Acid erosion is the slow dissolving of tooth enamel by acids that are not produced by bacteria. It is one of the most common causes of tooth wear in younger adults, and the cause is usually hiding in plain sight — in the daily soft drink, the lemon water, the post-workout sports drink, or the reflux that has never been properly diagnosed. At Dentist Pymble, we assess and treat acid erosion for patients across the Ku-ring-gai region, and the right treatment depends on identifying the source of the acid and addressing it before rebuilding what has been lost. This page covers what acid erosion is, what causes it, and how to stop it.

What is acid erosion?

Acid erosion is the chemical dissolution of tooth enamel by acids that are not produced by the bacteria in plaque. The acid attacks the enamel directly, softening it and then wearing it away. Once the softened enamel is lost, the body cannot grow it back — the damage is permanent. The good news: the rate of erosion can almost always be slowed significantly, and the lost structure can usually be rebuilt with modern materials.

Enamel starts to dissolve at a pH of around 5.5. Most soft drinks have a pH well below 3. Most sports drinks are in the same range. Citrus juices are similarly acidic. Wine is acidic. Even some health foods — apple cider vinegar, lemon water, kombucha — are acidic enough to cause erosion when consumed regularly. The saliva in your mouth normally buffers these acids and starts the remineralisation process, but when the acid exposure outpaces the saliva’s ability to recover, the result is net loss of enamel.

Common causes of acid erosion

The three main categories:

• Dietary acid — soft drinks (including diet and zero-sugar versions), sports drinks, citrus juices, wine, citrus fruits, vinegar-based foods, and kombucha. The most common source in younger adults.
• Gastric acid — gastroesophageal reflux disease (GORD), hiatus hernia, frequent vomiting (including during pregnancy or from eating disorders), and rumination. The pattern of wear often shows up on the inside (palatal) surfaces of the upper front teeth, which is a useful diagnostic clue.
• Environmental acid — chlorinated swimming pools (frequent swimmers), industrial exposure to acids, and certain medications that reduce saliva flow. Less common but worth considering when dietary and gastric causes have been ruled out.

The most common combination we see is dietary plus gastric, particularly in patients who drink a lot of soft drink or sports drink and also have undiagnosed or under-treated reflux. Both sources work on the same enamel at the same time, and the effect is more than additive.

How to spot early signs of erosion

The early signs are subtle and easy to miss. The most common are:

• Teeth that look slightly translucent at the tips, particularly the upper front teeth
• Sensitivity to cold or sweet that wasn’t there before
• Fillings that start to look raised above the surrounding tooth (because the enamel around them has worn away)
• A slight yellowing of the teeth (as the yellow dentine shows through the thinning enamel)
• Small dents or “cupping” on the biting surfaces of the back teeth

By the time these signs are visible to the patient, the erosion has usually been happening for a while. The earlier we catch it, the less invasive the treatment needs to be. Regular check-ups are the main way to catch it early — the dentist sees the pattern before the patient does.

How is acid erosion treated?

Treatment has three phases: stop the acid, remineralise what you can, and rebuild what has been lost.

Stop the acid — identify the source and address it. Cut back on acidic drinks (or have them with meals rather than sipping throughout the day). Treat reflux with your GP. Manage vomiting in pregnancy with dietary changes. For environmental acid, address the exposure. Without this phase, the rebuilding work will fail.

Remineralise what you can — fluoride toothpaste, fluoride mouthwash, and in-chair fluoride applications help strengthen enamel that has been softened by acid. They cannot regrow enamel that has been physically lost, but they can slow the progression and harden the softened surface.

Rebuild what has been lost — for minor erosion, composite bonding in a single appointment is often the right answer. For moderate erosion, ceramic veneers or onlays provide a more durable and aesthetic result. For severe erosion, particularly when the bite has collapsed, full-coverage crowns on the affected teeth rebuild both the appearance and the function. The treatment depends on the extent of the damage and the patient’s goals.

How can I prevent acid erosion?

The biggest wins are the easiest:

• Reduce the frequency of acidic drinks — sipping a soft drink over an hour is much worse than drinking it in 10 minutes. Every sip resets the acid attack in your mouth.
• Use a straw — for drinks that have to be acidic, a straw positioned towards the back of the mouth reduces contact with the front teeth.
• Rinse with water after acid — water neutralises the pH in your mouth and helps the saliva start the remineralisation process.
• Don’t brush immediately after acid — wait at least 30 minutes. The enamel is soft after an acid attack, and brushing removes more than it would otherwise.
• Chew sugar-free gum — stimulates saliva flow, which buffers the acid and speeds remineralisation.
• Drink water between meals — the simplest, most effective preventive measure.

For patients with reflux, working with your GP to get the GORD under control is essential. For patients with eating disorders, recovery is the foundation of any dental treatment, and we are happy to work with your treatment team.

When should I see a dentist?

If you have noticed any of the early signs — translucency at the tips, new sensitivity, fillings looking raised, yellowing — it is worth a check-up. The earlier we catch the erosion, the less invasive the treatment needs to be. For patients with high exposure (frequent soft drinks, sports drinks, known reflux), a six-monthly check-up with the dentist is the right rhythm.

If you live in Pymble, Gordon, Turramurra, Wahroonga or anywhere else in the Ku-ring-gai area and you are worried about acid erosion, call our practice. We see neighbouring Gordon patients and other nearby residents, and the first conversation is always a free one.

Frequently asked questions

Can acid erosion be reversed? The softened enamel can be remineralised with fluoride and saliva. The physically lost enamel cannot be regrown. This is why prevention and early intervention are so important — once the structure is gone, the only options are to leave it, bond over it, or restore it.

Is diet soft drink safe for teeth? No, not from an erosion perspective. Diet soft drinks have a similar pH to regular soft drinks, and the sugar-free formulation does not change the acidity. The acid is what causes the erosion, not the sugar. The sugar adds the decay risk on top.

Does lemon water cause acid erosion? Yes, if consumed regularly. Lemon water has a pH of around 2-3, well below the threshold at which enamel dissolves. Sipping it throughout the morning is a particularly aggressive exposure. If you drink it, drink it quickly, rinse with water afterwards, and don’t brush for 30 minutes.

Is sports mouth hydration safe? Sports drinks are acidic (pH around 3-4) and contain significant sugar. For most people, water is the right hydration choice during exercise. Sports drinks have a place for sustained high-intensity exercise in hot conditions, but they are not a daily drink.

Can a dentist fix eroded teeth? Yes. The treatment depends on the extent of the damage. Composite bonding works for minor erosion. Ceramic veneers or onlays work for moderate cases. Crowns work for severe cases. The key is stopping the acid first, otherwise the restorative work will fail.