April 9, 2015

From the desk of Dr. Fass

Recently, we’ve seen efforts to limit the size of soft drinks that can be sold in fast food restaurants and convenience stores in New York City. We’ve also seen efforts to add health warning labels to some of these products. This is, I think, a reasonable effort to quell the tide of obesity amongst our children. The excessive consumption of so called “Empty calories” has been documented to lead to higher weight in all populations. But is the call for this extra charge too narrow in it’s scope? Why just carbonated beverages, and why not sports and diet drinks?

To understand the dental concerns, you need to understand dental decay. Decay results when a tooth is exposed to bacterial plaque that isn’t removed. The bacteria use sugars in the diet and produce acid. The acid, in turn, breaks down the structure of enamel and dentin of the teeth, leading to decay. The more frequent the sugar exposure, the more acid exposure. Any sugars can do this, including uncarbonated “Sports” or “Energy” drinks. Additionally, most of these products have very high acid levels themselves. Remember acid levels are measured as pH with 7.0 as neutral and acid levels going down to zero. The pH of battery acid is 1.0. Sodas can have a pH level as low as 2.3.
While diet drinks have no sugar, their acid levels are also quite high and can have a pH as low as 3.0. This alone contributes to weakened tooth structure and future risk of dental decay.

Perhaps it’s time to take overall health into consideration and discourage routine consumption of these products. Used in moderation, they can do no harm. Used to excess, the dental consequences can last a lifetime.
Any pH below 5.5 will damage enamel. When sugar is ingested, bacterial plaque will lower the pH for up to 20 minutes. So when carbohydrates are taken in frequently, the pH remains low for longer periods, resulting in tooth decay. When you add the effect of the acid in the food itself, the decay process can be accelerated.

I’ve often told my patients that the worst invention for dentistry was the screw top bottle that allows drinks to be re-closed and used over and over for a longer duration. Perhaps we might consider going back to the simple bottle cap and a single time use pattern