The Dangers of Tooth Enamel Abrasion
Updated: Sep 14
When I was a dental student, one faculty dentist told me he didn’t use toothpaste. I looked at him in bewilderment as if I was the first person who heard that the earth was round.
“What do you mean you don’t use toothpaste?”
He explained that toothpastes generally are too abrasive for his liking and that he preferred to dunk his toothbrush into a cup with some mouthwash.
For two years I did not heed his advice and kept to my toothpaste routine. As I became a full-time dentist and saw thousands of patients, I started noticing a trend of defects along the gumline in my elderly clientele. These were not soft, sticky cavities. Instead, they were hard to the touch, nonbacterial notches mainly on the root surface where there was gum recession. My Canadian analogy is when a beaver starts to take down a tree.
I thought of my previous dental mentor, and realized he was onto something.
Before diving deeper, let’s take a quick second to refresh on some basic tooth anatomy. Pretend a tooth is like an M&M Candy. You have a hard outer shell (Enamel), inner chocolate filling (Dentin) and instead of a peanut deep inside, a tooth has a hallow area with a nerve and blood vessels. Did you know that Enamel is actually translucent/clear? Its an optical illusion that your enamel is white. The thicker the enamel the whiter the appearance, and the thinner the enamel, well you can see through it into the yellow dentin layer.
Take a closer look at the people who live around you in your community and at the colours of their teeth. You will notice that when grouped in age cohorts there is a yellowing of teeth as their ages progress. Why is that?
Rigorous brushing, using a hard-bristled toothbrush, and abrasive toothpaste can wear your enamel down. Acid erosion from acidic foods or drinks, gastrointestinal disorders, and eating disorders can also wear the enamel away, leaving your teeth vulnerable to decay, becoming more sensitive and yellower in colour.
All toothpaste have some type of abrasiveness to it especially when coupled with a toothbrush; the level of abrasiveness can be is measured by RDA (Relative Dentin Abrasion chart at the bottom of the article). The American Dental Association created a range of abrasiveness that rates different toothpastes and their effect on the teeth. Their list ranges from 0-250 and is broken into 4 sections (“Low Abrasive” to “Regarded as a Harmful Limit”). Enamel is not as susceptible to abrasion (i.e. the wear on the teeth from a mechanical source, like a toothbrush with toothpaste) because of the hardness of the structure. The underlying structures of enamel like dentin and the root surfaces, which is much softer than the enamel portion of the tooth are affected by how abrasive a toothpaste is. We recommend trying to use toothpaste that is in the 0-70 range (blue section) on the RDA Value List along with a soft/extra soft toothbrush and a gentle, but thorough, touch. My routine now is that I keep a large bottle of Listerine beside my power toothbrush. I take a small sip of it and brush it around. It leaves a fresh taste, and it lacks abrasive particles.
In summary long term use of abrasive toothpastes will lead to yellowing of teeth via the thinning of enamel, and it will create notches along the gum line. Call our team at Moose Lake Dental to book your next check up appointment to learn more (519-341-1001) Sincerely Dr Rudik