Frequently Asked Questions About Acid Erosion and Pronamel
Acid Erosion: Facts & Causes
Understand what causes acid erosion of your teeth. Your diet is largely responsible, but there are other culprits as well.1
Acid erosion is a form of tooth wear caused by the chemical softening the outer surface of the tooth enamel.1 When enamel is exposed to acids from certain foods or drinks, it can temporarily soften and lose some of its mineral content. Once the enamel is softened it can be worn away more easily, especially if we aggressively brush our teeth.
Frequently consuming food and drinks with a high acid content, such as wine, fruit juices and sports drinks, can cause acid erosion, potentially damaging to the teeth.1 Saliva will help neutralize acidity, but if there are a lot of acidic foods and drinks in your diet, your teeth do not have a chance to repair themselves.1 Acidic foods cannot always be avoided since they are important to a healthy diet. However, you should note when and how often they are consumed:1
- Avoid brushing your teeth immediately after consuming acidic foods or drinks, when your enamel is most soft and more likely to be worn away. Wait an hour before brushing your teeth or consider brushing your teeth before you eat.
- Don't swish acidic drinks in your mouth—swallow them quickly. Consider drinking soft drinks through a straw to avoid contact with your teeth. When it comes to the effects of acid erosion, studies suggest that the way you drink acidic beverages has more of an effect on your teeth than the quantity you drink. And the less you have acids in contact with your teeth, the better.
- Have regular dental check-ups and follow your dentist's or dental hygienist's advice. Find a dental professional at affordable rates.
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When foods containing sugars or starches are eaten, the bacteria in the mouth (in plaque) convert these products to acids that can lead to dissolving of the tooth enamel. Over time, this can cause the enamel to break down and a cavity to form, which may require restorative intervention (or a filling) by a dentist. While decay is a localized process (ie: it does not affect all the teeth at one time), erosion occurs across the whole tooth surface that has been exposed to acid.2 Erosive tooth wear does not involve bacteria or dietary sugars, but is the result of direct action of acids (either from food, drinks or the stomach) on the tooth enamel surface.2 Over time, this acidic softening can result in significant wear, leading to reduced thickness of enamel and a change in texture, shape and appearance of teeth. This may also lead to tooth sensitivity.
pH is a measure of how acidic or alkaline a substance is.3 The pH scale ranges from 1 to 14, with 1 being very acidic, 7 neutral and 14 very alkaline.3 Tooth enamel can dissolve with a pH of approximately 5.5 or below, and dentin (the substance located between the enamel surface and the underlying root) can dissolve at a pH of approximately 6.5 or below.3 Some fruit teas, wine and sports drinks can be highly acidic and therefore potentially damaging to the teeth.1 This is not to say, however, that acidic food and drinks should be avoided.
Acidic foods should certainly not be avoided altogether. Fruit, for example, is an essential part of a healthy, balanced diet and a good source of many vitamins. As a leading healthcare company, Sensodyne Pronamel is working to make people aware of the issue of acid erosion to ensure that they take small steps to minimize the risk. For example, it is best not to regularly brush teeth immediately after consuming acidic food or drinks as this is when tooth enamel is softened and more vulnerable to wear—it is best to wait at least 1 hour, and some experts believe even longer.1
Diet and the way that acidic food and drinks are consumed are the most likely causes of acid erosion. However, it can also result from stomach acids in the mouth, for example, because of bulimia (vomiting) or indigestion (regurgitation/gastric reflux).1 There are also instances—as a result of occupational or industrial exposure—where acid erosion has been brought about, for example, by prolonged inhalation of acidic fumes.1
Acid Erosion: Effects
If your teeth are impacted by acid erosion, there are a range of signs that may tip you off.
The effects of acid erosion can wear away the enamel and change the texture, shape and appearance of your teeth, which may cause tooth sensitivity. People often do not become aware of the effects of acid erosion until they have reached an advanced stage. Detailed dental examinations can help to detect the effects of acid erosion in the earlier stages. Here are the typical signs and effects of acid erosion:
- Transparency: Teeth may appear slightly "glassy" or transparent near their biting edges. This tends to be an earlier warning sign of acid erosion.5
- Discoloration: Teeth can have a yellow appearance as enamel becomes thinner and the darker dentin shows through. Discoloration tends to occur in the later stages of acid erosion.1
- Rounded Teeth: As acid erosion advances, teeth can develop a rounded, "sandblasted" look on their surface and edges.1
- Cupping: Small dents may appear on the chewing surfaces of the teeth in advanced stages of acid erosion. Fillings also may appear to rise up.1,5
- Sensitivity: As dentin becomes exposed through loss of enamel, twinges, tingles or aches may occur in the teeth when consuming hot, cold or sweet foods and drinks.1 Tooth sensitivity can occur at any stage of acid erosion, from early to advanced.1
As tooth enamel is worn away, the underlying dentin may be exposed, causing teeth to become more sensitive.1 When nerve endings in the dentin are activated, a slight twinge can be felt when consuming hot, cold or sweet foods and drinks.3
Over time, acid erosion may require dental treatment in order to protect the tooth and the underlying dentin. A dentist may decide to place a bonded filling, a veneer or a crown to restore the tooth to its former color and shape.3 In extreme cases, the damage caused by the effects of acid erosion may result in extraction of the tooth.1
There are many factors that contribute to the progression of the effects of acid erosion. Consumption habits and teeth are different and can change the rate at which acid erosion occurs.1,3
The effects of acid erosion can wear away the tooth's surface and edges, which can make the teeth look older (for example, yellowing, rounding and cracking of the teeth in later stages).1,3 There are many factors that contribute to the progression of acid erosion, especially the frequency and concentration of acids in contact with the teeth and the volume and defense of an individual's saliva.3 Everyone's teeth, lifestyles, consumption, and brushing habits are different and can alter the rate at which acid erosion affects teeth.1,3
Acid Erosion: Prevalence
Acid erosion has become more common than ever and can occur in individuals of any age.1
A global study estimates that the average prevalence of erosion in adult teeth rangers between 20% and 45%.1 In the United States, dental erosion may affect up to 80% of adults.1
Yes, U.S. dentists report that they have seen an increase in the number of patients with the effects of acid erosion.1 Modern diets high in acidic foods and drinks could have contributed to that increase. Also, improved oral hygiene, education, and restorative treatments have extended the lifespan of teeth in the 21st century. However, as teeth are lasting longer, they are subject to the effects of wear—particularly from acids and tooth brushing—over a longer time.
