Just thinking about vomiting often arouses a queasy feeling in our stomachs. Some people even throw up merely at the sight of someone else retching. After vomiting, our natural instinct is to run to the bathroom for relief and then head to the sink to brush our teeth.
People who suffer from frequent reflux or vomiting are at risk for irreversible dental deterioration.
When gastric acids overpower the neutralizing saliva in the mouth, teeth are in treacherous territory.
People who suffer from GERD, bulimia, alcoholism, and hyperemesis gravidarum are at risk of dental erosion.
After vomiting, rinsing with water instead of brushing teeth is recommended to prevent damage while the enamel is soft.
However, is brushing right after vomiting a good idea? Keep reading to learn more about post-vomiting oral care.
What is dental erosion?
Dental erosion is a chemical process that results in the demineralization and deterioration of tooth enamel, which is the tooth’s outer covering. Though enamel is the hardest substance in our bodies, it can be damaged. Since enamel is not composed of living cells, but rather minerals, damage to the enamel is irreversible.
When the surfaces of the teeth are exposed to acids, the enamel can become weakened. Demineralization can then occur, which can lead to progressive dental erosion. If you notice a loss of the smooth texture on your teeth, or if you sense that the broad chewing surface of your back teeth is becoming flattened, you may be experiencing dental erosion.
Causes of dental erosion
There are two types of causes of dental erosion – intrinsic and extrinsic. Intrinsic causes come from within the body, while extrinsic causes come from outside the body.
Intrinsic causes of dental erosion are caused by acids that originate from within the body. For example, someone suffering from regular reflux often burps up their most recent meal. Reflux occurs to everyone at one time or another. However, frequent bouts of intestinal contents reversing and gastric acids coming into the mouth can erode the teeth.
Extrinsic causes of dental erosion are the opposite of intrinsic causes. Some examples of extrinsic causes are as follows:
- Drink. Drinking beverages with low pH level (soft drinks, sports drinks, fruit juices, etc.).
- Sugar. Eating foods high in sugar.
- Swimming. Exposing teeth to chlorinated water (people frequenting chlorinated pools).
Dental erosion – who's at risk?
People who suffer from the following conditions are at risk of developing dental erosion:
- Gastroesophageal reflux disease (GERD);
- Bulimia nervosa;
- Chronic alcoholism;
- Hyperemesis gravidarum.
GERD is a common condition in which intestinal contents reverse their flow. Instead of food and liquids moving down the intestinal tract, small amounts of gastric contents come back up the esophagus, the tube that connects the mouth and the stomach.
People with GERD are disposed to dental erosion, with the most deterioration occurring while they sleep. With less swallowing happening at night, acids rest on the teeth and eat at the enamel.
According to the American Dental Association, 5% of women in the age range of 18 to 35 struggle with bulimia nervosa. Of this 5%, more than 90% experience dental erosion. The gravity of impact depends on the frequency, duration, and intensity of vomiting episodes.
Since alcohol is an acidic beverage and vomiting is a symptom, chronic alcoholism is a double-barreled culprit of dental erosion. As with bulimia nervosa, frequency, duration, and intensity of vomiting directly affect the severity of damage to the teeth.
Hyperemesis gravidarum is a rare condition in which pregnant women experience excessive and uncontrollable vomiting. Normally, our saliva neutralizes acids coming from vomiting or acidic foods and beverages. However, when the amount of acid is greater than the saliva’s ability to neutralize, teeth are at risk.
Should you brush your teeth after vomiting?
To brush, or not to brush, that is the question. For decades, it has been taught that prompt oral hygiene is recommended after an episode of vomiting. However, recent research indicates the contrary.
It is surprising that thorough oral hygiene can unknowingly progress to tooth deterioration. Since tooth enamel is softest during the time right after vomiting when acid is at its greatest concentration in the mouth, immediate brushing is not advised. It is recommended to avoid brushing your teeth for sixty minutes after a vomiting episode.
Tips to prevent dental erosion
Since dental erosion is irreversible, prevention is the best medicine. Some recommendations for post-vomiting oral care or regular oral hygiene are as follows:
- Rinse. Rinse mouth with water, saline rinse, or milk after vomiting.
- Wait. Hold off for 60 minutes after vomiting to brush teeth.
- No sugar. Chew sugar-free gum.
- Straws. Drink acidic beverages through a straw.
- Brush. Under normal circumstances, brush with a soft bristled toothbrush and use fluoride toothpaste.
- Less. Decrease intake of acidic beverages and high sugary foods.
Furthermore, dental erosion begins with the softening of the tooth’s outer layer, the enamel. It progresses with loss of volume, and teeth becoming increasingly softer. Therefore, a dental examination will expose any signs of dental erosion and may help determine any underlying causes that are contributing factors.
In conclusion, frequent and intense vomiting that is prolonged puts people at risk for dental erosion. Dietary and lifestyle choices are also determinants.
Since dental erosion is irreversible, prevention is the name of the game. If you want to keep those pearly whites looking shiny, clean, and intact, proper oral hygiene is imperative. However, what you have done in the past may not be the best course of action.
Looking for relief from the nasty taste and feel, we naturally crave the freshness of toothpaste and a good scrub. However, research recommends restraint. Instead of reaching for the toothpaste and toothbrush, pour a cup of water and rinse.
- Oncology Nursing News. Vomiting-Related Dental Erosion: What Nurses Need to Know.
- American Dental Association. Dental Erosion.