Saturday, February 19, 2005

Which Drinks Damage Your Teeth the Most?

WebMD has a Dental Channel article on a paper presented in the January/February Journal of the Academy of General Dentistry:

Researchers Blame Sports Drinks and Other Favorites, but Beverage Makers Find Fault With the Study

Feb. 16, 2005 -- Sports drinks and other beverages are on the losing end of a new study about dental erosion.

The study appears in General Dentistry's January/February issue. It tracks tooth erosion from a wide variety of drinks including cola and noncola soft drinks, sports drinks, commercial lemonade, bottled iced tea, and black tea.

The study found that noncola soft drinks, energy/sports drinks, and commercial lemonade "showed the most aggressive dissolution effect on dental enamel," write researchers J. Anthony von Fraunhofer, MSc, PhD, FRSC, FADM, and Matthew Rogers, DDS.

Rogers is with the USAF Dental Corps; von Fraunhofer is a professor of biomaterials science in the oral and maxillofacial surgery department at the University of Maryland Baltimore Dental School.

The study's results came from marinating chunks of healthy human tooth enamel in the drinks for a total of 14 days, weighing them every 24 to 48 hours. The solution's acidity was checked, and solutions were changed daily.

The study was intended to simulate the effects of normal beverage consumption over about 13 years.

"We were totally shocked at how aggressive these were towards dental enamel," von Fraunhofer tells WebMD. "This study revealed that the enamel damage caused by noncola and sports beverages was three to 11 times greater than cola-based drinks, with energy drinks and bottled lemonades causing the most harm to dental enamel," he says, in a news release.

The study's design drew criticism from the American Beverage Association (ABA), which represents nonalcoholic commercial drinks including soft drinks, sports drinks, bottled teas and waters, and juices.

"It certainly doesn't mirror reality," Richard Adamson, the ABA's vice president for scientific and technical affairs, tells WebMD. "Nobody holds liquid in their mouth 24 hours a day, 14 days in a row."

Adamson points out that saliva helps protect the mouth, as does brushing the teeth. He says that dental erosion has multiple causes, including behavior, lifestyle, diet, and genetics. "I would say it's irresponsible to blame foods, beverages, or any single factor for dental enamel loss," he says.

Craig Horswill, PhD, agrees. He's a principal scientist at the Gatorade Sports Science Institute. "Oral health is more complicated than one simple food," Horswill tells WebMD.

In 2002, a Gatorade-funded study of sports drinks and dental erosion appeared in the journal Caries Research. Participants were 304 Ohio State University athletes, most of whom drank sports drinks while training and during competition for high-intensity sports.

"We didn't have the chess team there," says Paul Casamassimo, DDS, a professor at Ohio State's dentistry college who worked on the study. "We found no relationship between dental erosion and sports drinks at all," Casamassimo tells WebMD.

Von Fraunhofer stands by the study and says he isn't trying to trash any drink. "What we're saying is, by all means, drink what you want. Don't sit and sip [these drinks] for a long time. Rinse out with a bit of water. That will minimize the effects. The other thing to realize is that when once enamel is gone, it's gone forever. It doesn't come back."

SOURCES: von Fraunhofer, J. General Dentistry, January/February 2005. News release, Academy of General Dentistry. J. Anthony von Fraunhofer, professor of biomaterials science, University of Maryland Baltimore Dental School. Richard Adamson, vice president, Scientific and Technical Affairs, American Beverage Association. Paul Casamassimo, DDS, professor, Ohio State University's dentistry college. Craig Horswill, principal scientist, Gatorade Sports Science Institute. News release, Quaker Oats Company. Matthew Rogers, DDS, USAF Dental Corps. Caries Research, July/August 2002; vol 36: pp 281-287

One of the most frustrating occurrences in my practice of over 25 years is the lack of education regarding the destruction of teeth by these caries and erosion producing foods and drinks.

Health classes which are required in most California high schools do NOT provide the information necessary to stop the epidemic of tooth decay and periodontal disease.

Hopefully, new internet resources and the new media of Blogs among other educational media will pass along the word.

We can only hope.

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