Frequently Asked Questions

Frequently Asked Questions

Get the facts on Acid Wear and Pronamel® toothpaste

Acid Wear and Acidic Foods

  • What is Acid Wear?
  • It is a form of Tooth Wear that is caused by acid softening the surface of the tooth's enamel. When tooth enamel (the tooth's hard surface) is exposed to acids (from food, drinks or the stomach e.g. due to sickness or regurgitation), it temporarily softens and loses some of its mineral content. Saliva will help neutralize acidity, restore the mouth's natural balance and slowly reharden the tooth enamel. However, because the tooth's recovery process is slow, if the acid attack happens frequently, the tooth does not have a chance to repair. When the enamel surface is soft and we brush our teeth, the enamel can be worn away more easily, becoming thinner over time. This wearing of enamel caused by acid is called Acid Wear.

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  • Is Acid Wear the same as cavities?
  • No. Cavities are caused by bacteria in the mouth, which convert sugar and carbohydrates from the foods we eat into acid. This acid gradually dissolves the tooth enamel and dentin resulting in tooth decay. Acid Wear is not caused by bacteria, but instead occurs when food acids act directly on the surface of the tooth, where they can soften the tooth enamel. Cavities also often happen in one localized area, while Acid Wear can occur in the whole mouth.

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  • What are some of the causes of Acid Wear?
  • Frequent consumption of food and drinks with a high acid content can cause enamel erosion. When tooth enamel is exposed to acids (from food, drinks or the stomach), it temporarily softens and loses some of its mineral content. Saliva will help neutralize acidity, restore the mouth's natural balance and slowly reharden the tooth enamel. However, because the tooth's recovery process is slow, if the acid attack happens frequently, the tooth does not have a chance to repair itself.

    Wine, many fruits and some soft drinks can be highly acidic and therefore potentially damaging to the teeth. Some acidic foods should not and cannot be easily avoided, since they are important to a healthy diet. But care needs to be taken as to when and how often they are consumed. It’s not just what is consumed that causes Acid Wear, but also the way that acidic items are held within the mouth. Holding or retaining acidic food or drinks in the mouth can increase the acidic drink's contact with the tooth or teeth, again increasing the risk of Acid Wear. Acid Wear can also be caused by internal acids. This is common in people who suffer from gastric reflux disease as well as some eating disorders.

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  • Can Acid Wear be caused by anything other than diet?
  • Diet and the way acidic food and drinks are consumed is major cause of Acid Wear. However it can also result from stomach acids in the mouth, for example, as a consequence of Bulimia or indigestion (Gastric Reflux). There are also instances - as a result of occupational or industrial exposure where Acid Wear has been caused by prolonged inhalation of acidic fumes.

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  • What foods are deemed acidic?
  • Higher Acidity

    Foods

    Fruits: Blackberries, blueberries, cherries, cranberries, grapes, grapefruit, lemons, limes, pineapples, pomegranates, raspberries and strawberries

    Other: Fruit jellies and jams, gelatin, lemon juice, pickles, salad dressings, vinegar and ketchup

    Beverages

    • Apple juice/cider
    • Grapefruit juice
    • Orange juice
    • Energy drinks
    • Fruit juices: Apple, cranberry and grapefruit
    • Wine: Red and white
    • Soft drinks (incl. diet)

    Medium Acidity

    Foods

    Fruits: Apples, apricots, figs, mangos, nectarines, oranges, peaches and pears

    Vegetables: Tomatoes and beans

    Other: Green olives, honey, pesto, and raisins

    Beverages

    • Beer

    Lower Acidity

    Foods

    Bread: Rye, wheat and white

    Cheese: Cheddar and Parmesan

    Vegetables: Artichokes, asparagus, avocados, broccoli, cabbage, carrots, cauliflower, celery, corn, cucumber, eggplant, yams and zucchini

    Other: Black olives, cereal (with milk), rice, and peanut butter

    Beverages

    • Milk
    • Mineral water
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Acid Wear: Effects

  • How does Acid Wear affect teeth?
  • Acid Wear can weaken the enamel or change the surface texture, shape and appearance of teeth, which may also cause tooth sensitivity.

