One Sided Tooth Melting
Significant acid reflux (GERD) and sleeping position are the causes behind this one sided destruction. The patient lost hearing in her right ear so she slept on her right side so her good left ear was up and she could hear if her children woke up in the middle of the night. Acid from her stomach came up during the night because it was no longer kept in the stomach by gravity and pooled along her cheek next to her lower teeth. The upper teeth are protected by a large salivary gland duct that empties saliva above and washes the acid down into the lower vestibule and onto the lower teeth..
This is a dramatic example but we see the more subtle effects of acid reflux on teeth on a daily basis in our office. We actually can often tell what side a patient sleeps on by the pattern of destruction. This case demonstrates many symptoms that indicate erosion caused by acid reflux:
1. The brown /green discoloration of the lesions almost the color of bile. Note this is different than the clean white erosion we showed with vitamn C destruction in our previous blog.
This is also different than the abrasion caused simply by over zealous brushing which occurs lower on the necks of the teeth on the root surface.
2. The erosion is worse as you go back further in the mouth, Bulimics, those who throw up intentionally have more destruction on the backs of their front teeth although they often have acid reflux also caused by damage to the valve at the top of their stomach.
3. The destruction is almost always worse on the lower teeth as noted above the upper teeth are protected by a large salivary gland flow.
We restored her teeth using bonded fillings that release fluoride to protect her teeth.
Look for our coming blog Acid Reflux and Teeth in which we will discuss the causes, incidence, symptoms and treatments more completely.