Dissolving Our Teeth With Energy Drinks

Sugar is known to cause harmful damage to the teeth, but acid can play a significant role in dissolving a tooth’s protective layers. It is slow like the erosion of the seashore by waves, or the wind erosion of giant rocks in the desert. Acid effects teeth in a similar capacity. Cavities can form from acidic bacteria after eating sugar, which can cause our tooth structure to erode by frequently consuming acidic drinks. Fourteen percent of schoolchildren, ages 5 to 9 years, have erosion in their permanent teeth, and 43 percent of adolescents.

So what is the ultimate culprit? Soft drinks, sports drinks, energy drinks, fruit juice, and even wine, if ingested frequently enough, will cause tooth erosion. Our serving size in America of flavored drinks has increased from 7 ounces in the fifties, to 12 ounces in the sixties, to 20 ounces in the late nineties. So the quantity is greater, but that is not the main problem. The two primary causes are the amount of acid in drinks has increased and the frequency of consumption has increased. Phosphoric and citric acid are added to most all of these drinks. The drinks with the highest amount of acid are energy drinks like Red Bull, Rockstar, Monster Energy®, and 5-hour ENERGY®. These energy drinks should be avoided entirely because they are 2 to 5 times more acidic than soft drinks or sports drinks like Gatorade®.

So you think you’re in the clear with fruit juice? Fruit juices are often more acidic than soft drinks. The most important factor is the frequency you consume acidic drinks. Sipping them over a period of an hour or more is much more erosive than having one drink in 15 minutes. That is because when acid drinks or foods enter your mouth your saliva will slowly neutralize the acid over the next hour whereas constantly sipping doesn’t gives your saliva a chance to neutralize the acid. And swishing the liquid back and forth between your cheeks is the worst because you are acid washing your teeth repeatedly. So what can you do? We recommend no energy drinks, no sipping, and no swishing. Drink water after consuming an acidic drink. Never brush your teeth right after an acid drink or food because it can increase the potential for erosion. It is best to wait one hour before you brush. Use a low abrasive high fluoride toothpaste like Sensodyne® or ProNamel®, because they are designed to put a coating on your teeth to make them more acid resistant to erosion and cavities.

* When acidity is referred to, it means titratable acidity not ph. Titratable acidity is the amount of a liquid (usually Sodium Hydroxide) it takes to neutralize an acid.

Bottled Water

The average person in U. S. drinks 167 bottles of water a year.  In the United States, we spend 12 billion dollars on 30 billion bottles per year.  Bottled water comes from two sources the ground or the faucet and then treated with different methods.  Water from the faucet comes from a city’s municipal water system.  Spring water can come from a well, spring or pumped from underground aquifers.  Some bottled water may be too acidic.  This acid can erode your teeth when an acidic brand of water is sipped throughout the day.  The acidity of water is indicated by its’ pH.  A pH of 7 is neutral, pH less than 7 is acidic and greater than 7 is basic. Vinegar would have a pH of 2.  The following table shows the acidity of different brands of water.  However, some brands will vary in different parts of the country and bottle to bottle. We do not recommend ones that have a pH less than 6. ( See Table)

Harmful Toothpastes

We spend 2.2 billion dollars on toothpaste in the United States. The number of choices on the shelves is mind-blowing, but what you don’t know, and the toothpaste companies don’t seem to care about, is the permanent tooth destruction toothpastes are causing. Toothpastes have abrasive particles usually containing hydrated silica. These particles can vary greatly in their abrasiveness. Toothpastes have abrasive ratings called “Relative Dentin Abrasivity” which can range from 8 to 200. Low abrasive toothpastes are considered to be less than 70, medium 70 to 100, high 100 to 150, and harmful greater than 150. If toothpaste is too abrasive, it will wear the enamel of your teeth regardless of the softness of your toothbrush. This usually causes sensitivity, staining, increased risk of cavities, and weakening of the tooth. Ironically, some of the toothpastes marketed for sensitivity are too abrasive, worsening the problem they claim to correct. Further proof of toothpaste abrasivity can be seen by the other uses of toothpaste such as scrubbing grout in the shower, linoleum scuffs, jewelry, and crayon on walls just to name a few. Delmarva Dental Services recommends low abrasive toothpastes. (See Toothpaste Abrasiveness Table)


Vaping (E-cigarettes) were developed in China in 2003, making their way to the US by 2006-2007.  However, they were unregulated by the FDA until 2016.  Even so, their use is skyrocketing, and a large number of users fall into the category of middle and high school-aged children.  In 2015, 3 million students reported using vape devices (for reference, this number was a half million more than the previous year).  The concern is that many Americans have looked at vaping as “harmless” or a “safe alternative” to cigarettes.  Newer research is showing us that this may not be true.

The liquid used in an e-cigarette is customizable.  There are flavors that can be added, but it also contains chemicals that can include formaldehyde, lead, and aluminum among others.  Nicotine may also be added to the vape liquid.

Vaping affects the mouth and oral tissues because it enters the mouth at its hottest temperature – just as it is heated and “vaporized” it is inhaled.  The result is that there can be burns on the palate, stomatitis (white patches with pinpoint red areas), dry mouth, and gum recession or degradation.  Menthol breaks down the periodontal ligament (the ligament that holds the tooth in the jaw bone) thus causing destruction of the periodontal tissues.  Nicotine is a vasoconstrictor, meaning it decreases blood flow.  This can result in decreased bleeding of the gums, and tighter tissues, but not necessarily because they are healthy!  Dryness of the mouth due to the vaping can also result in root decay and bad breath.

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