    People often do not become aware of Acid Wear until it has reached an advanced stage. Detailed dental examinations can help to detect Acid Wear in its earlier stages. Here are the typical signs and effects of Acid Erosion:

    • Weak: the acids in everyday food and drink can weaken enamel making it easier to wear away
    • Thin: as more enamel wears away teeth can become visibly thinner
    • Transparent or See-through: as the enamel thins, the edges of your teeth can appear transparent or see-through
    • Yellow: as our weakened enamel is worn-away, the more yellow dentine layer underneath can become more visible
    • Dull: as the enamel wears away our teeth may lose their shine, making them appear dull
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  • What is the link between Acid Wear and sensitivity?
  • As tooth enamel is worn away, the underlying dentin may be exposed. This is a softer part of the tooth and as it becomes exposed, teeth may be more sensitive. A slight twinge can be felt when consuming cold, hot or sweet foods or drinks.

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  • How quickly can the effects of Acid Wear occur?
  • There are many factors that contribute to the progression of Acid Wear, most notably the frequency and concentration of the acids in contact with the teeth and the volume and defense of an individual's saliva. Everyone's lifestyle, consumption habits and teeth are different, and all can affect the rate at which Acid Wear affects teeth.

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  • What are the long-term consequences of Acid Wear?
  • When tooth enamel is exposed to acids, it temporarily softens and loses some of its mineral content. When the enamel surface is soft and we brush our teeth, the enamel can be worn away more easily, becoming thinner over time. This thinning can lead to teeth appearing translucent, becoming discolored or yellow, can cause teeth to crack or become sandblasted in appearance and can also cause sensitivity. In the long term, the effects of Acid Wear may require dental treatment in order to protect the tooth and the underlying dentin. A dentist may decide to place a bonded filling, a veneer or a crown to restore the tooth to its former color and shape.

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Acid Wear: Who is Affected?

  • Is the number of people affected by Acid Wear increasing?
  • Yes, the number of people showing signs of Acid Wear is rising due to the number of people keeping their natural teeth longer, combined with the acidity in the modern diet.

    In the 20th Century, dental diseases, for example tooth decay and gum disease, were widespread. This greatly affected the life span of teeth and meant that most people did not retain their teeth for life.

    Improved oral hygiene and restorative treatments have extended the life span of teeth in the 21st Century. However, as teeth are lasting longer, they are subject to the effects of wear, particularly from acids and tooth brushing, over a longer period of time.

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  • Who is most likely to be affected by Acid Wear?
  • Experts agree that nearly everybody with natural teeth will develop some signs of Acid Wear.

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  • Can children have Acid Wear?
  • Yes. "Baby teeth" are very much at risk from Acid Wear because they are less mineralized and therefore the enamel is softer than adult teeth. Acid Wear in primary teeth can also lead to Acid Wear in permanent teeth. For both reasons, great care should be taken with the acidic content of a child's diet. In fact, levels of Acid Wear among youth 11-14 highlight the need for early prevention. Children should be encouraged to form good oral hygiene habits and limit brushing directly after consuming acidic fruits or fruit juices.

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  • Is it true that Acid Wear is something that people should not worry about until they are older?
  • No. Experts agree that nearly everybody with natural teeth will develop some signs of Acid Wear. Acid Wear can affect all ages and cannot be reversed. Protecting teeth early is the best way to prevent future Acid Wear.

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Acid Wear: Prevention

  • What can be done to help prevent Acid Wear?
  • To help protect your teeth against the effects of dietary acids, there are several steps that can be taken:

    • Follow the advice of your dental professional and make sure you have regular dental check ups
    • Allow acidic foods and drinks to pass through your mouth quickly to reduce the time they are in contact with your teeth
    • If possible, drink soft drinks through a straw directed into your mouth and not directly at your teeth
    • Avoid brushing your teeth immediately after consuming acidic foods and/or drinks, as this is when enamel is at its softest and most likely to be damaged
    • Use Pronamel® as your daily toothpaste to reharden acid-softened enamel
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  • Can the effects of Acid Wear be reversed?
  • No, the effects of Acid Wear cannot be reversed. Once enamel is gone, it's gone for good. In fact, in the advanced stages of Acid Wear there is likely to be a need for expensive and complicated dentistry to restore teeth to normal function. This is why understanding the problem and taking steps to minimize risk is so important.

