What exactly is dental erosion and why does it occur? These are some of the questions that NIOMs are dealing with. Mulic begins by explaining that acid in the mouth can have both internal and external sources:

“The endogenous source of acid is stomach acid, and we often see this in patients with reflux or eating disorders such as bulimia. Whereas exogenous acid comes from the acidic foods and drinks we consume, which predominantly has a low pH level. Both caries and erosive lesions can be treated, but erosion is less likely to remineralise, i.e. rebuild, the natural tooth substance”, Mulic explains. This makes prevention and early diagnosis essential.

Young people are particularly prone to acid damage

According to Mulic, as many as a third of 18-year-olds in Oslo have dental erosion, with even higher figures in other parts of the country.

“In Rogaland, we see that almost 60 per cent of young people between the ages of 16 and 18 have dental erosion. These are alarming figures,” she says.

Researcher Amela Tulek points to consumption patterns as a key factor:

“Many adolescents consume large quantities of energy drinks, soft drinks and other acidic beverages, which they consume throughout the day. This leads to constant acid exposure, significantly increasing the risk.”

However, dental erosion is not limited to adolescents. Children and adults with reflux problems,  eating disorders or lifestyles with a high intake of acidic foods and drinks may also be at risk.

“The trend of healthy living can actually damage teeth, for example through overconsumption of lemon water, smoothies or citrus fruits,” warns Mulic.

Especially young people are prone to dental erosion, mainly because of consumption of energy drinks, soft drinks and other acidic beverages.
Photo: Lifestyle, iStock

How does dental erosion occur?

Dental erosion occurs when acid lowers the pH level in the mouth, causing enamel to weaken and minerals to dissolve. This acid can come from underlying medical conditions such as reflux or eating disorders, although high and regular consumption of acidic drinks is the most common cause of erosion. Drinking patterns also play a major role in the development of the damage. Tulek explains:

“It's not just about what you drink, but also how. Sipping soft drinks or energy drinks over a long period of time is much worse than drinking a glass quickly with a meal.”

Another important factor is the way we treat our teeth after acid exposure.

“Brushing your teeth immediately after consuming something acidic can exacerbate the damage, because the enamel is weakened and more vulnerable,” says Mulic. Instead, she recommends rinsing your mouth with water, if practical. The researchers emphasise the importance of brushing twice a day with fluoride-containing toothpaste.

In addition to lifestyle changes, genetics and individual factors also come into play.

“Some people have stronger enamel, while others are more vulnerable to acid damage. The composition of saliva in some people provides better protection against acid damage compared to others. This is partly genetically determined,” explains Tulek.

Three photos of teeth with different types of dental erosions
Different types of dental erosions. Photo: Aida Mulic

When the damage has already occurred

Once teeth erosion has occurred, it is important to limit and stop its development. Fluoride is a common preventive agent, but the effect can vary.

“Fluoride has a strong effect on caries, but is not as effective against erosion,” says Tulek. She adds that research is underway on various fluoride products and other preventive agents with higher concentrations of fluoride to halt the development and progression of acid damage.

For severe cases, restorative dental treatment such as fillings or crowns may be necessary.

“We always try to prioritise minimally invasive treatment, but when the damage is severe more extensive measures may be necessary,” Mulic explains.

Prevention of acid damage

Research into dental erosion is crucial to developing better methods of prevention and treatment. Due to the irreversible damage caused by erosion, it is not possible to study the problem directly on patients. Tulek explains:

“We use animal models and laboratory tests to simulate the effects of acid on teeth. This allows us to test different preventatives and understand which treatments work best.”

In addition to the technical aspects, the researchers emphasise the importance of raising awareness of acid damage among both healthcare professionals and the general public.

“Many people don't recognise the problem until it's severe, which makes education and early diagnosis very important,” says Mulic.

Dental erosion is not just an aesthetic problem; it can also lead to serious functional consequences.

“Patients can experience pain as a result of sensitivity in the teeth, exposure of the nerve (pulp), problems with chewing and aesthetic challenges such as discolouration and chipping,” says Mulic.

Tulek adds that acid damage can also affect the bite and lead to the collapse of the dentition in young patients, which can cause permanent changes to the facial profile.
This makes prevention even more important, especially among children and adolescents.

"Most cases of acid damage could be avoided with better lifestyle choices and awareness of the risks," Mulic points out.

A long-term challenge

Erosion is a growing challenge, fueled by modern lifestyles and increased consumption of acidic beverages. Through research, education and prevention, we can reduce both the incidence and consequences of this condition.

As Tulek concludes:

“It's about understanding the risks, making small but important changes in our daily lives, and using our knowledge to protect our teeth for the future.”

Mulic concludes with an important message:

“Dental erosion is irreversible, but not inevitable. It's all about balancing lifestyle and prioritising oral health.”
 

How to Prevent Dental Erosion

Prevention is first and foremost about reducing exposure to acid and maintaining good habits:

•    Drink water.
•    Avoid and limit your intake of acidic beverages such as soft drinks, juices and energy drinks.
•    Avoid sipping acidic drinks over a long period of time; preferably drink at mealtimes and swallow immediately afterwards, possibly using a straw.
•    Rinse your mouth with water after acid exposure.
•    Use fluoride.
•    Have regular check-ups with a dental hygienist or dentist.