A growing number of people (especially teenagers) are having significant problems with erosion of their teeth. Erosion is the destruction of the tooth structure by acids that do not come from the bacteria involved in tooth decay. These acids can come from foods, from the stomach (from reflux or vomiting) or from the environment. 62% of 15 – 18 year olds have erosion to their permanent teeth. Acids in foods include citric, malic, phosphoric, tartaric, acetic and carbonic. Carbonic is the least erosive. This is very much a growing problem. We are seeing increasing numbers of patients will loss of the surface of the tooth (TSL). Often the molars will look as is if 'someone has taken pieces out of the biting surface with a melon baller'.
The following lists shows those foods and drinks that may cause dental erosion,
Foods and drinks that have the potential to cause dental erosion
Soft drinks – carbonated and diluted squashes (including the ‘diet’ varieties and sports drinks).
Fresh fruit juices and fruit juice drinks.
Wine, alcopops, cider and perry, spirits consumed with mixers
Some herbal teas.
Fresh fruit such as citrus fruit and apples (not bananas) if eaten often in large quantities.
Vinegar, sauces and pickles (large quantities).
Acidic sweets e.g. acidic fruit drops.
Chewable aspirin and vitamin C tablets (large quantities).
Foods and drinks with low/no erosive potential
Bread (sandwiches, toast, crumpets and pitta bread).
Pasta, rice and starchy staple foods.
Fibrous foods (e.g. raw vegetables).
Low-sugar breakfast cereals (e.g. shredded wheat).
Sugar-free chocolate and sugar free chewing gum.
Tea and coffee (unsweetened).
So to combat the effects of acid in the diet (and tooth decay) the following is recommended.
Key dietary recommendations to safeguard dental health
- Reduce the frequency and amount of sugary and acidic food and drinks and try to limit these to mealtimes.
- When a structured meal plan is not followed, limit the consumption of sugary foods to 3-4 times a day.
- Avoid sugary and acidic foods and drinks close to bedtime.
- Consume foods and drinks that do not cause, or are known to protect against, dental decay and erosion.
- Consumption of some sugar-free products may help achieve these goals in practice.
- Avoid brushing immediately after consuming acidic food and drinks.
- Chew sugar-free gum for 20 minutes immediately after meals. (Adults and older children only)
- Use a straw for drinking any acidic drinks.
- Read manufacturers labels to identify hidden sugars and acids and follow recommendations on the dilution of squashes and the use of products.
- Do not add any drink or food to a baby’s bottle, except formula milk, expressed breast milk, cow’s milk or water.
- Provide all drinks (including formula) in a cup or beaker to infants from the age of 6 months and cease bottle-feeding by 1 year.