Erosion, Acid Reflux,GERD, Bulemia (Eating Disorders), and Your Teeth

Healthy Teeth

Cavity (Tooth Decay or Caries)

Acid Erosion

What does tooth decay and acid erosion look like?

Erosion, Acid Reflux (GERD), Bulemia (Eating Disorders), and Your Teeth

Enamel is generally a semi-opaque off-white color, and slightly rough when it first comes into the mouth. Acid from bacterial plaque can cause white and brown/black spots to show up on the teeth.Erosion makes the enamel quite shinny and smooth.As time goes on the teeth become more yellow due the loss of this semi opaque layer exposing the dentine underneath which is yellow/orange.Once the dentin layer is exposed, the loss of tooth surface accelerates because the dentin layer is much softer that enamel.

What does acid do to teeth?

Your enamel (the hard white outer layer) on your teeth is comprised primarily of Calcium and Phosphorous, These elements are actually considered metals. Metals are susceptible to dissolving by acid. 

Where does this Acid come from?

Foods and drinks can contain acid. Acetic acid in vinegar, phosphoric acid in soda drinks, and citric acid in many fruits are the most common sources. Another source are stomach acid. Bacteria in your mouth break down sugars and starches in our foods to create lactic acid.

How common is Tooth Decay?

Tooth decay is the most common common communicable disease on earth, the bacteria is passed from family members to infants shortly after birth. These bacteria continue to inhabit the mouth and stick to teeth in a film called plaque. Bacteria from family members can be different strains from one person to another. Depending on the strains of bacteria one is infected with  the person can be more or less prone to acid formation.The more sugary and starchy foods a person consumes, the more acid that these bacteria can produce. Essentially the longer sugars and starches remain in the mouth, the more acid is produced. 

How Common is Tooth Damage from Acidic Foods?

This varies by how one eats and drinks acidic foods. People who drink a lot of acidic foods like orange juice and grapefruit juice  and soda may experience erosion over time. Another factor is how a person drinks these substances. If someone uses a straw and swallows quickly, the acid effect will be minimal to none. However, if a person swishes the liquid in the mouth, there is more acid in contact with the teeth and there will me more erosion.

How common is Acid Reflux (GERD)?

Acid Reflux is becoming more and more common as people age. For some reason as we get older, our bodies can overproduce too much acid and the natural valve in our throat can become less efficient allowing this excess acid to back up into the throat and mouth when laying down. In addition, the population is becoming more obese. Obese people have more weight on thir airway when laying down and larger tongues and other tissues in the back of the throat. The combination leads to airway obstruction and poor breathing at night. When someone is laying down and having difficulty getting air in to breath, they begin to choke and literally suck acidic stomach fluid into their throat and mouth. this acidic condition will  erode(dissolve) the teeth.

How common is Bulemia (Eating Disorder)?

this condition is more common than we can determine. It has two  forms. One is a physiologic form that has to do with tough and biology. We all know that many women will have morning sickness which leads to bouts of vomiting, Other people are what we call gaggers, or prople with very sensitive digestive systems. These people often have difficulty keeping food down and will often vomit after eating, or an incident that triggers an episode of gagging. The other form is a psychological form of vomiting related to self image and some form or exaggerated need to lose weight or keep weight off. Bulemia really became common after the popularity of very slender models who gained tremendous  exposure in the media (ie. Twiggy in the late 60's).  This form is usually seen in women and teenagers dealing with some trauma, or depressive incidents in the past. Sadly, rarely will these individuals admit to the act of forced vomiting and they do everything possible to hide their actions. When confronted with the suspicion of it, they can withdraw and become rather argumentative in denial until they are "ready for help"'.

What other factors can influence Acid Erosion?

Other factors that can effect acid erosion include, lower saliva flow, para functional habits and, oral hygiene, As we age, our saliva flow is reduced and this saliva is an acid buffer for the foods and drink, In addition there are thousands of medications that reduce salive flow when taken which again reduces the buffering capacity. Parafunctional habits like tooth clenching and grinding have an added effect of crushing the teeth that are already softened by acid attack. Poor oral hygiene will leave the acids from bacterial plaque on the teeth longer. Not using a fluoride rinse or toothpaste or having regular fluoride treatments by a dentist will also keep the teeth more prone to all forms of acid attack as fluoride hardens the enamel.

In Conclusion

When teeth first come into the mouth, they have a certain amount of enamel that will only decrease over time from wear and acid attack. Your dentist can advise you if any of these forms or acid attack are occuring. Intervention through testing, diet modification, habit changes, medications, and certain preventive hygiene procedures are all methods to ensure that your teeth stay bright, and strong thorough your lifetime. See your dentist regularly and follow the advice given.

Dr. Neal answers all of your questions about Erosion, Acid Reflux (GERD), Bulemia (Eating Disorders), and Your Teeth

 at Crystal Lake Dental Associates.

Your comments are welcome