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When you think about heartburn, you probably think of a burning sensation in your chest or a foul taste in your mouth, and possibly you worry about how it’s affecting your esophagus. But did you ever think about your teeth? When acid comes up from the stomach, through your esophagus, and into your mouth, it may be giving your pearly whites an acid bath on the regular.
"Acid erosion of the teeth is definitely something we see in patients," says Samantha Rawdin, DMD, a prosthodontist (a dental specialist who goes through an additional three years of training after dental school to focus on esthetics, complex rehabilitations, and implants) at Gallery 57 Dental in New York City.
Acid tends to affect two specific areas of the teeth, Dr. Rawdin explains: the inside of the upper front teeth and the biting surfaces of the lower bottom teeth. Those particular areas are most exposed to the acid because they’re the least protected by your tongue. You may notice that these parts of the teeth start to look darker, she says. "The enamel of the teeth becomes worn away and you start to see the dentin—the layer underneath the enamel—which is much more yellow in color.”
It's probably difficult for you to look at the inside of your upper front teeth without great lighting and a dental mirror, so it's important to see your dentist regularly for checkups. And be sure to mention to your dentist if you experience heartburn so they know to look for any acid erosion, because it doesn’t happen overnight. "It takes years to show up," Dr. Rawdin says. The more often you have untreated heartburn and the more years you've dealt with it, the more likely you'll experience this dental issue.
If you have heartburn and your dentist notices acid erosion on your teeth, they’ll likely recommend that you seek out treatment from either your primary care physician or a gastroenterologist if you're not doing so already, who can help you figure out the best way to treat your heartburn to prevent the problem from getting worse. Acid erosion is irreversible, Dr. Rawdin explains, and the longer it goes on, the worse it can get for your teeth: Dentin is softer than enamel, so your teeth may start to discolor, wear down, or even break. If this happens, your dentist may suggest treatments like bonding, crowns, or dental implants.
One tip Dr. Rawdin gives her reflux patients: Don't brush your teeth immediately after experiencing heartburn. "A lot of patients do this and it's the worst thing they can do, because there's acid in your mouth and you're taking an abrasive—your toothpaste—and scrubbing it all over your teeth. That will make your teeth wear away faster," she says. "Just rinse your mouth out with some water first and give it a little bit of time before you brush your teeth."
The bottom line: As with many medical issues, the earlier you catch the problem, the easier it is to treat. Keep an open line of communication with all your doctors, including your dentist. This way, the only problem at your next appointment will be your dentist telling you to remember to floss.
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