Frequently Asked Questions About Acid Erosion and Pronamel®

Acid erosion and Acidic Foods

  • What is acid erosion?

    It is a form of tooth wear caused by acid softening the tooth’s surface. When tooth enamel (the hard surface of the tooth covering the crown) is exposed to acids (from food, drinks or the stomach e.g. due to sickness or regurgitation), it temporarily softens and loses some of its mineral content. Saliva will help neutralize acidity, restore the mouth's natural balance and slowly reharden the tooth enamel. However, because the tooth's recovery process is slow, if the acid attack happens frequently, the tooth does not have a chance to repair. When the enamel surface is soft and we brush our teeth, the enamel can be worn away more easily, becoming thinner over time. This wearing of enamel or dentin caused by acid is called acid erosion.

  • Is acid erosion the same as cavities?

    No. Cavities are caused by bacteria in the mouth, which convert sugar and carbohydrates from the foods we eat into acid. This acid gradually dissolves the tooth enamel and dentin resulting in tooth decay. Acid erosion is not caused by bacteria, but instead occurs when food acids act directly on the surface of the tooth, where they can soften the tooth enamel. Cavities also often happen in one localized area, while acid erosion can occur in the whole mouth.

  • What are some of the causes of acid erosion?

    Frequent consumption of food and drinks with a high acid content can cause enamel wear. When tooth enamel is exposed to acids (from food, drinks or the stomach), it temporarily softens and loses some of its mineral content. Saliva will help neutralize acidity, restore the mouth's natural balance and slowly reharden the tooth enamel. However, because the tooth's recovery process is slow, if the acid attack happens frequently, the tooth does not have a chance to repair itself. Wine, many fruits and some soft drinks can be highly acidic and therefore potentially damaging to the teeth. Some acidic foods should not and cannot be easily avoided, since they are important to a healthy diet. But care needs to be taken as to when and how often they are consumed. It’s not just what is consumed that causes acid erosion, but also the way that acidic items are held within the mouth. Holding or retaining acidic food or drinks in the mouth can increase the acidic drink's contact with the tooth or teeth, again increasing the risk of acid erosion. Acid erosion can also be caused by internal acids. This is common in people who suffer from gastric reflux disease as well as some eating disorders.

  • Can acid erosion be caused by anything other than diet?

    Diet and the way acidic food and drinks are consumed is the major cause of acid erosion. However, it can also result from stomach acids in the mouth, for example, as a consequence of bulimia or indigestion (gastric reflux). There are also instances - as a result of occupational or industrial exposure where acid erosion has been caused by prolonged inhalation of acidic fumes.

  • What foods are deemed acidic?

    Higher Acidity

    Foods

    Fruits: Blackberries, blueberries, cherries, cranberries, grapes, grapefruit, lemons, limes, pineapples, pomegranates, raspberries and strawberries


    Other: Fruit jellies and jams, gelatin, lemon juice, pickles, salad dressings, vinegar and ketchup


    Beverages

    • Apple juice/cider
    • Grapefruit juice
    • Orange juice
    • Energy drinks
    • Fruit juices: apple, cranberry and grapefruit
    • Wine (red and white)
    • Soft drinks (including diet)              

    Medium Acidity


    Foods


    Fruits: Apples, apricots, figs, mangos, nectarines, oranges, peaches and pears


    Vegetables: Tomatoes and beans


    Other: Green olives, honey, pesto and raisins


    Beverages

    • Beer

    Lower Acidity


    Foods


    Bread: Rye, wheat and white


    Cheese: Cheddar and parmesan


    Vegetables: Artichokes, asparagus, avocados, broccoli, cabbage, carrots, cauliflower, celery, corn, cucumber, eggplant, yams and zucchini


    Other: Black olives, cereal (with milk), rice and peanut butter


    Beverages

    • Milk
    • Mineral water

Acid Erosion: Effects

  • How does acid erosion affect teeth?

