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 info@toothwear.co.uk or call 020 7486 7180.