Behavioral Factors that Influence Erosive Tooth Surface Loss

Behavioral factors play a significant role in determining the extent of erosive tooth surface loss. The factors can include the manner in which dietary acids are introduced into the mouth (such as sipping, gulping, swishing, or using a straw) as this affects how long the teeth are in contact with the erosive challenge. Factors can also include diets high in acidic food (including sweets, fruits, and vegetables) and acidic beverages, oral hygiene practices (such as using toothpaste or excessive toothbrushing or flossing), the use of acidic medications or oral hygiene products, consumption of alcohol, frequent consumption of designer drugs, and nighttime baby-bottle feeding with acidic beverages.2

One point of note is that even healthy dietary lifestyles, such as vegetarianism and raw foodism, have been linked with more dental erosion due to the large amounts of acidic fruits and vegetables consumed. Other healthy lifestyle habits, such as drinking herbal tea (such as rose hips and lemon, which have a pH of 2.6 to 3.9) also promote erosion.2 Even cosmetic procedures may pose a problem: Some whitening gels have been found to soften and alter enamel, suggesting an increased susceptibility to dental erosion.38

Figure 2.
Interactions of the different factors for the development of dental erosion.
Adapted from: Lussi A. Erosive Tooth Wear: From Diagnosis to Therapy. Basil, Switzerland: Karger; 2006. Monographs in Oral Science Series. Vol 20.