Acid Erosion & Tooth Wear in Marsden Park

Acid erosion is the silent, slow, often-unnoticed wearing away of tooth enamel by acid. By the time a patient notices the wear, the damage is usually significant. At our Dentist Marsden Park practice, MM Dental diagnoses and manages acid erosion as part of our check-up workflow and our cosmetic dentistry service for patients across Marsden Park, St Marys, Schofields and the wider northwest Sydney corridor. This page covers what acid erosion is, the dietary and medical causes, the early signs, what to do to stop it, and how it is treated.

The honest opening: acid erosion is the only common dental disease that is not caused by bacteria. It is caused by acid. The treatment starts with finding the acid source, not with the dental restoration.

What is acid erosion of teeth?

Acid erosion is the chemical dissolution of tooth enamel by acids that are not produced by oral bacteria. The most common sources are dietary (soft drinks, citrus, wine, sports drinks) and medical (gastric reflux, eating disorders, frequent vomiting). The Australian Dental Association and Better Health Channel’s tooth erosion page both describe this as a process distinct from decay, although the long-term result (tooth structure loss) looks similar.

The chemistry in plain language:

• Tooth enamel is made of crystals (mostly hydroxyapatite) that dissolve in acid. The critical pH is around 5.5. Below that, the enamel starts to lose minerals.
• Bacterial decay (caries) involves bacteria in plaque that convert sugar into acid, which then dissolves enamel. The acid is produced locally on the tooth surface.
• Acid erosion involves acid that arrives at the tooth from elsewhere. The acid source is not in the plaque. It is in what the patient is eating, drinking, or refluxing.
• The pattern of wear is different — bacterial decay typically starts in the pits and fissures and between the teeth. Acid erosion typically starts on the smooth surfaces (the biting edges of the front teeth, the palatal surfaces of the upper front teeth) and progresses in a distinctive pattern.

The honest framing: most patients with acid erosion do not have a bacterial decay problem. They have an acid problem. The treatment that fixes decay (better brushing, less sugar) does not fix erosion. The treatment that fixes erosion (stop the acid, rinse after exposure, wait to brush) is the right one.

What causes acid erosion?

The causes of acid erosion fall into two groups: dietary acid (what you eat and drink) and medical acid (what comes back up from the stomach). The Better Health Channel’s tooth erosion page is the standard patient reference for the causes.

The dietary causes, ranked by how erosive they are:

• Soft drinks — the worst offender by a long way. Cola, lemonade, energy drinks, and even diet versions are all highly acidic (pH 2.5-3.5) and often sipped slowly over an hour or more. The combination of high acid content and prolonged contact is the perfect erosion recipe.
• Sports drinks — marketed as healthy, but most have a pH of 3-4 and a high sugar content. Frequent use during sport is a common cause in teenagers and athletes.
• Citrus juices — orange, lemon, grapefruit. Acidic and often sipped over breakfast. The “lemon water in the morning” trend is a real cause of erosion we see in practice.
• Wine — both red and white. White wine is more acidic. Frequent wine drinkers show a characteristic erosion pattern.
• Frequent fruit snacking — apples, citrus, berries. Whole fruit is healthy, but the acid is real.
• Vinegar-based foods — pickles, salad dressings. Frequent consumption contributes.

The medical causes:

• Gastro-oesophageal reflux (GORD) — stomach acid rising into the oesophagus and sometimes the mouth, often at night. The patient may not know they have reflux. The wear pattern is on the palatal (inner) surfaces of the upper front teeth. A GP workup is part of the case.
• Eating disorders (bulimia) — self-induced vomiting exposes the teeth to stomach acid repeatedly. A sensitive case that requires a multidisciplinary approach.
• Frequent vomiting from other causes — morning sickness in pregnancy, chemotherapy-induced nausea, cyclical vomiting syndrome. Each has its own management.
• Medications that cause acid reflux or dry mouth — some antidepressants, antihistamines, and asthma medications. The dentist may be the first to notice the erosion.

The honest framing: most cases involve more than one source. A patient who drinks soft drinks throughout the day AND has undiagnosed reflux is getting acid from both ends. Identifying all the sources is part of the case.

What are the early signs of acid erosion?

The early signs of acid erosion are teeth that look glossy or translucent at the edges, fillings that sit proud of the surrounding tooth (the tooth has worn down around them), a yellowish appearance as the yellow dentine shows through thinning enamel, and sensitivity to hot, cold, and sweet. These signs are caught at a routine check-up before the patient notices them, which is one of the reasons the 6-monthly visit matters.

