Acid erosion in children

Acid Erosion in Children

 The shiny, white enamel that covers your teeth is the strongest substance in the human body- wow!! It’s super strong, with a 96% mineral content, but acids can degrade enamel over time. Acid erosion is a chemical break down, which can lead to loss of tooth structure, sensitivity, and sometimes severe pain. Erosion is seen in a range of 30-52% of children, and 25% of those cases are severe. So, let’s talk about acids and ways to protect that precious enamel.

 Causes

Enamel has a critical pH of 5.5, meaning at a pH of 5.5 or lower, dissolution of enamel occurs. Simply put, we want to avoid things with a pH of 5.5 or lower.

 There are two sources of acids: intrinsic and extrinsic.

 1.     Intrinsic- it originates within the body, typically through the regurgitation of gastric contents into the mouth, which happens most commonly through gastroesophageal reflux (GERD).

2.      Extrinsic- this is typically related to your child’s diet.

• Juice- orange juice, apple juice, etc

  • pH is approximately 2.5

• Sports drinks- Gatorade and Powerade.

  • pH is approximately 3.0

  • Even consuming 1 sport drink a week is strongly associated with erosion!

• Carbonated beverages- seltzer water, sodas.

  • pH of soda is approximately 3.0

  • pH of seltzer water, such as LaCroix is 2.7

  • 1 soft drink/day is strongly associated with dental erosion!

• Acidic fruits- oranges, lemons, grapefruit.

  • Fruits are healthy choices. Dental erosion is linked to citrus fruits if consumed more than twice a day.

• Candies- Sour Patch Kids, Sprees, SweeTARTS, Fun Dip, Warheads

  • The pH of candies can be so low, even less than 2.0 in some cases!

  • Sour gummy candies are especially hard on the teeth because of their low pH and because they are retained in the grooves of the teeth for a longer period of time.

• Medicines- chewable vitamin C

  • pH is approximately 2.3

• Coffee

  • For all of our parents reading this that are fueled by coffee, the pH is approximately 5.0

Signs at home

Your child may be a “picky” eater, as they are avoiding foods that trigger their GERD, such as tomatoes, fried foods, or hot dogs. They may have coughing at night, frequent choking, belching, frequent clearing of their throat, describe a sour taste in their mouth, or describe “spicy” burbs. Sleep apnea and GERD are commonly related, as well as anxiety. Surprisingly, chlorinated swimming pools can cause dental erosion in competitive swimmers, so even knowing your child’s hobbies is important to us!

Signs at the dental appointment

We check for signs of acid erosion at your child’s 6-month dental cleaning appointment. The molar teeth will have a concave loss of tooth structure, and this characteristic “cupping” will be categorized and monitored at each appointment. They will also appear shiny and hard. In the front teeth, a thinning biting edge may be the first sign. Tooth erosion can be the first sign of GERD in previously undetected cases! The pediatric dentist plays a vital role in your child’s overall health.

If erosion is noted, we will discuss this with you and may recommend you follow up with your pediatrician.

Prevention

• Saliva

  • Saliva has a buffering capacity and naturally protects the teeth. Staying well hydrated with water in the Florida heat is very important!

• Good oral hygiene

  • Brushing immediately after consuming an acidic food or beverage is not ideal, as this can accelerate wear on the enamel. Waiting 30 minutes after consumption to brush is the best.

• Fluoride

  • Fluoride decreases the amount of erosion that can occur. Fluoride through daily toothbrushing with fluoridated toothpaste is awesome! The fluoride varnish we apply at your child’s 6-month cleaning has been shown to inhibit acid erosion as well. The dentist may recommend a prescription fluoride toothpaste, too.

• Dietary modifications

  • The goal is to decease acidic intake! Decreasing the intake of sodas, juices and sports drinks is a great place to start. Limiting acidic foods and drinks to mealtimes is also recommended. Finishing a meal with water is beneficial.

 Treatment

After dietary education and oral hygiene education have been discussed, the dentist may recommend white fillings or stainless-steel crowns depending on which teeth are affected and the severity. The goal is to alleviate sensitivity, prevent further loss of tooth structure, and maintain the baby teeth until they are lost naturally.