Endogenous acids

Acidic conditions can be created by eating disorders or gastrointestinal conditions, such as chronic gastric reflux, in which the source of the acid will be hydrochloric acid from the stomach. Stronger acids can degrade pellicle by proteolysis, and thus predispose the tooth surface to mineral loss from erosion. However, these conditions predispose to caries as well because of the likelihood of greatly increased counts of mutans streptococci through their preference for highly acid conditions. A preventive program for these patients must address the microbial risk factors for caries as well as the erosion potential.