Dental Erosion: A New Perspective
by Dr. V Kim Kutsch
Dental erosion is a major health concern that puts the dentition at biomechanical risk. Two recent studies brought up dental erosion from a perspective we don’t often think about. Prolonged periods of low pH in the mouth can result in net mineral loss. If this pH challenge is extrinsic we generally relate it to foods and drinks. If the acidic source is internal, we generally think about GERD or Silent Reflux. The system can be placed out of balance by having too much acid present, or by not having the capability to neutralize the acid, as in the case of Hypo-salivation and Xerostomia. These are pretty straightforward. But what about when medications or oral care products are acidic, and maybe even when they are being used to provide relief from dry mouth symptoms?
Two recent studies examined this issue and provided some insight. The first paper examined medication-related dental erosion.1 It highlighted the various potential causes for erosive tooth wear, with the different drugs prescribed for patients as a risk factor. The authors concluded that several therapeutic medications can directly or indirectly be associated with dental erosion.
The second study examined the pH and erosive potential of commonly used oral moisturizers.2 The authors examined a number of products and looked at their erosive potential, and used tap water as a control. The products included Oasis, Bioténe Moisturizing Mouth Spray, CariFree CTx2 Spray, Mouth Kote, Thayer’s, Bioténe Oral Balance, Rain, tap water, and citric acid. The authors concluded that there was a significant negative correlation between the pH values and the erosive potential. The CariFree product demonstrated the highest pH at 9.1 and zero erosive potential.
These two studies add a new perspective to our growing body of knowledge on dental erosion. Sometimes, medications and even the medication we’re prescribing or recommending to relieve symptoms may actually contribute to the erosive process. It is important to know the pH of dental products and know the potential impact those products may have for a patient.
- Thomas MS, Vivekananda Pai AR, Yadav A. Medication-Related Dental Erosion: A Review. Compend Contin Educ Dent. 2015 Oct;36(9):662-667.
- Delgado AJ, Olafsson VG, Donovan T. pH and Erosive Potential of Commonly Used Oral Moisturizers. J Prosthodont. 2015 Jul 27. doi: 10.1111/jopr.12324