Examination and cause-finding
We map where the enamel has been lost, because the pattern tells us whether the acid is coming from the diet, from the stomach or both, and photograph the teeth so change can be measured.
About this treatmentDental condition · Wimpole Street, Marylebone
Enamel erosion: acid wear that thins teeth without any bacteria involved
Erosion is the dissolving of enamel by acid that did not come from plaque. Fizzy drinks, wine, citrus, vinegar-based dressings and stomach acid all have a pH low enough to soften the tooth surface on contact, and once softened it is rubbed away by the tongue, by food and by the toothbrush. Because no bacteria are involved, erosion does not behave like decay. It affects whole surfaces rather than single points, it produces smooth, glassy dishes rather than sticky holes, and it tends to hit the biting edges of the front teeth and the cusps of the molars first. The loss is gradual and irreversible: enamel does not grow back. What can be done is to stop the acid, protect what remains and, where the teeth have become short, thin or sensitive, rebuild them. Our Wimpole Street dentists see a great deal of erosion in fit, health-conscious patients whose diets are full of fruit, sparkling water and smoothies, which surprises many of them.
Recognising it
How it usually feels
Front teeth that look shorter, thinner or slightly see-through at the edge
The incisal enamel is the first to go, leaving a translucent or greyish rim.
Teeth that have yellowed despite whitening
Thinner enamel shows more of the darker dentine beneath; bleach cannot change that.
Smooth, shiny hollows on the biting surfaces of molars
Cupping of the cusps where acid pools and softens the enamel.
Fillings that stand proud of the surrounding tooth
The resin resists acid while the enamel around it dissolves away.
Sensitivity to cold, sweet or even breathing in
Exposed dentine transmits temperature straight to the nerve.
Behind the symptoms
What's going on
- 01
Acidic drinks sipped over time
Cola, sports and energy drinks, fruit juice, flavoured sparkling water, cider and white wine are all well below the pH at which enamel starts to dissolve. Sipping across an afternoon keeps the mouth acidic for hours, which is far more damaging than drinking the same amount quickly with a meal.
- 02
Fruit, especially citrus
Lemon in hot water, grapefruit, oranges and berries eaten frequently produce the same effect. Patients who suck lemon slices or chew vitamin C tablets often show erosion concentrated on the front teeth where the acid was held.
- 03
Acid reflux and heartburn
Stomach acid is many times stronger than any drink. Reflux, whether felt as heartburn or silent, brings acid up into the mouth, particularly at night, and erodes the insides of the upper teeth and the tops of the lower molars. It is often the dentist who first suggests the diagnosis.
- 04
Vomiting and eating disorders
Repeated vomiting from bulimia, pregnancy sickness or medical conditions exposes the teeth to gastric acid directly. The pattern of loss on the inner surfaces of the upper front teeth is characteristic, and we discuss it sensitively and without judgement.
- 05
A dry mouth
Saliva is the natural buffer that neutralises acid and rebuilds enamel. Medication, dehydration and mouth breathing all reduce it, so the same diet does far more damage in a dry mouth than in a well-lubricated one.
Before your appointment
What you can do today
- Keep acidic drinks to mealtimes, drink them through a straw placed behind the front teeth and finish them rather than sipping for hours.
- Rinse with plain water or milk after anything acidic, and wait at least an hour before brushing.
- Use a soft brush, a low-abrasion fluoride toothpaste and gentle pressure; a sensitive-teeth formula can help with twinges.
- If you have heartburn, reflux or a sour taste on waking, see your GP; treating reflux protects the teeth as well as the oesophagus.
- Keep a two-day diet diary before your appointment listing every drink and snack with its timing; it usually reveals the culprit.
These are holding measures, not a substitute for an examination. Use any pain relief exactly as directed on the pack and check with a pharmacist if you take other medicines.
In the chair
How we treat it at Wimpole Street
Fluoride varnish and desensitising
Concentrated fluoride applied to worn surfaces hardens the remaining enamel and closes the exposed dentine tubules that cause sensitivity.
