Being such a fan of the airway, I resolved at the beginning of my dental training that I was never going to be a butterfingers and compromise a patient’s right to breathe, by accidentally dropping anything down the throat. I was an even bigger fan of the butterfly sponge in the early days of post-qualification.
As we dental professionals know all too well, alcohol is acidic and therefore highly erosive, especially when consumed frequently, in large quantities over an extended period of time. It may also be that the high alcohol intake occasionally causes vomiting, which can exacerbate the damage to the dentition.
To help prevent tooth wear, advise patients to:
1. Drink still water or low fat milk between meals
2. Limit fruit juice to once per day
3. Avoid carbonated drinks
4. Swallow any acidic drinks immediately to reduce contact time with the teeth
5. Use a wide-bore straw to drink acidic drinks to limit the contact time with the teeth
6. Dilute and keep any acidic drinks chilled, as this reduces the damaging low pH potential
7. Rinse the mouth after acidic foods and drinks with water for 15-30 seconds to dilute any remaining acids
8. Snack on cheese or drink some milk following consumption of an acidic beverage
9. Wait at least an hour to brush teeth after consuming any acidic drinks
10. Use a toothpaste that is fluoridated to 1400ppm and low in abrasivity
12. Use a fluoridated mouthwash every day at a different time to tooth brushing, as well as before or after acidic drinks to help limit the erosive potential
12. Chew sugar-free gum, especially that containing xylitol, after drink to help neutralise the acidic environment in the mouth.
If you are concerned that any of your patients are showing signs tooth wear, simply visit www.toothwear.co.uk, email This email address is being protected from spambots. You need JavaScript enabled to view it. or call 020 7486 7180.
Patients need to know that alcohol is acidic and therefore highly erosive, especially when consumed frequently, in large quantities over an extended period of time. It may also be that the high alcohol intake occasionally causes vomiting, which will exacerbate the damage to the dentition.
It’s also worth sharing with them that carbonated drinks, including sugar-free varieties, will have a similar effect on their dentition.
As well as coronal height being reduced, patients may also suffer with hypersensitivity due to the wear. In such cases, using a fluoridated mouthrinse every day at a different time to toothbrushing is an effective first line of defence. A desensitising toothpaste and/or prescription fluoride toothpaste can be helpful in alleviating sensitivity, while use of a calcium phosphate paste, applied in carriers, is an additional option if the symptoms are severe. Also, placing protective covering restorations can eliminate sensitivity and minimise further wear.
Further advice includes:
• Guiding the patient in brushing effectively yet gently with a relatively soft toothbrush and a toothpaste low in abrasivity
• Not swishing drinks around the mouth and waiting an hour after consuming an acidic drink before brushing to avoid damaging the softened enamel
• Rinsing the mouth with fluoride mouthwash or water before or after acidic drink consumption to help limit their erosive potential
• Chewing sugar-free, xylitol- or sorbitol-sweetened gum to help neutralise acid in the mouth.
The London Tooth Wear Centre® offers an evidence-based and comprehensive approach to managing tooth wear. To request advice, make a referral or for further information on the work of the London Tooth Wear Centre®, please visit www.toothwear.co.uk, email This email address is being protected from spambots. You need JavaScript enabled to view it. or call 020 7486 7180.