    Acid erosion can weaken the enamel or change the surface texture, shape and appearance of teeth, which may also cause tooth sensitivity. People often do not become aware of acid erosion until it has reached an advanced stage. Detailed dental examinations can help to detect acid erosion in its earlier stages. Here are the typical signs and effects of acid erosion:

    • Weak: The acids in everyday food and drink can weaken enamel, making it easier to wear away
    • Thin: As more enamel wears away, teeth can become visibly thinner
    • Transparent or see-through: As the enamel thins, the edges of your teeth can appear transparent or see-through
    • Yellow: As our weakened enamel is worn-away, the more yellow dentin layer underneath can become more visible
    • Dull: As the enamel wears away our teeth may lose their shine, making them appear dull
  • What is the link between acid erosion and sensitivity?

    As tooth enamel is worn away, the underlying dentin may be exposed. This is a softer part of the tooth and as it becomes exposed, teeth may be more sensitive. A slight twinge can be felt when consuming cold, hot or sweet foods, or drinks.

  • How quickly can the effects of acid erosion occur?

    There are many factors that contribute to the progression of acid erosion, most notably the frequency and concentration of the acids in contact with the teeth and the volume and defense of an individual's saliva. Everyone's lifestyle, consumption habits and teeth are different, and all can affect the rate at which acid erosion affects teeth.

  • What are the long-term consequences of acid erosion?

    When tooth enamel is exposed to acids, it temporarily softens and loses some of its mineral content. When the enamel surface is soft and we brush our teeth, the enamel can be worn away more easily, becoming thinner over time. This thinning can lead to teeth appearing translucent, becoming discoloured or yellow, can cause teeth to crack or become sandblasted in appearance and can also cause sensitivity. In the long term, the effects of acid erosion may require dental treatment in order to protect the tooth and the underlying dentin. A dentist may decide to place a bonded filling, a veneer or a crown to restore the tooth to its former colour and shape. That is why brushing your teeth with Pronamel® is so important. It helps to protect your enamel, keeping it strong so your teeth can keep their natural whiteness.

    Healthy, white teeth should start with strong enamel

    Une dent blanche et saine à côté d'une dent jaunie sous l'effet de l'usure par acide

    Strong enamel without acid erosion

    Une dent blanche et saine à côté d'une dent jaunie sous l'effet de l'usure par acide

    Weakened translucent enamel with acid erosion

Acid Erosion: Who is affected?

  • Is the number of people affected by acid erosion increasing?

    Yes, the number of people showing signs of acid erosion is rising due to the number of people keeping their natural teeth longer, combined with the acidity in the modern diet. In the twentieth century, dental diseases, for example tooth decay and gum disease, were widespread. This greatly affected the life span of teeth and meant that most people did not retain their teeth for life. Improved oral hygiene and restorative treatments have extended the life span of teeth in the twenty-first century. However, as teeth are lasting longer, they are subject to the effects of wear, particularly from acids and tooth brushing, over a longer period of time.

  • Who is most likely to be affected by acid erosion?

    Experts agree that nearly everybody with natural teeth will develop some signs of acid erosion.

  • Can children have acid erosion?

    Yes. "Baby teeth" are very much at risk from acid erosion because they are less mineralized with softer enamel than adult teeth. Acid erosion in primary teeth can also lead to acid erosion in permanent teeth. For both reasons, great care should be taken with the acidic content of a child's diet. In fact, levels of acid erosion among youth aged 11 to 14 highlight the need for early prevention. Children should be encouraged to form good oral hygiene habits and limit brushing directly after consuming acidic fruits or fruit juices.

  • Is it true that acid erosion is something that people should not worry about until they are older?

    No. Experts agree that nearly everybody with natural teeth will develop some signs of acid erosion. Acid erosion can affect all ages and cannot be reversed. Protecting teeth early is the best way to prevent future acid erosion.

Acid Erosion: Prevention

  • What can be done to help prevent acid erosion?

    To help protect your teeth against the effects of dietary acids, there are several steps that can be taken:

    • Follow the advice of your dental professional and make sure you have regular dental check ups
    • Allow acidic foods and drinks to pass through your mouth quickly to reduce the time they are in contact with your teeth
    • If possible, drink soft drinks through a straw directed into your mouth and not directly at your teeth
    • Wait at least 30 minutes to brush your teeth after having acidic foods or drinks. By then, your enamel is no longer at its softest and most vulnerable
    • Use Pronamel® as your daily toothpaste to reharden acid-softened enamel. Healthy, white teeth start with strong enamel.
  • Can the effects of acid erosion be reversed?

