2. Introduction
• Dental Erosion also known as Acid Erosion is a type of tooth
wear. It is the loss of dental hard tissue caused by intrinsic or
extrinsic acid that is not produced by bacteria.
• Dental erosion does not begin as a subsurface enamel lesion
that is conducive to remineralization, as in the caries process.
It is often widespread and may involve the entire dentition.
• Dental hard tissue loss associated with erosion is almost
always complicated by other forms of tooth wear such as
attrition and abrasion.

3. • Dental erosion results in tooth surface softening, which
inevitably accelerates tissue loss caused by tooth-to-tooth
contact while chewing and grinding (attrition) or by abrasive
wear while mechanically brushing or cleaning tooth surfaces
(abrasion).
• At Dr.Sachdeva’s Dental Clinic, we tell our patients that if
Dental Erosion is not managed effectively, it may result in
substantial loss of enamel and subsequent exposure of the
underlying dentin, which can, in turn, lead to dentin
sensitivity, loss of vertical height and esthetic problems.

4. What is dental erosion?
• Dental Erosion is the loss of tooth enamel caused by acid
attack.
• Enamel is the hard, protective coating of the tooth, which
protects the sensitive dentine underneath.
• When the enamel is worn away, the dentine underneath is
exposed, which may lead to pain and sensitivity.

5. Besides erosion, other types of tooth wear can be described:
 Attrition: This type of tooth wear is caused by natural tooth-
to-tooth friction. This can happen while clenching or grinding
your teeth, for example in cases of bruxism, which often
occurs involuntarily during sleep.
 Abrasion: This is physical wear and tear of the tooth surface
that happens with brushing teeth too hard or using an
improper toothbrush, improper flossing or biting on hard
objects (such as fingernails, bottle caps, or pens).

6. • Abfraction: Is a theoretical concept explaining a loss of tooth
structure not caused by tooth decay (non-carious cervical
lesions). It is suggested that these lesions are caused by forces
placed on the teeth during biting, eating, chewing and
grinding; the enamel, especially at the cementoenamel
junction (CEJ), undergoes large amounts of stress, causing
micro fractures and tooth tissue loss.

7. What causes Dental Erosion?
Dental Erosion is caused by sustained direct contact between
tooth surfaces and acidic substances;
1. Acidic foods and drinks
• The most common cause of dental erosion is due to acidic
foods and drinks.
• Drinks low in pH levels that cause dental erosion include fruit
juices (mainly orange and apple), sports drinks, wine, beer
and carbonated drinks (such as colas or lemonades).

9. • A diet high in sugars can also cause erosion.
• Frequency rather than total intake of acidic juices or foods is
seen as the greater factor in dental erosion.
• Saliva acts as a buffer, regulating the pH when acidic drinks
are ingested and protecting the enamel from demineralization
(which is the loss of its mineral content).
• However, if acid attacks happen too often, the buffering
capability of saliva decreases and the enamel does not have a
chance to repair itself. Over time, you start to lose the surface
of your teeth.

11. 2. General conditions
• People with bulimia or gastro esophageal reflux disease
(GERD) are all at higher risk of dental erosion because the
gastric acid from the stomach comes into contact with the
teeth.
• For example, bulimia is a condition where patients make
themselves sick so that they lose weight.
• Frequent vomiting erodes tooth enamel and can lead to
cavities.

12. 3. Other causes
• Other causes include:
• A number of medications such as vitamin C, aspirin or
antihistamines
• Dry mouth or low salivary flow (also known as xerostomia),
because the buffering capability of saliva is not present to
counterbalance the acidic environment
• Genetic or inherited conditions
• Environmental factors such as friction, wear and tear, stress
etc.

13. Signs of Erosion
Recognizing erosion signs is an important first step in solving the
problem. We at Dr.Sachdeva’s Dental Clinic, help our patients
recognize these signs.
Sensitivity
• In the early stage of enamel erosion, there may be an
increased sensitivity when eating hot, cold, or sweet foods.
• In later stages, teeth become extremely sensitive to
temperatures and sweets. The enamel gets eroded away,
exposing the sensitive dentin and making it more vulnerable

15. Discoloration
• Enamel is white. Dentin, the sensitive tissue located below
the enamel, is yellow. So if your teeth develop more of a
yellow tinge, it may be due to enamel loss.
• The first change of color usually happens on the cutting edges
of the central incisors as they become transparent.
• In later stages, the enamel erodes and more dentin is
exposed. This will cause the teeth to appear yellow.

