Working towards eradicating Erosive Tooth Wear

Latest update 22/02/2022

The research into Erosive Tooth Wear continues to have impact as one of the two impact cases for 2021/2 REF for the Faculty of Dentistry, Oral & Craniofacial Sciences at King's College London. Making headlines around the world, our research into this condition has highlighted the damage caused by eating of drinking acidic foods between meals.

It crucially uncovered that it wasn’t just about what people eat, but how they eat, that increases their chances of developing the condition. Those who consumed acidic drinks twice a day between meals, such as soft drinks, water with a slice of lemon or hot fruit flavoured teas, were more than 11 times more likely to have moderate or severe tooth erosion.  This figure was halved when drinks were consumed with meals.

But what is Erosive Tooth Wear?

Erosive Tooth Wear is the third most common oral condition – King’s research found it affects up to 30% of European adults. It is the premature wearing of teeth due to the softening of the dental enamel from dietary or gastric acids, combined with wear and tear. It occurs when the outer layer (enamel) of the tooth slowly dissolves. This can lead to changes in the shape or appearance of teeth, and they can become sensitive when eating or drinking cold food and drinks. At its worst, the tooth structure can gradually wear away.

Enamel covers the outside of the tooth and is the first barrier to protect the pulp.  While it is possible for acidic damage in the enamel to be repaired in the right conditions, severe Erosive Tooth Wear reduces quality of life and can mean complex and costly procedures, costing up to £30,000 per patient.

Erosive Tooth Wear is mostly aggravated by the types of food we eat and how we eat them. As a preventable condition, researchers have found that some people have habits which increase both the duration and the force that the acids are in contact with teeth, such as holding drinks in their mouth, or sipping them over long periods of time.

Medical conditions and Erosive Tooth Wear

As well as dietary erosion, academics at King’s also found that many medical conditions can result in the erosion of tooth enamel.  Dentists can play a key role in the detection of health conditions including anorexia nervosa, bulimia and Gastro-Oesophageal Reflux Disease (GORD).  Our published research show that regurgitated or vomited stomach contents are highly acidic and repeated contact with tooth enamel results in erosive tooth wear.

Building the Foundations

Erosive Tooth Wear can cause major problems for both individuals and communities. Often the causes and treatment options are poorly understood. 

To help break down these barriers and ensure research from King’s is translated into better health, King’s Professor Bartlett, Head of Prosthodontics and Professor Nigel Pitts, King's Dean for Impact, work with leading academics from across Europe, to run the Erosive Tooth Wear Foundation, a registered UK charity since 2018.

The foundation’s website provides key information on the condition for dentists, helping them to recognise and record the condition in clinical notes. For patients it provides a resource to help them understand the condition and the underlying science, the scale of the problem and how to best prevent, and where appropriate, manage the problem. Using a range of education tools, the Foundation team are working to spread information widely across patients and the public.

The future

As a result of increasing the public and professional awareness of the condition, the Erosive Tooth Wear examination has now been incorporated into three international dental software programmes for clinical records and within dental schools in the UK. 75% teach the examination as part of their routine clinical care for undergraduates.

But there is still work to be done. The team from King’s are calling for a basic Erosive Tooth Wear examination to be incorporated into every clinical examination performed in the UK.  This they say, would reduce the potential for patients to develop severe levels of the condition and remove it as one of the most common oral health conditions in the country.