keeps the salivary pH at a low level.
It's a common misconception that dental erosion only comes from acidic food and beverages. Unfortunately, acids from the stomach can rise up through the esophagus and damage exposed tooth surfaces when they reach the mouth. Conditions like gastroesophageal reflux disease, morning sickness and bulimia all expose the teeth to gastric contents. This causes the pH in the mouth to drop rapidly, and damage to tooth structure can then occur.
Brushing twice a day is a habit that is greatly encouraged. What patients may not be aware of is that by brushing shortly after acid exposure they may actually be damaging their teeth, according to the Colgate® Oral Health Network for Professional Education and Development. Teeth should actually be brushed before consuming an acidic food or beverage, or other exposure, not immediately afterwards. Otherwise, acid is being brushed on the tooth surface, and structure weakened by erosion can also be removed during brushing. Alternatively, brushing should occur 1 to 2 hours afterwards to give time for the pH to return to normal through the natural action of saliva.
Dental hygienists should recommend an enamel-strengthening toothpaste, like Colgate® Enamel Health™ Enamel Toothpaste, so patients can help protect their enamel from future damage.
When you detect erosion, ask your patients about their eating and drinking habits. Coffee, tea, wine, pickles, yogurt and many common condiments are actually quite acidic. If eating and drinking these, patients should be advised to avoid snacking on them or drinking them throughout the day, to keep acid exposure to a minimum.
Saliva is the mouth's first line of defense against an acid attack. When saliva levels are low or saliva has a poor buffering ability, there is less protection against erosion. Recommend that patients swish with water or milk after eating or drinking anything acidic, to help remove acid and increase the pH. A high concentration fluoride toothpaste, such as Colgate® PreviDent® 5000 Enamel Protect (Rx only), is another great solution to help protect their smile.
It's crucial that dental hygienists take the time to explain to patients the destructive processes that are going on inside their mouths. By reviewing the causes of erosion with your patient, you'll be able to pinpoint the offending habits and pave the way for a self-guided change.
- Examine carefully for signs of erosion.
- Educate your patients about the causes of erosion, including lesser-known ones.
- Recommend products and daily habits that help preserve patients' healthy smiles.
Dental erosion causes loss of tooth structure and needs to be prevented. It is, therefore, essential that dental hygienists address erosion and its causes with patients, and provide advice on how to prevent dental erosion and help protect teeth against irreversible damage.