Why Do Teeth Experience Acid Erosion?

October 2009

By: Dr. Scott R. Harden

Recently, I have had many teenagers coming into my dental office with unusually large amounts of advanced decay, which is based upon “erosion” of their teeth.

The occurrence of this dilemma in my practice coincided with the recently aired ABC news report on “Mountain Dew Mouth” in the Appalachian area of Kentucky, which will be discussed below.

What is Tooth Erosion?
“Tooth erosion” is defined as the chemical removal of mineral from the tooth structure, a progressive condition, and involves both your enamel and exposed root surfaces. Tooth erosion becomes pathological when it leads to pain, abscesses and loss of function or esthetics. Distinctively different from “tooth decay is caused by bacterial damage of tooth structure (bacteria produce acid from sugars in your mouth), while “tooth erosion” is caused by chemical damage of tooth structure.

A thin layer of hard tissue called enamel protects your teeth. Usually your saliva can help maintain the natural pH balance (levels of acid or alkaline) in your mouth, wash away food particles, and rebuild the minerals in your teeth. But sometimes, highly acidic foods, drinks, and drugs can overwhelm saliva’s beneficial effects and soften the tooth enamel, leading to tooth erosion.

Sources of Acid Wear Tooth Damage or Erosion
How and why do teenagers and adults experience tooth erosion from acid? As noted above, highly acidic foods and drinks are contributing factors to “tooth erosion”. Bulimia or self-induced vomiting is an extreme example of “acid erosion”, which afflicts almost 100% women, but this is not the focus of this article. There are a number of other ways that a person can get acid wear tooth damage. The main cause of tooth erosion is by drinking water with high acid content. This is very typical among people who have their own wells. The other main cause of acid wear tooth damage or “erosion” is fruits and vegetables, both of which are acidic. Among all fruits, lemons, oranges, strawberries and grapefruits are known to contain the highest levels of acid. Among all vegetables, tomatoes are known to contain the highest level of acid. Certain drinks, such as sports drinks, sodas and fruit juices are also known to have notable levels of acid which may contribute to acid wear tooth damage.

Studies Regarding Acid Erosion of Teeth
Returning to the recent televised report of “Mountain Dew Mouth”, this program sited that a 20 oz Mountain Dew contains 19 teaspoons of sugar and contains the critical ingredient of acid that erodes your teeth. A University of Maryland study showed that after soaking teeth in various sodas, (a great science fair project – hint hint), Mountain Dew eroded teeth 2-5 times more than regular colas equating to as much as 6% of the teeth.

Based upon another recent 2008 study of all popular beverages in the United States, “tooth erosion” was measured on tooth enamel and tooth roots, and this study sited that tooth destruction from acid erosion was greatest for Gatorade, Red Bull, Coke, Diet Coke and 100% apple juice from most to least.

Other studies have focused on the pH or acidity of soft drinks and shown that any pH below 4.0 is statistically associated with “tooth erosion”. Shown is a table of actual pH values for various soft drinks that is quite interesting.

Dental erosion, which is associated with consumption of acidic beverages, is a potential oral health concern. The best advice is to decrease your intake of sodas to prevent this problem from occurring. If your dentist states you have signs of “demineralization” or “tooth erosion” make sure you rinse well with water following any intake of colas or juices since exposure time is a key factor or simply drink more water in place of soft drinks. Brush and floss regularly and consider a good daily fluoride rinse along with routine check ups every six months at your dentist.