Acid from food and drink mostly touches the outside of the front teeth. Acid that comes up from the stomach takes a different route, washing over the tongue side of the upper teeth and the chewing surfaces at the back. That difference in where the wear sits is why a dentist is sometimes the first to suspect reflux, occasionally in people who have never had heartburn.
Stomach acid is much stronger than dietary acid
Enamel begins to dissolve once the acidity around it passes a critical point, and stomach acid is far more acidic than that threshold (Lazarchik and Frazier, General Dentistry, 2009). Each episode that reaches the mouth is therefore a harsh exposure. In gastro-oesophageal reflux disease (GORD), the valve at the top of the stomach does not seal well, so that exposure can happen many times a week. A systematic review (Pace and colleagues, Alimentary Pharmacology and Therapeutics, 2008) found a strong association between GORD and dental erosion, although not everyone with reflux develops erosion.
The same chemistry underlies erosion from diet, which our article on enamel erosion covers in more detail.
The pattern a dentist picks up
Reflux wear is often smooth and glassy rather than chipped. Common findings include:
- a polished, thinned surface on the inner side of the upper front teeth
- shallow scooped areas on the chewing surfaces of back teeth, with older fillings standing slightly higher than the tooth around them
- front teeth whose edges look thin or slightly translucent
- a gradual yellowing as more of the darker dentine underneath shows through
- sensitivity to cold, sweet or acidic food that slowly increases
Grinding, brushing too hard and diet can produce overlapping signs, so the overall picture and your history matter. A dentist cannot diagnose GORD, but can point out a pattern that suggests it and suggest you talk to your GP.
Night-time and silent reflux do the most damage
Saliva is the mouth's main defence against acid. It dilutes it, neutralises it and supplies minerals that help the surface recover. During sleep, saliva flow falls sharply, so acid that rises at night lingers longer. Some people have reflux with little or no burning, sometimes called silent reflux, and may only notice a sour taste on waking, a hoarse voice or a cough. Others have none of these. Recurrent vomiting, for any reason, causes a similar pattern of wear and deserves the same care.
Two jobs at once: protecting the teeth and controlling the acid
Dental care can slow the wear and repair damage, but it cannot stop acid from arriving. Reflux treatment can reduce the acid, but it does not replace lost enamel. The best results come when both happen together, with your GP or gastroenterologist looking after the reflux and your dentist or OHT looking after the teeth.
Habits that limit the damage
After a reflux episode or vomiting, rinse with plain water or a fluoride mouthwash to clear the acid. There is no need to wait a set time before brushing: a 2024 scoping review in Caries Research found that brushing with fluoride toothpaste soon after an acid challenge did not add measurable wear. Brush with a soft brush and fluoride toothpaste, and ask whether a higher-strength fluoride toothpaste suits you. Sugar-free gum after meals encourages saliva. Avoiding large meals late in the evening and not lying down soon after eating may reduce night-time episodes, and your doctor can advise on others.
Restoring what has been lost
Early erosion is often managed with fluoride, desensitising products and monitoring. Where teeth have become short, sensitive or weak, they can be rebuilt with tooth-coloured bonding, onlays or crowns, depending on how much tooth remains. Our guide to fillings, inlays, onlays and crowns compares these. It usually makes sense to bring the reflux under control first, because new restorations sit in the same environment as the teeth they repair.
What patients ask about reflux and teeth
Does reflux medicine fix the teeth?
It can reduce further erosion, which is the main aim, but lost enamel does not grow back. Teeth that are already worn may need repair.
I only get reflux now and then. Should I worry?
Occasional reflux is much less of a risk than frequent or night-time episodes. The protective habits are easy to adopt, and reflux that is persistent or getting worse is worth raising with your GP.
Can a dentist tell how long erosion has been happening?
Not precisely. Comparing photographs and models over time shows whether the wear is still active, which is often more useful than estimating when it started.
If your teeth feel more sensitive or look shorter or more yellow than they used to, the team at Lumi Dental in Melrose Park can look at the pattern and suggest how to protect them. Contact us, read about our general dental care, or see what is on offer on our deals page.
