Understanding Tooth Wear

Key Takeaway: Your teeth can wear down from three different causes: erosion (acid dissolving enamel), attrition (teeth grinding against each other), and abrasion (external trauma like aggressive brushing)....

Your teeth can wear down from three different causes: erosion (acid dissolving enamel), attrition (teeth grinding against each other), and abrasion (external trauma like aggressive brushing). Understanding which type you have is important because each requires different treatment.

Erosion specifically means your teeth are being dissolved by acid—not scratched or ground down. Once enamel is eroded, it cannot grow back. So prevention is far more important than trying to fix erosion after it develops.

Acidic Foods and Their pH

Citrus fruits are the most acidic foods. Lemon is pH 2.0 to 2.2 (extremely acidic), lime is pH 2.0 to 2.3, grapefruit is pH 2.9 to 3.3, and oranges are pH 3.5 to 4.0. These are significantly below the safe pH of 5.5 for teeth. Tomato products are tricky. Fresh tomato (pH 4.3 to 4.9) is close to the danger zone but not quite there. However, tomato paste concentrates the acid to pH 3.5 to 4.0, making it more erosive. Tomatoes with added vinegar (in preserved or pickled forms) drop to pH 2.5 to 3.0. Vinegar (pH 2.4 to 3.5) and vinegar-containing foods (pickles, pickled vegetables, vinegar-based salad dressings) are quite acidic. Fermented foods and drinks vary widely. Kombucha is pH 2.5 to 3.0. Many "health" drinks marketed as fermented add citric acid for preservation, making them quite erosive. Berries are acidic too. Strawberries (pH 3.0 to 3.5), raspberries (pH 3.2 to 3.5), and blackberries (pH 3.5 to 4.0) can contribute to erosion. Wine is pH 2.8 to 3.7, and beer ranges from pH 3.5 to 5.5 depending on type.

Distinguishing Erosion from Other Wear

Erosion affects smooth surfaces, creates cupped or concave areas, and may spare the areas near the gum line. Erosion appears symmetric on both sides of the mouth. Attrition (grinding) affects top and bottom surfaces of teeth, creates flat worn facets, and is often accompanied by jaw pain or muscle tenderness. Abrasion (aggressive brushing) affects the gum line area primarily, creating V-shaped notches. It correlates with where you brush hard.

Many people have a combination—erosion from acidic foods plus attrition from grinding, for example. Your dentist can identify which processes are affecting your teeth.

Your Saliva Protects You

Your saliva is your mouth's defense system. It contains minerals (calcium and phosphate) that repair early acid damage to enamel. It also contains buffering compounds that neutralize acid and bring your mouth pH back to normal.

However, saliva's protective power varies from person to person. Some people have very effective buffering saliva that quickly neutralizes acid. Others have weak buffering ability and experience more erosion from the same acid exposure. If you have weak buffering (your dentist can test this), you need extra protection.

Assessing Erosion Severity

Dentists use a scoring system to track erosion progress. Early erosion shows loss of surface shine and texture—your teeth no longer have that normal slightly textured surface. Moderate erosion shows visible flattening or cupping of tooth surfaces, and you might start seeing yellowish dentin underneath. Severe erosion involves substantial dentin exposure, shortened tooth appearance, and sensitivity.

If you notice any of these changes, tell your dentist right away. Early intervention can stop progression before significant damage occurs.

Smart Eating Strategies

You don't need to eliminate acidic foods entirely. Instead, modify how you eat them:

Eat whole fruits instead of juice. Eating an orange takes one to two minutes. Your teeth have brief acid exposure. Sipping orange juice for 20 minutes creates prolonged acid exposure. Consume with meals. During meals, your mouth produces extra saliva that buffers acid better. Eating citrus at lunch is less damaging than eating it alone mid-afternoon. Eat acidic foods with calcium-rich foods. Consuming lemon with cheese, strawberries with yogurt, or tomato with milk provides protective minerals that reduce net erosion. Drink water after acidic foods. Rinsing your mouth with plain water dilutes acid and washes away food particles. It doesn't neutralize acid like baking soda does, but it helps. Wait before brushing. Acid temporarily softens enamel. Brushing immediately after acidic food causes extra damage from the toothbrush trauma. Wait 30 minutes before brushing. Chew sugar-free gum after meals. Gum stimulates saliva production, which buffers acid and repairs early damage. Twenty minutes of gum chewing after an acidic meal helps protect teeth.

Protecting Eroded Teeth

If you already have erosion damage:

Use fluoride gel. Custom-fitted trays with 5,000 ppm fluoride gel applied 5 to 10 minutes daily strengthen remaining enamel and reduce sensitivity. This is especially important if you continue eating acidic foods. Use sensitive toothpaste. Special toothpastes block the tiny holes in dentin (exposed when enamel erodes) that cause sensitivity. Use them twice daily. Brush gently with a soft brush. Eroded teeth are already weakened. Aggressive brushing causes additional damage. Limit acidic food frequency. If possible, consolidate your acidic food consumption rather than spreading it throughout the day.

Natural vs. Acidic

Just because a food is natural or healthy doesn't mean it's safe for teeth. Many "superfoods" and "health foods" are quite acidic. Acai bowls, kombucha, fresh-pressed vegetable juices with citrus, and other trendy foods often contain significant acid. Check ingredients and preparation methods.

When to See Your Dentist

Schedule an appointment if you notice:

  • Teeth appearing shorter than before
  • Increased sensitivity to cold or touch
  • Yellowish tint appearing on teeth
  • Rounded or flattened tooth edges
  • Visible wear or cupping on tooth surfaces

These signs indicate erosion progression. Your dentist can recommend preventive measures and potentially restore damage if it's severe.

Summary

Acidic foods (citrus pH 2.0-4.0, tomato products pH 3.5-4.9, fermented foods pH 2.5-3.0, and others) dissolve tooth enamel below the critical pH of 5.5. Prevention strategies include eating whole fruits instead of juice, consuming acidic foods with meals (when saliva is elevated), pairing acidic foods with calcium-rich foods, waiting 30 minutes before brushing, and rinsing with water after acid exposure. Fluoride strengthening treatments protect eroded teeth. Early detection through regular dental visits allows intervention before significant erosion develops. Smart food choices and eating strategies let you enjoy acidic foods while protecting your teeth.

Related reading: Caries Risk Assessment and Key Vulnerability Factors and Flossing Benefits.

Conclusion

> Key Takeaway: Your teeth can wear down from three different causes: erosion (acid dissolving enamel), attrition (teeth grinding against each other), and abrasion (external trauma like aggressive brushing). Talk to your dentist about what options work best for your situation.