Dental erosion: when acids wear your teeth down, signs and solutions

Dental erosion: chemical wear, not decay

Dental erosion is the gradual loss of enamel, then dentine, caused by acids that do not come from bacteria. These acids come from food and drinks, or from the stomach through reflux and vomiting. Unlike decay, there is no localised hole: the whole surface thins, becomes smooth and eventually shortens the tooth. Lost enamel does not grow back, which is why it matters to spot the problem early, deal with its cause and, where needed, protect the teeth with bonded restorations.

Erosion affects all ages, including teenagers who drink a lot of acidic drinks. It is often discovered late, because it does not hurt in the early stages.

Erosion, abrasion, attrition: the faces of tooth wear

Dentists use the term tooth wear to cover several mechanisms that often occur together in the same person:

• erosion, which is chemical and caused by acids;
• attrition, the wearing of teeth against each other, typical of grinding and clenching (bruxism);
• abrasion, caused by external friction: over-vigorous brushing, a very abrasive toothpaste, a habit of biting objects;
• notch-shaped lesions at the neck of the teeth near the gum, which usually result from a combination of these factors.

These mechanisms add up: enamel softened by acid wears away much faster with brushing or grinding. That is why your dentist does not simply note that teeth are worn, but tries to work out how much is chemical and how much is mechanical. Simple tools exist for this, such as the BEWE index (Basic Erosive Wear Examination), which gives a score to each area of the mouth and makes it possible to track changes from one visit to the next.

Warning signs to look out for

Erosion changes the appearance of teeth in a fairly characteristic way:

• smooth, shiny enamel, as if varnished, losing its fine natural texture;
• see-through incisor edges that are thin and chip easily;
• small hollows on the tips of the molars, where yellow dentine shows through;
• old fillings standing proud of the tooth, because the enamel around them has worn faster;
• teeth that look more yellow, as dentine shows through thinner enamel;
• shorter teeth, giving an older-looking smile;
• sensitivity to cold or acidic drinks, covered in detail in our article on tooth sensitivity.

Where the wear is located gives clues: marked wear on the inner surface of the upper front teeth suggests acid from the stomach, while wear on the visible surface of the front teeth points more towards drinks.

Where the acid comes from: habits, reflux and vomiting

Our article on diet and dental health lists acidic foods and drinks. Here the focus is on how they are consumed:

• sipping an acidic drink for hours at a desk or in front of a screen;
• holding the drink in the mouth or swishing it between the teeth;
• drinking lemon water every morning on an empty stomach, or taking apple cider vinegar shots;
• chewing vitamin C tablets or letting effervescent tablets dissolve in the mouth;
• having an acidic drink at bedtime, when protective saliva decreases.

Acids from inside the body are even more aggressive, because stomach acid is very strong:

• gastro-oesophageal reflux, sometimes silent, without noticeable heartburn;
• repeated vomiting: severe pregnancy sickness, eating disorders, heavy alcohol use, some digestive conditions.

When your dentist sees wear that suggests these causes, they will raise it tactfully and may refer you to your doctor. A dry mouth, often linked to certain medicines, also increases the risk, because saliva normally neutralises acids.

Slowing erosion in everyday life

Treatment always starts with the cause. A few habits greatly reduce acid attack:

• keep acidic drinks to mealtimes rather than spreading them through the day;
• drink them cold and quickly, perhaps with a straw pointed towards the back of the mouth;
• rinse with water after an acidic drink, or finish a meal with a piece of cheese or a glass of milk;
• chew sugar-free gum to stimulate saliva;
• after vomiting, rinse with water (your dentist may suggest a mild bicarbonate solution) and do not brush straight away;
• use a soft brush and a low-abrasion fluoride toothpaste; some stannous fluoride toothpastes have shown a protective effect against erosion;
• have reflux treated by your doctor: protecting the teeth without treating the stomach is not enough.

Your dentist may also apply a fluoride varnish or prescribe a higher-fluoride toothpaste depending on your risk. If you clench at night, a protective splint limits the mechanical wear that adds to erosion. Photos or impressions repeated over time show whether the wear has stabilised.

Repairing worn teeth: from composite to veneers

When tooth loss is visible, bothersome or exposes dentine, several options are discussed, always after the cause has been brought under control:

• bonded composite: added directly to the tooth, it covers exposed dentine, lengthens worn edges and can be adjusted later. It is often the first step because it requires almost no drilling;
• onlays and table tops in ceramic or composite, thin restorations that cover the biting surface of worn molars and restore height;
• veneers on the front teeth, when enough enamel remains; see our dental veneers page;
• crowns, reserved for very damaged teeth.

In advanced wear, teeth have sometimes lost so much height that there is no room left for a restoration. The dentist may then plan a controlled increase in bite height, first tested with temporary restorations, or use targeted additions that let the teeth adjust gradually. These plans are prepared carefully from impressions and photographs. Small lesions are managed like routine cavity treatment, using bonded materials.

Having your tooth wear assessed in Agdal

Erosion is judged across the whole mouth and over time. At German Dental Clinic in Agdal, the dentist examines wear tooth by tooth, asks about your habits, drinks, possible reflux and medicines, and notes any sensitivity. A digital impression with the intraoral scanner serves as a reference to compare the condition of your teeth at later visits.

You then receive advice tailored to your situation and, if restoration is useful, a plan explained step by step, from the simplest option to the most comprehensive. If your teeth seem shorter, more see-through or more sensitive than before and you are in Rabat, you can book an appointment for an assessment.