Frequent Vomiting, Acid Reflux, and Tooth Erosion: When the Backs of Front Teeth Wear

Frequent vomiting or reflux wears the inside of the upper front teeth first. How to protect teeth after vomiting, and how to seek help gently if you're worried.

Has your child said their front teeth feel sensitive, or have the edges of their front teeth started to look thin? Changes like these can be linked to frequent vomiting or acid reflux. Here's a calm look at why these changes happen, how to protect the teeth, and how to reach out if you're worried your child may be struggling emotionally.

Stomach acid is strong enough to dissolve teeth

The acid your stomach uses to digest food is very strong. The outer layer of a tooth (enamel) is the hardest tissue in the body, but strong acid dissolves it. If vomiting or reflux happens only once in a while, saliva washes the acid away and helps the tooth surface recover. But when it happens again and again, the surface wears away bit by bit with no time to recover. This is called erosion.

The changes often show up first on the inside (tongue side) of the upper front teeth. You may see things like these:

• The inside of the upper front teeth becomes glossy and smooth.
• Teeth feel sensitive to cold or sweet foods.
• The edges of the front teeth get thin and let light through.

These changes come on slowly and often don't hurt, so a dentist is often the first to notice, before your child or family does. There are many possible causes. It can be a physical problem like gastroesophageal reflux, and sometimes it's linked to an emotional struggle such as an eating disorder. So changes in the teeth can be one clue that helps you see whether your child needs support.

Protecting the teeth, and being there for your child

After vomiting, here's what to do:

1. Don't brush right after vomiting. Scrubbing a surface softened by acid can wear it down more.
2. Instead, rinse the mouth with water or water with baking soda mixed in. This helps wash away and neutralize the acid left in the mouth.
3. Brush 30 minutes later.
4. Keep up the habit of brushing twice a day with fluoride toothpaste. Fluoride helps strengthen the weakened surface.
5. Ask the dentist about professional fluoride treatments.

If your child often has heartburn or says a sour taste often comes up into the mouth, ask the pediatrician to check for acid reflux. Treating the cause is the surest way to protect the teeth.

If you notice intense worry about weight or food, trips to the bathroom right after meals, or eating in secret, it can weigh heavily on you. At times like this, the most important thing is not to confront. An eating disorder isn't about willpower or doing something wrong. It's a condition that needs support. It's an emotional struggle, and it's also an illness that can cause physical complications, so getting help early matters. Pushing hard can make a child hide things even more.

• Pick a quiet, relaxed moment and share your concern, like "You've seemed to be having a hard time lately, and I'm worried."
• Avoid comments about body shape, weight, or how much they eat.
• Even if your child denies it, don't push, and let them know they can talk to you anytime.
• Don't try to handle it alone, and don't wait until your child admits it. Talk with the pediatrician or a mental health professional early.

If your child faints, seems extremely weak, says their heart is racing or pounding, or looks severely dehydrated, get medical care right away.

Frequently asked questions

When to see the dentist

• Your child often says the front teeth feel sensitive
• The inside of the upper front teeth looks smooth and worn
• The edges of the front teeth look thin and see-through
• Vomiting or a sour taste coming up happens again and again
• Along with changes in the teeth, you notice worries about food or weight

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A guide to the decisions behind dental care

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The information in this article is for general educational purposes and does not replace professional dental care. Talk to a dentist about your child's condition.

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