Bottles of water with pieces of fruit or a large glass of orange juice can act as a healthier substitute for sodas today.
But scientists have shown that these drinks, as well as fruit teas, can cause irreparable damage to teeth.
However, not everything is so bleak.
Researchers from King's College London, with decades of experience, have discovered that the way and time of drinking can significantly prevent tooth erosion.
I went to a meeting with the team to examine my teeth.
Caries and erosion
When we were children, we were always warned about cavities, the tiny holes that form in our teeth, and that sweets and chocolate could ruin our smiles.
When we eat sugary foods, the natural bacteria that form on our teeth feed on those sugary residues in our mouths and create those holes.
If these holes are not large, they can usually be repaired with a filling, but tooth erosion is a different problem.
Acids from food and drinks attack the enamel, the outer layer of the tooth, slowly wearing it away, along with the dentin underneath.
Enamel protects the softer layers of the teeth, but it cannot defend itself against the constant attack of acids and sugars.
Once the enamel is eroded, there is no going back.
“Tooth erosion occurs when enamel is overexposed to acids and sugary foods and drinks,” says Polivios Charalambous, a dentist and member of the dental erosion research team at King’s College.
"If left untreated, enamel loss can lead to a variety of dental problems, including stains, cracking, crowning or rough edges of teeth, sensitivity to cold or heat, and tooth translucency," he adds.
How and when to drink to avoid damaging your teeth
Dr. Polyvios Charalambous used a pH meter to measure the acidity in my mouth while I drank orange juice three different ways.
I drank slowly, swirling it in my mouth and keeping the liquid in my mouth.
- To protect teeth, the pH value in the mouth should be close to neutral (around seven).
- Drinking orange juice lowered the pH to 4,7, and it took 18 seconds to return to neutral.
- Holding the juice in the mouth (10 seconds) increased acidity and it took five times longer for the pH to normalize.
- Shaking the juice lowered the pH to three, and it took more than 30 times longer to return to neutral.
The experiment showed that holding or swirling acidic beverages in the mouth causes greater tooth damage, as it prolongs and/or increases the contact of acidic beverages with the tooth surface.
"To protect your teeth, don't hold acidic drinks in your mouth for long, and you can use a straw to reduce contact of the liquid with your teeth."
"Research confirms that using a straw reduces dental erosion caused by carbonated drinks," says Haralambous.
A team from King's College found that consuming acidic foods and drinks, especially between meals, poses the greatest risk of tooth erosion.
Those who consumed acidic drinks twice a day between meals, such as sodas, water with a slice of lemon, or hot fruit teas, had more than 11 times the risk of moderate or severe tooth erosion.
This risk was halved when the drinks were consumed during meals.
If you consume these drinks during, or immediately before or after meals, you can better protect your teeth.
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Which drink causes the most erosion?
A team from King's College compared the impact of four different beverages on tooth erosion by immersing enamel samples in orange juice, Coca-Cola, ayran (a refreshing yogurt-based drink), and fruit tea.
After 60 minutes, the damage was identical to consuming three such drinks a day for two days.
On microscopic images, erosion appeared as a dark line on enamel samples.
The results were surprising.
The most damage was caused by carbonated drinks, followed by orange juice, red berry tea, and finally ayran, which had the mildest effect on teeth.
Ayran is a traditional drink in many countries, including India, Pakistan, Lebanon, Syria, Turkey, Iran, and Armenia.
What foods cause the most tooth erosion?
Acidic foods and drinks can lead to tooth erosion.
Most fruits contain some degree of acidity, with citrus fruits like tangerines being more acidic than bananas and apricots.
Other examples of acidic foods and drinks are:
- Hot peppers
- Tomato and ketchup
- Kimchi
- Sauerkraut
- Vinegar (especially apple cider) and pickles
- Fruit juices and syrups
- Fruit-flavored water – for example, adding a slice of lemon to water
- Flavored teas, including berry, rosehip, ginger, and lemon teas
- Most alcoholic beverages
- Carbonated drinks (sugar-free carbonated drinks cause the same amount of tooth erosion as those with sugar)
The problem is that many of these foods and beverages are beneficial for overall health.
But there are ways to eat them while protecting your teeth from erosion:
Consume calcium-rich foods, such as cheese, yogurt, and milk, at the end of a meal to neutralize the acid in your mouth.
- Use sugar-free gum to increase saliva production, which helps protect your teeth.
- Instead of fruit tea, drink black tea, which has been proven to have less of an effect on tooth erosion.
- Instead of citrus fruits, add cucumber, mint, and rosemary to your water.
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How common is dental erosion?
Dentists warn that dental erosion has become a very common problem worldwide and is growing rapidly.
According to a 2013 study led by David Bartlett, head of prosthodontics at King's College Dental Institute, nearly 30 percent of adults aged 18 to 35 in Europe have moderate to severe tooth erosion.
By comparison, a more recent cross-sectional study conducted on 2.924 people of the same age group in six Arab countries found even higher rates of severe dental erosion.
Representation varied considerably.
Oman had the highest rate at 60,7 percent, followed by Saudi Arabia at 57,1 percent, the United Arab Emirates at 49,3 percent, Egypt at 32,9 percent, Kuwait at 31,5 percent, and Jordan at 16,5 percent.
How normal is tooth erosion?
"Dental erosion occurs throughout life on a physiological level."
"However, if you're not careful, factors like diet, habits, and medical conditions (for example, reflux of stomach acid into the esophagus) can speed up this process," says Dr. Haralambous.
Dentists can assess the extent of damage based on appropriate guides.
Since there is no way to replace enamel loss, the best approach is prevention.
See what a visit to the dentist was like during the coronavirus pandemic
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