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Acid Wear: A Modern Phenomenon?

  • Why is Acid Wear only now becoming a problem?
  • In the 20th Century, dental diseases, such as tooth decay and gum disease, were widespread. This greatly affected the life span of teeth and meant that most people did not retain their teeth for life. Improved oral hygiene and restorative treatments have extended the life span of teeth in the 21st Century. However, as teeth are lasting longer, they are subject to the effects of wear, particularly from acids and tooth brushing over prolonged time periods. Not only that, people today expect to keep their teeth healthy and looking good for longer.

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  • How long have dentists known that Acid Wear is a problem?
  • Dentists learn about Acid Wear at dental school; however, in the past, they encountered it less frequently. Now, as people are keeping their teeth longer, dentists are increasingly seeing signs of Acid Wear and are beginning to become aware of the problem it poses in the 21st Century. As such, dentists have to be increasingly vigilant in looking for early stages of the condition.

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Pronamel®

  • How does Pronamel® help protect teeth from Acid Wear?
  • Pronamel® has been specifically formulated to help protect teeth from the effects of Acid Wear:

    • It helps to reharden acid-softened enamel, making it more resistant to future acid attacks
    • It has low abrasivity to limit further enamel wear during the process of toothbrushing
    • It is pH neutral (non-acidic) to minimize acidity in the mouth
    • It is specifically formulated for people with sensitive teeth, which can be a sign and symptom of Acid Wear
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  • How often do I need to use Pronamel® for it to be effective?
  • Pronamel® should be used twice a day, every day, in place of your regular toothpaste. It will immediately begin to reharden acid-softened enamel, to help protect teeth from further Acid Wear.

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  • Does Pronamel® repair tooth enamel?
  • Once tooth enamel is lost, it cannot be replaced. However Pronamel® can help reharden tooth enamel that has been softened, to help protect your teeth from Acid Wear.

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  • Do I need to use regular toothpaste alongside Pronamel®?
  • No, Pronamel® is a toothpaste that provides all the benefits of a regular toothpaste: contains fluoride to fight cavities, freshens breath and provides plaque removal with brushing. Pronamel® should be used twice a day, every day, as your regular toothpaste.

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  • Are there any side effects from using Pronamel®?
  • There are no expected side effects from Pronamel® when used as directed. Always follow pack instructions.

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  • Why is it important that Pronamel® is low abrasive?
  • All toothpastes contain abrasives in order to remove stains from the tooth surface. Pronamel® has been formulated with a low abrasive toothpaste to minimize physical wear to the tooth surface. This is particularly important when the tooth enamel is softened as it is more vulnerable, contributing to enamel loss.

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Acid Wear in Children: Pronamel® For Children

  • Can children have Acid Wear?
  • Yes. "Baby teeth" are very much at risk from Acid Wear because they are less mineralized and therefore the enamel is softer than adult teeth. Acid Wear in primary teeth can also lead to Acid Wear in permanent teeth. For both reasons, great care should be taken with the acidic content of a child's diet. In fact, levels of Acid Wear among youth 11-14 highlight the need for early prevention. Children should be encouraged to form good oral hygiene habits and limit brushing directly after consuming acidic fruits or fruit juices.

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  • How does Pronamel® For Children work?
  • Pronamel® For Children was developed in conjunction with dentists to help protect children's teeth from Acid Wear and cavities. It works in several ways:

    • It's specially formulated to help reharden acid-softened enamel, making the children’s teeth strong and healthy
    • It also helps to protect against cavities
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  • When and how should Pronamel® For Children be used?
  • Your child should use Pronamel® For Children as a daily toothpaste, following this simple advice:

    • Brush twice a day for two minutes
    • Encourage your child to avoid swallowing and to spit out after brushing
    • Ask your dentist for advice on brushing techniques
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  • What happens if nothing is done about Acid Wear?
  • If left untreated, children may need dental treatment to protect the teeth and the underlying dentine from further damage.

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  • Does Pronamel® For Children treat sensitivity?
  • Pronamel® For Children contains the same optimized fluoride formulation as Pronamel®; however, unlike the adult variant, it does not contain a desensitizing agent - dentin sensitivity is rare in children and should be treated by a dentist.

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