About this treatmentComposite bonding to rebuild edges
Short, thin or chipped front teeth are restored with tooth-coloured resin sculpted directly onto the tooth, without drilling healthy enamel. This also shields the worn surface from further acid.
About this treatmentOnlays for cupped molars
Where the cusps of back teeth have dissolved and the bite has lost height, bonded ceramic or composite onlays rebuild the chewing surface and protect the tooth beneath.
About this treatmentVeneers for advanced wear
When the front teeth have lost significant length and colour, porcelain veneers or crowns restore their shape while covering the exposed dentine.
About this treatmentHygiene and dietary support
Our hygienists clean without abrasive pastes, review your diet diary with you and give specific, realistic changes rather than a blanket ban on everything acidic.
About this treatmentFees
Costs to expect
An examination at Wimpole Street is expected to be £95, fluoride varnish £40 and a hygiene visit from £89. For teeth that need rebuilding, composite bonding starts from £395 per tooth, which for a set of worn front edges usually means four to six teeth.
Onlays and crowns for eroded molars are indicative from £995 per tooth, and porcelain veneers from £1,095 per tooth where the wear is extensive. A written plan sets out which teeth genuinely need treatment and which can simply be protected and watched, so you are not paying to restore teeth that are stable.
Figures are indicative prices for Wimpole Street and are confirmed in a written plan once a dentist has examined you. Fees match our South Kensington and St Paul's clinics.
Don't wait if
When to see a dentist
- Your front teeth look shorter, more transparent or more yellow than in older photographs.
- Cold drinks or cold air cause sharp, brief pain.
- Old fillings feel raised above the surrounding tooth.
- You have heartburn, a sour taste on waking or a history of frequent vomiting.
- Front teeth chip on ordinary food.
- You drink acidic or sparkling drinks daily and have not had your teeth examined for a year.
FAQ
Common questions
Plain carbonated water is mildly acidic but sits well above the threshold at which enamel dissolves, so in moderation it is a low-risk choice. Flavoured sparkling waters are different: the citric or malic acid added for taste brings the pH down to a level comparable with fruit juice, and daily sipping of those does cause erosion.
Usually, yes. Erosion produces smooth, rounded, cupped surfaces and leaves fillings standing proud, whereas grinding produces flat, matching facets on upper and lower teeth that fit together like a key in a lock. Many patients have both, and the acid softens the enamel so that grinding removes it faster.
Not much, and it may increase sensitivity. The yellow is dentine showing through thinned enamel, and bleach lightens dentine only slightly. Covering the worn areas with bonding or veneers restores both the colour and the lost thickness.
Composite resin is not dissolved by dietary acid the way enamel is, so it protects the surface it covers. The margins where resin meets enamel remain vulnerable if the acid source continues, which is why we insist on addressing the cause before rebuilding. With the cause controlled, bonded edges typically last five to ten years before needing refreshing.
Acid-suppressing medication reduces the damage but does not always eliminate night-time reflux entirely. The enamel already lost will not return, so protecting the worn surfaces with fluoride and, where needed, restorations remains worthwhile. We review the wear at each check-up to confirm it has stopped progressing.
Marylebone, W1
Wimpole Street opens 1 October 2026
Leave your details and we will be in touch when the Marylebone diary opens. If the problem cannot wait, the same clinicians are already seeing patients in South Kensington and at St Paul's.
Related conditions
Opening 1 October 2026
Wimpole Street is not yet seeing patients. Until then, please book or call our South Kensington clinic on 020 7183 2362 or our St Paul's clinic on 020 7183 3709. Questions about the new clinic: wimpolestreet@md.co.uk.
Until we open
Need an appointment before 1 October 2026?
The same clinical team already works from two other Medical & Dental clinics. Book at either one now and, if you prefer, move your ongoing care to Wimpole Street once the doors open.
South Kensington
- 20 Old Brompton Road, London SW7 3DL
- Open seven days a week
- 020 7183 2362
St Paul's, City of London
- 5 Ave Maria Lane, London EC4M 7AQ
- Open Monday to Friday
- 020 7183 3709
