Suffered for centuries as burning pains in the throat and middle chest, we call it “heartburn.” Today we know heartburn occurs when acid escapes from the stomach and travels back up the esophagus. The one-way valve (sphincter) designed to keep acid only in the stomach sometimes relaxes open enough to allow the acid out. Powerful enough to dissolve even metal, that hydrochloric acid sometimes gets back up into the mouth. You may not even taste it.

When acid travels back up from the stomach, it is called “acid reflux.” About 1/3 of the population experiences some acid reflux, but for some people the problem is chronic. A condition called gastroesophageal reflux disease (GERD) affects millions of people and produces frequent acid reflux. GERD’s effects present a high risk of acid reaching the mouth and teeth. In some cases, GERD produces little or no obvious pain. In just a few months of repeated acid reflux, however, there can be noticeable changes in the person’s teeth. Unchecked, the acid erodes the teeth’s crucial hard protective enamel layer and can eventually destroy it permanently.

Strong enough to dissolve the tooth surface directly, the acid even when diluted by saliva can soften the tooth surface so it wears away layer by layer. Dentists can see the damage from acid reflux: the tooth appears flattened, thin, sharp, or pitted, and it may have a cratered or cupped appearance

There is good news, however:

• Regular dental checkups can spot acid reflux effects early.
• Diet and eating habit changes – reducing acidy foods and drinks with alcohol and caffeine, and not lying down flat soon after eating – are effective.
• Medications or supplements addressing stomach acid issues, and some anti-asthma treatments, also can help.
• Not brushing the teeth during or after a heartburn attack can reduce tooth erosion.
• Dentists can suggest toothpastes and mouthwashes to help teeth remineralize and replace enamel.
• In more serious cases of acid-eroded teeth, dentists can use dental crowns and veneers to stop further erosion while protecting existing tooth structures.

Heartburn and acid – enemies of your smile – are treatable. Ask about them at your very next dental appointment.