How acidic foods can speed up tooth surface loss 

November 15, 2021
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Abrasion typically occurs at the gumline, where the tooth meets the gums, often causing a distinctive V-shaped notch. This type of wear results from repeated pressure, such as aggressive brushing or grinding, weakening the area over time.
​​​​Tooth surface loss (TSL) is a progressive condition that affects the protective layers of teeth, often resulting from dietary choices and lifestyle habits. Associate Professor Dr Azwatee Abdul Aziz, Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, explains that TSL can be divided into two types: carious and non-carious. Carious TSL involves tooth decay due to bacterial activity, while non-carious TSL, often called tooth wear, does not involve bacteria but instead results from physical and chemical factors.

Types of non-carious tooth surface loss
Dr Azwatee categorizes non-carious TSL into three main types:
  • Abrasion: Abrasion typically occurs at the gumline, where the tooth meets the gums, often causing a distinctive V-shaped notch. This type of wear results from repeated pressure, such as aggressive brushing or grinding, weakening the area over time. “Our teeth have multiple layers,” says Dr Azwatee, “beginning with enamel, followed by dentine, and then the pulp, which contains nerves and blood vessels. Initially, wear only affects the enamel, but when it penetrates deeper into the dentine, it can cause increased sensitivity.”
  • Attrition: Attrition occurs when teeth grind against each other due to habitual practices like nighttime grinding, which gradually wears down the teeth over time.
  • Erosion: Tooth erosion is caused by exposure to acidic substances, including sour foods like pickles, lemons, and candies with pH levels below seven. “Energy drinks, sodas, and other acidic drinks are also common culprits,” notes Dr Azwatee. Erosion affects people of all ages, but teenagers may be especially vulnerable because they often consume more acidic beverages.
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External and internal causes of tooth erosion
Dr Azwatee identifies two additional erosion sources beyond acidic foods and drinks:

Extrinsic erosion: This is caused by acidic foods and beverages, which chemically wear down enamel over time.

Intrinsic erosion: This occurs when acidic elements from within the body, such as acid reflux, reach the mouth. The high acidity in these cases can accelerate tooth wear significantly.

Diagnosis and treatment
The approach to diagnosing and treating TSL depends on how advanced the erosion is. In early stages, a fluoride application may be recommended to promote tooth remineralization and slow progression. However, if the tooth appears visibly shortened and worn after years of erosion, restorative measures like fillings may be necessary to rebuild and protect the tooth’s structure.

Maintaining good oral health and understanding the effects of acidic foods and drinks can help protect teeth from long-term damage. Making informed choices and discussing concerns with a dentist can aid in preventing or managing tooth surface loss.