Ask Dr. Steven Davidowitz - Acid Erosion

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I recently received the following question on Acid erosion:

Dear Dr. Steven Davidowitz,

I was told that I have signs of “Acid Erosion.  How did this happen and what can I do now?


Here was my response:


I often ask my younger patients “What is as brittle as glass and at the same time, the hardest substance in your body?” The answer is: Your tooth enamel!

Each time you bite down it handles the equivalent of 160 pounds of pressure.  Think about how often you bite down during your lifetime. Enamel is the hard outer layer of your teeth, built to protect the inner more sensitive layers.

It’s amazing how Such A brittle substance handles all that pressure.  Enamel is actually made up of a dense forest of long rods. These rods start crisscrossing each other as they go deeper into the tooth, diffusing the pressure. However, enamel is built to deal with pressure, but Not Erosion! As strong as your enamel is, it doesn’t deal as well with acid and bacteria. It needs our help for that. The four main ways your enamel can get worn down are:

Acidic breakdown (usually from acidic drinks like soda, fruits, fruit juices, and sports drinks.)  Abrasion from rough brushing and tooth-whitening toothpastes.  Bad habits like tooth-grinding. And, High sugar-and-starch diets, which create acid byproducts.

Your dentist will check for signs of acid erosion while examining for tooth decay and oral health.  Signs we look for are “enamel Weakness” - The acids in everyday food and drink can weaken enamel making it easier to wear away.  This shows as a thinner looking enamel, as more enamel wears away, teeth can become visibly thinner or transparent.  As the enamel thins, the edges of your teeth can appear transparent or even see-through.  The middle part of the tooth may seem more yellow as our weakened enamel is worn away, the more yellow dentine layer underneath can become more visible. Additionally, as the enamel wears away, our teeth may lose their shine, making them appear dull.

Over time, not only can these effects get gradually worse, but teeth may also become sensitive as the protective enamel disappears and the dentine layer below is exposed.

You can start protecting your teeth today, to help stop Acid Erosion from getting any worse. Having an acid-rich diet can put your teeth at risk and this can happen more easily than you’d expect. As few as four acidic “occasions” throughout the day can put our enamel at risk from Acid Erosion, also known as Acid Wear.

Knowing how acidic foods and drinks are can also help you protect your teeth from the effects of Acid Erosion. Some examples of high acidic foods include: Lemon Juice, Red Wine, Sports Drinks Tonic Water, Cherries, Carbonated Soft Drinks, including diet soda!, Oranges, Plums, Iced Tea, Blackberries, blueberries and strawberries, Grapefruit Juice, Pickles, Vinegar, Apple Sauce , Apple Juice, Salad Dressing, Cranberries, Orange Juice, White Wine, and  Tomatoes

For chemists and scientists, pH is a measure of how acidic (pH 7 but less than 14) something is. For people concerned about an acidic diet and acid erosion, the most important thing to know is this: the lower the pH number, the more acidic a food or a drink is and the more harmful it is to your tooth enamel. For example, distilled water has a neutral pH of 7, while tomato juice might have a pH of 4 and lemon juice might have a pH of 2 – making the lemon juice the most acidic of the three.

Knowing the pH value of the foods we eat and the beverages we drink help us have a clearer picture of how acidic our diet really is. And knowing the acidity of our diet is an important step in making sure we protect our tooth enamel from Acid Erosion. The rule of thumb is the lower the pH, the higher the acidity and therefore the higher the risk it may cause Acid Erosion. If you are unsure, you can always ask your dentist to look up the pH levels of your favorite foods. 

Here are some very simple steps we can all take to start protecting our enamel from Acid Erosion, starting today:

1. Make an appointment to see your dentist if you haven’t been in the past 6 months.

2. Don’t give up the healthy food in your diet, particularly fruit,     but take a fresh look at how you eat it. If you’re eating     something acidic, have water, milk, or another non-acidic     food or drink with it.

3. Don’t swish, swirl or hold acidic drinks in your mouth for too long.

4. Many drinks, especially carbonated ones, can contribute to  Acid Erosion. Try drinking through a straw or substituting the     carbonated drink with water.

5. Try not to brush your teeth immediately after eating or  drinking but rather wait at least an hour.  And make sure you’re using a soft-bristled brush.

6. Consider using a fluoride mouthwash along with a fluoride paste to give you extra protection from the effects of     everyday acids.

Your Enamel Is Finite So Treat It Well! As amazing as your enamel is, it’s one of the only parts of your body unable to regenerate itself because it’s one of the only parts of your body not comprised of living cells. So protect your enamel by brushing regularly, flossing, and keeping your regularly scheduled checkups.

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New York Dentist