    No, the effects of acid erosion cannot be reversed. Once enamel is gone, it's gone for good. In fact, in the advanced stages of acid erosion there is likely to be a need for expensive and complicated dentistry to restore teeth to normal function. This is why understanding the problem and taking steps to minimize risk is so important.  

Acid Erosion: A Modern Phenomenon?

  • Why is acid erosion only now becoming a problem?

    In the twentieth century, dental diseases, such as tooth decay and gum disease, were widespread. This greatly affected the life span of teeth and meant that most people did not retain their teeth for life. Improved oral hygiene and restorative treatments have extended the life span of teeth in the twenty-first century. However, as teeth are lasting longer, they are subject to the effects of wear, particularly from acids and tooth brushing over prolonged time periods. Not only that, people today expect to keep their teeth healthy and looking good for longer.

  • How long have dentists known that acid erosion is a problem?

    Dentists learn about acid erosion at dental school; however, in the past, they encountered it less frequently. Now, as people are keeping their teeth longer, dentists are increasingly seeing signs of acid erosion and are beginning to become aware of the problem it poses in the twenty-first century. As such, dentists have to be increasingly vigilant in looking for early stages of the condition.

Pronamel®

  • How does Pronamel® help protect teeth from acid erosion?

    Pronamel® has been specially formulated to help protect teeth from the effects of acid erosion:

    • It helps to reharden acid-softened enamel, making it more resistant to future acid attacks with twice daily brushing
    • It has lower abrasivity to limit further enamel wear during the process of toothbrushing
    • It is pH neutral (non-acidic) to minimize acidity in the mouth
    • It is specially formulated for people with sensitive teeth, which can be a sign and symptom of acid erosion
  • How often do I need to use Pronamel® for it to be effective?

    Pronamel® should be used twice a day, every day, in place of your regular toothpaste. Actively strengthens and rehardens acid-softened enamel, to help protect teeth from further acid erosion. Healthy, white teeth should start with strong enamel.

  • Does Pronamel® repair tooth enamel?

    Once tooth enamel is lost, it cannot be replaced. However, Pronamel® can help reharden tooth enamel that has been softened, to help protect your teeth from acid erosion.

  • Do I need to use a regular toothpaste alongside Pronamel®?

    No, Pronamel® is a toothpaste that provides all the benefits of a regular toothpaste: it contains fluoride to help fight cavities, freshens breath and removes plaque with brushing. Pronamel® should be used twice a day, every day, as your regular toothpaste.

  • Why is it important that Pronamel® is lower in abrasivity?

    All toothpastes contain abrasives in order to remove stains from the tooth surface. Pronamel® is a lower abrasive toothpaste formulated to minimize physical wear to the tooth surface. This is particularly important when the tooth enamel is softened as it is more vulnerable, contributing to enamel loss.

Acid Erosion in Children: Pronamel® For Children

  • Can children have acid erosion?

    Yes. "Baby teeth" are very much at risk from acid erosion because they are less mineralized with softer enamel than adult teeth. Acid erosion in primary teeth can also lead to acid erosion in permanent teeth. For both reasons, great care should be taken with the acidic content of a child's diet. In fact, levels of acid erosion among youth aged 11 to 14 highlight the need for early prevention. Children should be encouraged to form good oral hygiene habits and limit brushing directly after consuming acidic fruits or fruit juices.

  • How does Pronamel® For Children work?

    Pronamel® For Children was developed in conjunction with dentists to help protect children's teeth from acid erosion and cavities. It works in several ways:

    • It's specially formulated to help reharden acid-softened enamel with twice daily brushing, to help keep your children’s teeth strong and healthy
    • It also helps protect against cavities
  • When and how should Pronamel® For Children be used?

    Your child should use Pronamel® For Children as a daily toothpaste, following this simple advice:

    • Brush twice a day for two minutes
    • Encourage your child to avoid swallowing and to spit out after brushing
    • Ask your dentist for advice on brushing techniques
  • What happens if nothing is done about acid erosion?

    If left untreated, children may need dental treatment to protect the teeth and the underlying dentin from further damage.

  • Does Pronamel® For Children treat sensitivity?

    Pronamel® For Children contains the same specially designed fluoride formulation as Pronamel®. However, unlike the adult variant, it does not contain a desensitizing agent. Dentin sensitivity is rare in children and should be treated by a dentist.

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