Fluoride toothpaste and tooth erosion

[Jaquta]

Dear Dr Tsang,

Hi.  Mum has concerns about me using a high fluoride toothpaste (Neutra Fluor 5000 Plus).  Based on what she has read she said that my teeth could become permanently mottled.  Is it safe to use this toothpaste?

Also, (sorry for all the questions) as I've mentioned earlier some of my teeth are quite badly eroded (my dentist said due to brushing too hard and with a hard toothbrush).  One of these is starting to discolor, is that a huge concern?  What would be a good solution to the problem?  Is filling them the best option?
I feel they have been a problem so have been trying to save for when I do go to the dentist in June.  Do I need to ask if I can bring my appointment forward?
I'm not sure whether it is staining due to tea or iron tablets or whether it is decay.  Food does become trapped in the eroded parts quite a lot.

[Jerome Tsang, DDS]

Actually no I haven't read it.  That reminds me I should order it and read it when I get a chance.  I'm actually reading a book called The China Study by T Colin Campbell (I believe).  Its a nutrition book.  Its quite interesting too.  Basically it states that our diet is an important contributor to the high incidence of cancer, heart disease, diabetes, etc.  

Just let me know how it goes.  Don't forget that sometimes its okay to just watch something and make sure it doesn't continue to worsen.  Taking a drill and removing tooth for something minor may not be the best idea and can worsen the situation as well.  

[Jaquta]

I haven't had a remotely normal diet since before I had my wisdom teeth out last year.
It is something I have tried to address.

I have been religious about my dental appointment in more recent years.  Prior to that  was ... ??
My old dentist actually gave me some dental sticks and told me to ?? to stimulate gum growth.  That wasn't something I did.  Maybe I was wrong.  It didn't feel like a great idea though.

I'll try talking to my GP first then my dentist after that.  I find it a little overwhelming when there is so much that needs addressing.

I have a migraine at the moment and this is a little challenging for me but before I got I was wondering if you had had an opportunity to read that book you recommended.  I will read it one day, it is just a little awkward right now.

Thank you for all your time again.

[Jerome Tsang, DDS]

Well the eating disorder definitely needs to be addressed.  I assume with your binge eating, if its still occurring, definitely exposes your teeth to frequent acid buildup from eating.  Now, of course I'm not saying you should stop eating or cut down your food intake because there's a happy healthy diet out there and you just need to find that particular balance.  

If the erosion is significant, then fillings can be done to address the issue.  Just make sure you go in for regular checkups to maintain them.  If you have concerns, I would bring them up with your doctor.

[Jaquta]

He first asked me to use it after a dental check up.  He had done an x-ray during a previous exam and due to radiation didn't want to expose me to more.  I guess it was a precaution.
I feel I'm at risk of cavities, etc due to stress and very bad binge eating.

I was trying to do a search so I could find a photo that represented the problem and was hoping it would have a description.  Our internet is painfully slow so that wasn't happening for me.
I feel the erosion is bad.  I had concerns that I may have had periodontal gum disease but both my dentist and doctor seemed to think it was OK.
I feel that about half of the top part of my tooth has eroded.  Discoloring is due to the dentin, isn't it?  That's not good is it?

My dentist said I brush too hard and to use a softer brush and to change my brushing technique -which I have.  I feel it's gotten worse.
I think he measured the degree of erosion last time.  Is hard to know what dentists do in your mouth half the time.
He was talking about fillings but that they can cause discoloration.

I feel angry that things have gotten to this point because I ask for advice (or help regarding the binging) and things get worse.
I am trying to problem solve this, as you suggest, and not get too emotional about it.  If I allow myself time to think I will feel devastated and I can't cope with that right now.

So would be asking for my check-up to be brought forward be the best solution.  Probably that question was slightly rhetoric.

What generally happens with people with eating disorders?  Do they generally end up with good results?  It's a very scary question for me to ask.

Thanks for taking the time to respond.

[Jerome Tsang, DDS]

I wouldn't worry too much about any mottling (fluorosis) only because it would tend to show up more during the development of teeth rather than when they are fully erupted and out.  The fluoride toothpaste was probably prescribed to prevent cavities. Your dentist must feel you are at high risk for future problems.

As for the erosion, it would be best to address the issue but its hard to say whats the best treatment option.  It depends on the extent of erosion and how much tooth structure is remaining.  Each tooth may have a different ideal treatment .

What has your dentist told you about in regards to your erosion?