Dental erosion (tooth erosion) is the irreversible loss of tooth enamel due to chemical processes that do not involve bacterial action.
Tooth enamel is a mineralized hard tissue that covers and protects the tooth. It is the hardest tissue of human body but it can be chemically dissolved in an acidic environment. The acids that cause dental erosion may come from intrinsic (e.g., gastroesophageal reflux, vomiting) or extrinsic sources (e.g., acidic beverages, citrus fruits).
The tooth enamel loss caused by the acids produced by dental plaque bacteria (tooth decay) is not dental erosion. Other forms of tooth enamel loss caused by mechanical and not chemical factors are tooth abrasion and tooth attrition.
Tooth erosion is a slow progressive process that leads to the loss of the protective hard tissues of the tooth caused by exposure to acids for long periods of time.
Monthly menstrual cycles produce many uncomfortable, and sometimes painful, symptoms, which can include cramps, headaches and bloating. With more intense, painful menstruation, a condition otherwise known as dysmenorrhea, regular vomiting also is a symptom. This monthly recurrence can cause severe tooth erosion, according to a study in the November/December 2008 issue of General Dentistry, the Academy of General Dentistry's (AGD) clinical, peer-reviewed journal.
This condition often masquerades as an eating disorder, since both dysmenorrhea and bulimia nervosa cause noticeable erosion on the back of the front teeth of the top jaw as a result of the exposure to stomach acid. However, it is imperative that patients understand the main distinguishing factor between the two conditions.
"Whereas bulimia nervosa is a voluntary act - the woman induces vomiting herself - dysmenorrhea is involuntary," says Mohamed Bassiouny, DMD, MSc, PhD, author of the study. "Contractions in the uterus or the abdominal wall force the patient to vomit without any cause."
Due to its uncontrollable force, dysmenorrhea also creates a different erosion pattern on the teeth. "A dentist can tell when a patient suffers from bulimia or dysmenorrhea, due to the distinct erosion patterns," says Dr. Bassiouny. "When vomiting is voluntary, the individual controls the direction and force," he says. "The tongue creates a tunnel which protects, in most instances the back teeth. When a patient has dysmenorrhea, the erosion affects almost all surfaces of the dentition to varying extents."
