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Caries Process and Prevention Strategies: Erosion
Non-acid Risk Factors

Course Author(s): Susan Higham, BSc, PhD, CBiol, MRSB; Chris Hope, BSc (Hons), PhD, FHEA; Sabeel Valappil, BSc, MSc, PhD, PGCertEd, FHEA; Phil Smith, BDS, MDS, PhD, FDS, DRD, MRD, FDS (Rest Dent) RCS (Edin), FHEA

Non-acid Risk Factors

The presence of acid is not the only way in which the wear of enamel occurs. Another mechanism is called chelation. Certain agents can complex with calcium to remove it from enamel, thus triggering demineralization. Or, agents can complex with calcium in saliva, reducing saliva’s supersaturation and ability to remineralize the tooth surface. Some calcium-chelating agents include mouth rinses that include the ingredient EDTA, and food and beverages that contain citric acid. Up to 32% of the calcium in saliva can be complexed by citrate at concentrations common in fruit juices, reducing the supersaturation of saliva and driving the equation to dissolution of tooth mineral.23

Another non-acid erosion risk factor is dry mouth. This can be caused by dehydration, salivary gland dysfunction or by the use of some medications such as anti-histamines, anti-emetics, anti-depressants, tranquilizers, or illegal designer drugs. Because the mouth is dry, the teeth have significantly less protection from acid.2

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