Low Enamel Due to Acid Reflux - Crowns Needed?

Thank you in advance for your help! Reflux has stripped most of the enamel from my front top 4-6 teeth. These teeth are now smaller in length, thinner @ the base, and have slightly more space between them. Looking closely, the circumferences of these teeth are more translucent while the center is solid. I'm told I need crowns on these teeth, but the thought of shaving them permanently is scary. Are crowns a common/necessary solution to my problem or is it a purely cosmetic suggestion? Thank you!

Doctor Answers 4

Full crown restoration after significent enamel loss due to acid reflux???

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I couldn't see from your photos, but I'm assuming that your acid reflux has caused much more damage to the back side of your teeth than the front?  Once you lose your enamel protection your teeth will change position and erupt to hit more on the back side of the teeth, on the dentin.  The dentin is about 1/4 as hard as enamel, and thus, will wear away much more with a combination of any residual acid reflux you still have and natural tooth wear caused by your bite.  I clearly think full crowns would be the treatment of choice.  However, you are in luck, as today some very nice materials are available to use for your crowns that require only minimal tooth preparation, yet can be thin and strong.  This material is called EMax porcelain, and is a very amazing material.  Whereas most porcelain fused to metal crowns require more drilling of the tooth and then are cemented with a regular dental cement, the EMax porcelain can be bonded to either enamel or dentin, and have a much better grip on the underlying tooth than the regular cement just mentioned.

Laguna Niguel Dentist

Are Crowns Necessary for enamel erosion from reflux?

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I do not think this is suggested as a cosmetic fix but a way of trying to try to save your teeth. The first step would be to correct the acid reflux problem. The acid has already caused enamel loss and you want to stop it before it gets to the dentin.  I suggest you find a medication that will treat your Relfux problem.  Then I would try to modify the ph balance in your mouth by minimizing acidic foods and beverages. Decrease abrasive forces as brushing with a toothbrush that has hard bristles ....you need to create less abrasian from all sides here, Use a remineralizing agent and flouride wash or varnish which may help. You can try bonding agents first before you go to crowns, but I would do everything that I could to correct the acid reflux and any other wear and tear you might be unknowingly causing your teeth.  If you do the crowns now, the same thing will happen to them as what is going on with your own teeth.  You need to stop or lower the ph level and reflux first if means modifying your diet, managing your stress level, and taking medication prescribed by your medical doctor.  Be mindful of drinking milk and using antacids which act as a barrier against the acid and help your teeth.  Hope this helps and start now!

George Koutsoukos, DDS
Valencia Dentist

Fixing worn teeth from acid erosion is more complex than crowning them.

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Acid reflux may be a sign of sleep apnea among other reasons, so first get a handle on that.  Secondly, you are right in being concerned about having your already worn down teeth shaved down more for crowns.  You have lost enamel, so you actually need your teeth lengthened.  Upper front teeth cannot generally be lengthened and thickened in the back without lengthening your back teeth at the same time.  So you need to find a dentist that is well-trained in bite correction to further explain this to you and give you your options.

Michael Firouzian, DDS
Columbus Dentist

Crowns for Acid Reflux Teeth

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First of all, try to get the acid reflux under control, or you will continue to destroy your enamel on other teeth and possibly around the margins of your new crowns. Make sure you see a dentist well versed in occlusion because you will be adding to the length of the teeth. This is much more than cosmetics. It is health & function.

Jay Neuhaus, DDS
New York Dentist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.