The signs worth knowing:

• Glossy or translucent incisal edges — the biting edges of the front teeth lose their natural matte texture and become shiny and translucent. Often the first visible sign.
• Fillings sitting proud of the tooth — the original filling was level with the tooth. Over time, the surrounding enamel wears away, and the filling looks like it is “sticking out”. A clear sign the surrounding tooth is losing structure.
• Yellowing of the front teeth — the dentine underneath the enamel is yellow. As the enamel thins from erosion, the dentine shows through more, and the teeth look more yellow.
• Sensitivity to temperature and sweet — the thinned enamel exposes more of the sensitive dentine underneath.
• Cupping on the biting surfaces of the back teeth — small indentations on the cusps of the molars, often where the patient grinds the most. A classic erosion pattern.
• Cracking and chipping of the incisal edges — the thinned enamel is brittle and chips under normal biting forces.

The most useful rule: any of these signs in a young adult or a heavy soft drink consumer warrants a closer look. Erosion is much cheaper to manage in the early stages than after the teeth are visibly shorter.

How is acid erosion treated?

Acid erosion is treated by stopping the acid, remineralising the weakened enamel, and restoring the lost structure with composite bonding or ceramic restorations. The order matters: stop the acid first, then restore. The ADA’s tooth erosion treatment guidance and Better Health Channel cover the standard approach.

The treatment sequence:

1. Identify and address the acid source — dietary modification, GP workup for reflux, multidisciplinary care for eating disorders. Without this step, the restoration will fail.
2. Remineralise the weakened enamel — fluoride toothpaste, fluoride mouthwash, professionally applied fluoride varnish. The weakened enamel can re-harden to some extent if the acid is removed and fluoride is supplied.
3. Monitor the progression — photographs, study models, regular reviews. The rate of wear tells the dentist whether the source is under control.
4. Restore the lost structure — composite bonding for moderate cases, ceramic veneers or crowns for advanced cases. The restoration is done once the wear has stabilised.
5. Maintain the result — ongoing dietary vigilance, GP follow-up for reflux, night guard if bruxism is a co-factor.

The honest framing: a beautiful set of veneers placed on a patient who continues to drink soft drinks and has undiagnosed reflux is a temporary restoration. The case planning is everything. Stop the acid, then build back the tooth.

How can acid erosion be prevented?

The most effective prevention is reducing the frequency of acid exposure (sip water between meals, not soft drinks), rinsing with water after acid exposure, and waiting at least 30 minutes before brushing to allow the enamel to reharden. The ADA’s tooth erosion prevention guidance is clear on these practical steps.

The prevention list, ranked by impact:

• Reduce frequency of acidic drinks — one glass of soft drink with a meal is far less erosive than sipping a 1.25L bottle over three hours. The frequency matters more than the total amount.
• Drink through a straw — the acid bypasses the front teeth. Cheap, simple, effective.
• Rinse with water after acid exposure — dilutes the acid and starts the remineralisation process. Chewing sugar-free gum stimulates saliva, which is the natural neutraliser.
• Wait 30 minutes before brushing — the enamel is temporarily softened after an acid exposure. Brushing immediately erodes the softened enamel. Wait, then brush.
• Use a fluoride toothpaste and mouthwash — fluoride strengthens the enamel and helps it resist acid attacks. Particularly useful for patients with active erosion.
• Treat the medical cause — GP management of reflux, multidisciplinary care for eating disorders, medication review if drugs are contributing.

The honest framing: the patients who maintain their teeth long-term are the ones who treat the acid as a lifestyle issue, not just a dental one. Diet, hydration, and medical management are part of the dental picture.

Frequently asked questions (supplementary)

Is acid erosion reversible? Early-stage erosion (softened but not yet lost enamel) is partially reversible with fluoride and reduced acid exposure. Lost enamel (a visible cavity in the tooth) is not reversible. The lost structure has to be restored.

Can acid erosion cause tooth sensitivity? Yes. The thinned enamel exposes the sensitive dentine underneath. Treating the erosion and restoring the lost structure usually resolves the sensitivity.

Are sports drinks really that bad for teeth? Yes. Most sports drinks have a pH of 3-4, well below the critical pH of 5.5 where enamel starts to dissolve. Water is the right choice during sport. Sports drinks are useful only for athletes in prolonged high-intensity exercise (over 60-90 minutes).

Is lemon water bad for teeth? Yes, if consumed frequently. Lemon water has a pH of around 2-3, similar to soft drinks. The “morning lemon water for health” trend is a real cause of erosion. If you are going to drink it, drink through a straw, rinse with water after, and wait 30 minutes before brushing.

Will my eroded teeth get worse if I do nothing? Yes. Erosion is progressive. Without addressing the cause, the wear continues, the teeth get shorter, the bite changes, and the eventual restoration is more complex and more expensive.

Ready to start?

A 30-minute consultation at our Dentist Marsden Park practice is the right place to start. We will look at the wear pattern, identify the likely acid source, and recommend the right next step. For a routine check, the check-up appointment is the right place. For cosmetic concern about the appearance of the teeth, the cosmetic dentistry service handles the restoration side. We regularly see patients from neighbouring St Marys and across the wider northwest Sydney corridor. Book online or call our practice.