Experts agree that nearly everybody with natural teeth will develop some signs of acid erosion over the course of their life.1
No, because experts agree that nearly everybody with natural teeth will be affected by signs of acid erosion.1 A 2015 global study of children and adolescents indicated that 34% of children and teens around the world exhibited signs of dental erosion, indicating that it’s never too early to start paying attention to the health of your teeth.1
Acid Erosion: Protection
Learn how to protect your teeth against the harmful effects of acid erosion.
- Avoid brushing teeth immediately after consuming acidic food or drinks, as this is when the enamel is at its softest. It is best to brush teeth before meals or wait at least 1 hour after eating before brushing teeth.1,3
- Drink acidic drinks quickly—don't swish them around or hold them for prolonged periods within your mouth. Consider using a straw placed towards the back of the mouth.1,3
- Brush teeth gently, but thoroughly, with a soft-bristled toothbrush.1,3
- Select a toothpaste that is low in abrasion, non-acidic and has maximum fluoride availability.1,3
- Schedule regular dental check-ups and talk to a dental professional about any concerns.1,3
- Brush twice a day with a toothpaste like Pronamel® to help re-harden acid-softened tooth enamel and protect against the effects of acid erosion.
Once the damage has been done, it cannot be reversed, which is why most forms of intervention focus on prevention and reduction.1 In the advanced stages of acid erosion, restorative procedures might be necessary.1 This is why understanding the problem and taking steps to minimize risk are so important.
Acid Erosion: A Modern Phenomenon?
Acid erosion of the teeth has been around for a long time.
Up until recently, dental health issues such as tooth decay and gum disease were widespread. Improved oral hygiene and restorative treatments have extended the lifespan of natural teeth in the 21st century. However, as teeth are lasting longer, they are subject to the effects of wear, particularly from acids.1 Also, modern diets high in acidic foods and drinks can contribute to the effects of acid erosion for people of any age.1,3
Dentists learn about the effects of acid erosion at dental school; however, in the past, they encountered it less frequently.3 Now, as people are keeping their teeth longer, dentists are increasingly seeing signs of acid erosion and are becoming more vigilant in looking for early stages of acid erosion.
Yes, but in the early 20th century, dental diseases—for example, tooth decay and periodontal disease (a disease affecting the gums and bone that support the teeth)—were widespread. Food-based dental erosion was first described by Sicilian lemon pickers in the 1890’s.3 This greatly affected the lifespan of teeth and meant that most people did not retain their teeth for life. Improved oral hygiene and restorative treatments have extended the lifespan of teeth in the 21st century. However, as teeth are lasting longer they are becoming subject to the effects of acid erosion.
Sensodyne® Pronamel® Fluoride Toothpaste
There are different Pronamel product lines to help you protect your teeth against the harmful effects of acid erosion.
Pronamel® toothpaste has been specifically formulated to help protect teeth from the effects of acid erosion. It works in several ways:
- It helps to re-harden acid-softened enamel, making it more resistant to further effects of acid erosion.
- It is minimally abrasive to limit further enamel erosion during the process of tooth brushing.
- It is pH neutral (non-acidic) to be kind to tooth enamel.
- It is specially formulated for people with sensitive teeth, which can be a sign of the effects of acid erosion.
Pronamel® toothpaste should be used twice a day, every day, in place of your regular toothpaste. It will immediately begin to help protect teeth from the future effects of acid erosion.
Once tooth enamel is lost, it cannot be replaced.1 However, Pronamel® toothpaste can help re-harden acid-softened tooth enamel and protect it from wearing away.
No. Pronamel® toothpaste should be used as your regular toothpaste. It contains fluoride to fight cavities, freshens breath, and cleans teeth. Plus, it re-strengthens acid-softened enamel to protect against the effects of acid erosion. For maximum effectiveness, Pronamel® toothpaste should be used twice a day, every day as your regular toothpaste.
Yes, Pronamel® toothpaste provides all the benefits of a regular toothpaste as well as helping to protect teeth against the effects of acid erosion. It contains fluoride to fight cavities and clean teeth.
There are no unusual side effects from using Sensodyne® Pronamel® toothpaste.
- Dental Erosion. American Dental Association. https://www.ada.org/en/resources/research/science-and-research-institute/oral-health-topics/dental-erosion. Accessed 9/17/23.
- Dental Erosion. National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/9881285. Accessed 9/21/23.
- What is Tooth Erosion? Causes, Diagnosis, and Treatment. University of Southern California School of Dentistry. https://ostrowonline.usc.edu/tooth-erosion/. Accessed 9/21/23.
- Contemporary diagnosis and management of dental erosion. National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/33410255/. Accessed 9/21/23.