These days a fruity water or a tall glass of orange juice may seem like a healthier alternative to a cold drink. But scientists have found that these drinks can cause irreversible damage to our teeth. Researchers at King’s College London (KCL) in the UK have found that if the timing and method of drinking is right, damage to teeth can be prevented to a large extent.
I met the team to get my test done and got my teeth tested. When we were children, we were always warned about cavities. We were told that sweets and chocolate could ruin your smile. When you eat sweets, the bacteria on your teeth feed on the sugar left in your mouth, causing cavities to form. Unless these cavities are very large, they can usually be repaired with fillings.
But the thinning of the enamel (called tooth erosion) is different from this. The acids present in food and drinks attack the outermost layer of the tooth i.e. enamel and gradually make it thin. They also damage the dentin layer underneath. Enamel protects the soft inner layers of the tooth. But it cannot withstand the constant attack of acid and sugar for long. Once the enamel becomes thin or is gone, it cannot be brought back.
Dr. Polyvios Charalambous, a dental surgeon and member of the team doing research on enamel at King’s College London, says, “When the enamel has to repeatedly face a lot of acid and sweet food and drinks, then the enamel starts becoming thin.” He added, “If enamel loss is not stopped in time, it can lead to many problems on teeth, including stains, cracks, broken edges or roughness, tingling sensation from cold or hot, and transparent appearance of teeth.”
How and when to drink?
Dr. Charalambous tested the pH level (acidity) of orange juice in my mouth while drinking it in three different ways. The pH of the mouth should be near neutral (around 7) to protect teeth. Drinking orange juice straight caused the pH to drop to 4.7 and it took 18 seconds to return to normal. Holding the juice in the mouth for 10 seconds increased the acidity further and the pH took five times longer to return to normal. Swirling the juice in the mouth caused the pH to drop to 3 and it took 30 times longer to return to normal.
Which drink does the most damage?
This experiment made it clear that drinking acidic drinks by holding them in the mouth or swishing them causes more damage to the teeth. This is because there is a longer and more pressure contact between the acidic drink and the tooth surface.
Dr. Charalambous said, “To protect the teeth, do not keep the acidic drink in the mouth for a long time. You can also use a straw, so that the drink goes directly into the mouth and touches the teeth less. Research has also found that using a straw reduces the risk of thinning of enamel caused by cold drinks.” The KCL team found that eating acidic food and drinks in between meals poses the greatest risk of thinning of enamel.
People who drank acidic drinks twice a day between meals, such as soft drinks, lemon water or hot fruit tea, were more than 11 times more likely to have moderate or severe thinning of enamel. When the same drinks were taken with food, this risk was halved. So if you drink these drinks at the right time, i.e. with food or just before or after, then you can keep your teeth more safe. The KCL team saw the effect of four different drinks on teeth. For this, samples of the outer layer of the tooth (enamel) were immersed in orange juice, cola, buttermilk and fruit tea.
The damage that was seen after an hour was as if someone had drunk three glasses of these drinks every day for two days. In the microscope pictures, the thinning of the tooth layer appeared as a black line. The results were surprising. Cold drinks caused the most damage. Then orange juice, then red berry tea. Iron caused the least damage, which proved to be the mildest for teeth. Iron is a drink that is very popular in many countries like Pakistan, Lebanon, Syria, Turkey, Iran and Armenia.
Which food items cause more damage to teeth?
Acidic foods and drinks can cause enamel to thin. Most fruits contain some level of acidity.
Some examples of acidic foods and drinks are:
- Chilli
- Tomatoes and tomato sauce (ketchup)
- Kimchi
- Sauerkraut
- Vinegars and pickles (especially apple cider vinegar)
- Fruit squash
- Lemon-infused flavoured waters
- Flavoured teas such as berry teas, rosehip, ginger and lemon
- Most alcoholic drinks
- Soft drinks (sugar-free soft drinks are just as harmful as sweetened ones)
The challenge is that many of these foods and drinks are also good for your health.
- But take them wisely so that the teeth are not damaged.
- Take calcium-rich foods like cheese, yogurt or milk at the end of the meal. These help in reducing the acid in the mouth.
- Chew sugar-free chewing gum. This will increase saliva production and keep the teeth safe.
- Drink black tea instead of fruit tea. This reduces the risk of thinning of enamel.
- Prepare flavored water by adding cucumber, mint or rosemary instead of lemon and orange.
How common is thinning of enamel?
Dentists say that thinning or weakening of enamel has now become a very common problem all over the world and it is also increasing rapidly. According to a study done in 2013 by Dr. David Bartlett, head of the Prosthodontics Department of King’s College London Dental Institute, about 30% of adults between 18 and 35 years of age in Europe are troubled by this problem from moderate to severe level.
In comparison, a new study of 2,924 people of the same age group in six Arab countries found even higher rates. The situation was different in each country. The highest rate of tooth enamel was found in Oman at 60.7%, followed by Saudi Arabia at 57.1%, UAE at 49.3%, Egypt at 32.9%, Kuwait at 31.5% and Jordan at 16.5%.
How thin is it normal for enamel to thin?
Dr. Charalambous says, “A little wear on teeth happens throughout life, it is a natural process. But if you are not careful, your diet, habits or certain diseases (such as acid reflux) can accelerate it.” Dentists check this damage through a guide. The results can sometimes be a cause of concern, because once the enamel is worn away, it cannot be restored. Therefore, the best way is to prevent tooth decay before it happens.
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