16. Changes in shape
• Teeth may show a broad rounded concavity and the gaps
between teeth can become larger.
• Indentations may appear on the surface of the teeth.
• The edges of teeth become more rough and irregular as
enamel erodes.
• In later stages of dental erosion, teeth begin to crack off and
become coarse. Your teeth may appear thinner or smaller
than normal.
• Also, the lower portion of your front teeth can look
transparent as opposed to opaque. Either of those conditions
is an indication of dental erosion.

17. • Though dental erosion often coexists with attrition and
abrasion, it has some distinctive characteristics in location,
appearance and morphology.
• The most frequently affected areas are the palatal surface of
maxillary incisors and the occlusal surface of the mandibular
first molars in adolescents.
• Early signs of erosion often include smooth and flat facets on
facial or palatal surfaces, and shallow and localized dimpling
on occlusal surfaces.
• Without intervention, erosive wear will progress, leading to
deep cupping lesions with exposed dentin and eventual loss
of occlusal morphology.

19. What can I do to prevent Dental Erosion?
Dentists in North Delhi, suggest these few simple steps to
prevent Dental Erosion;
• Reduce the frequency of acidic and sweet food and beverage
intake. This decreases the sugar/acid exposure time and
allows the eroded tooth surface to harden.
• Have acidic food and drinks, and fizzy drinks, sodas and pops,
just at mealtimes. This will reduce the number of acid attacks
on your teeth.
• Drink quickly, without holding the drink in your mouth or
‘swishing' it around your mouth. Or use a straw to help drinks
go to the back of your mouth and avoid long contact with
your teeth

20. • Chew sugar-free gum after eating. This will help produce
more saliva to help cancel out the acids which form in your
mouth after eating.
• Brush your teeth last thing at night and at least one other
time during the day, with fluoride toothpaste. Use a small-
headed brush with medium to soft bristles.
• Wait for at least one hour after eating or drinking anything
acidic before brushing your teeth (this gives your teeth time
to build up their mineral content). If you can, rinse your
mouth immediately with clear water after eating acidic foods
or drinking acidic drinks

21. • Use fluoride toothpaste. Fluoride acts as a remineralizing
agent for the enamel. You can also apply fluoride gels or
varnishes to the teeth.
• Children up to three years old should use a toothpaste with a
fluoride level of at least 1000ppm (parts per million). Three-
year-olds to adults should use toothpaste that contains
1350ppm to 1500ppm.

22. Clinical interventions
1. Apply fluoride varnish to tooth surfaces susceptible to
erosion: A protective film containing fluoride will reduce
direct contact between tooth surfaces and acids and deliver
fluoride to strengthen the enamel surfaces.
2. Treat underlying diseases associated with the presence of
intrinsic acids intraorally: This includes GERD, bulimia,
regurgitation. It is often necessary to establish close
consultation with the patient’s physicians when an intrinsic
cause of erosion is suspected.

23. 3. Treat conditions causing salivary hypofunction;
• When low saliva flow rate is established as a factor for erosion
in a specific patient, measures should be taken to improve
saliva flow, where possible.
• This may include consultation with the patient’s physicians on
adjustment of medications causing dry mouth, and referrals
for evaluation and treatment of autoimmune diseases such as
Sjogren’s syndrome

25. Prevention and management
• If no effective intervention occurs at an early stage, the
eventual outcome of dental erosion is severe loss of dental
hard tissues that adversely affects function and esthetics.
• In patients with extensive dentin exposure, transient and
persistent pain due to dentin sensitivity and pulp pathology
may further reduce quality of life.
• Severe erosive tooth wear can be managed restoratively.
Composite resins and ceramics can be used for partial and full
coverage restorations to restore the esthetics and function of
the teeth.

26. • However, if the restored teeth continue to be subjected to
severe erosive challenges, the restorations may fail in due
course following marginal deterioration and continued loss of
surrounding dental hard tissues.
• Therefore, preventive measures for dental erosion are not
only essential for early intervention and primary prevention of
erosive tooth wear, but they are also important for secondary
prevention of erosion around restorations.

27. For more information, you can book an appointment at
Dr Sachdeva's Dental Aesthetic And Implant Institute,
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
Phone : +919818894041,01142464041
Our Websites:
www.sachdevadentalcare.com
www.dentalclinicindelhi.com
www.dentalimplantindia.co.in
www.dentalcoursesdelhi.com
www.facialaestheticsdelhi.com

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