I guess I’m showing my age, but I remember a time when fizzy drinks used to be considered a treat only for special occasions, fruit juices usually had to be freshly squeezed at home and “sport drinks” didn’t exist at all.
These days, walk through any supermarket and you’ll find aisles chock-full of the stuff. Soft drink cabinets and vending machines surround us in our daily lives, not just in shopping centres and food outlets, but also at petrol stations, newsagents, gyms, railway stations and bus interchanges.
No doubt food industry executives have been congratulating themselves on a job well done, achieving spectacular growth in market reach and penetration. But it’s not without a cost – to our kids’ teeth as well as our hip pockets.
Dentists are now seeing the downside of this increased consumption in the form of tooth erosion, especially in children and young adults. Research in the UK has identified fizzy drinks as by far the biggest factor causing dental erosion among teenagers. This is different from dental decay (caries) in that it’s not related to the sugar content but to the acidity of these and many other drinks. Often parents don’t seem to understand the difference between decay and erosion. For example, diet versions of fizzy drinks may contain no sugar but are still highly acidic.
The table below shows the acidity (pH) of some common drinks. Enamel dissolves when the pH drops below 5.5.
Erosion happens slowly, as acidic drinks soften the surface layer of enamel, causing it to wear down when chewing. You lose only a few microns at a time but eventually the enamel becomes so thin, it perforates on top to expose the sensitive dentine layer underneath. Dentine is also softer than enamel so it then wears down more rapidly to create defects that look like little potholes on the chewing surfaces of the teeth. These tiny “cupping lesions” are often the first sign of the problem a dentist will notice. If the acid intake continues, eventually these little potholes join up and once all the enamel is gone, the teeth can begin to wear down quite severely, sometimes right to the gum line!
Enamel is also lost on the sides of the teeth and this is made even worse by brushing too soon after acid consumption. As the enamel thins, the underlying yellow/brown colour of the dentine starts to show through more and the teeth appear artificially smooth and featureless. They can also become very sensitive to hot/cold and sweet substances.
By far the best strategy to combat dental erosion is prevention. Start by identifying any sources of dietary acid and reduce your frequency of intake. Your dentist or a dietician can help with this.
Whenever possible, substitute plain water or milk for acidic drinks and make sure you keep well-hydrated at all times, as dehydration due to physical work or exercise reduces your saliva flow. Saliva is a good natural buffer for neutralising dietary acids and re-hardening those acid- softened enamel surfaces.
You can manage problems related to exposed dentine hypersensitivity by switching to desensitising toothpastes and delaying brushing for an at least an hour or two after acid intake, so your saliva has time to do good things for your teeth. Professionally-applied and home use of fluoride supplements and re-mineralising creams like Tooth Mousse can also help. Again, your dentist can advise what is appropriate for you.
In severe cases, complex reconstruction of the teeth may be required and this can sometimes end up costing tens of thousands of dollars!
I wonder if the day will come when these acidic drinks, like cigarettes, will have to be labelled with a health warning.
Previously, we spoke about how your dentist can help if you have cancer. To view this blog, please click here.