What is Enamel Erosion?
Enamel is a highly mineralized acellular tissue, composed predominantly of a crystalline form of calcium phosphate known as hydroxyapatite. While providing the mechanical strength required for chewing, the high mineral content makes enamel susceptible to an erosive process of demineralization by acid. Unlike the situation with caries, eroded tooth surfaces are normally clean and free of dental plaque. The common sources of acid are dietary fruits, fruit juices and carbonated drinks. Acids can soften the enamel which if not re-hardened, can then be worn away. Once the enamel is lost, the body cannot replace it.
The erosive process is invisible in early stages. If there is progression to tooth wear, anatomical features such as cingulums and mamellons start to become less distinct. In later stages on anterior teeth the enamel can thin at incisal edges and become more translucent, eventually chipping away. Once dentine is exposed the teeth appear yellower and tooth sensitivity can develop. In severe cases, loss of tooth tissue compromises function, as well as patient comfort and aesthetics.
Erosive tooth wear is a common and increasing problem, with effects that accumulate with age. A recent study showed around 30% of young adults in European countries were affected*.
*Bartlett DB et al. Prevalence of toothwear on buccal and lingual tooth surfaces and possible risk factors in young European adults. J Dent. 2013; 41:1007–1013