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acidic drinks

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Lemon Citrus Can Cause Tooth Acid Erosion
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I got the following email from an Oral Answers reader asking about the difference between acid erosion and tooth decay.  He writes:

“What is the difference between acid erosion and tooth decay?  How to I ensure that I minimise both of these.  Also which is the best toothpaste to use to prevent this, I have heard of duraphat (Note from Tom: Duraphat is a fluoride product marketed as Duraflor in the United States) which i know helps with decay and pronamel which helps with erosion but I do not know if both help with both.”

Preventing Tooth Decay and Acid Erosion

The Difference Between Tooth Decay and Acid Erosion

Both tooth decay and acid erosion involve your tooth structure getting dissolved. The main difference between tooth decay and acid erosion is the source of the acid.

In acid erosion, your teeth are dissolved by acidic foods, drinks, or environmental sources of acid that come into contact with your teeth.

To learn how to spot acids that eat away your teeth, read How to Identify Acidic Foods and Drinks.

Tooth decay, however is caused by millions of tiny bacteria that live on your teeth that excrete acid, which eats away at your teeth.

To learn more about these bacteria, read What Every Human Needs to Know About Plaque.

Preventing Tooth Decay and Acid Erosion

The second part of this reader’s question involved preventing tooth decay and acid erosion.  The best way to prevent tooth decay is by getting rid of the bacteria on your teeth regularly through brushing and flossing.  You might also want to learn about 12 weapons of plaque destruction and these 25 things that increase your risk of getting tooth decay.

 Preventing acid erosion is as simple as not eating or drinking too much acid.  You might be surprised to learn that many of the drinks we enjoy made this list of 9 acidic drinks that can dissolve your teeth.

As far as strengthening your teeth, most any toothpaste contains fluoride, which protects your teeth.  It probably doesn’t matter which type of toothpaste you’re using as long as it contains fluoride and you’re brushing regularly.

Conclusion

Tooth decay is caused by acid from bacteria that live on your teeth.  Acid erosion is caused by acids that you eat, drink, or otherwise expose to your teeth.

You can prevent tooth decay and acid erosion by brushing and flossing regularly and minimizing your intake of acidic foods and drinks.

Do you have any questions about tooth decay and acid erosion?  I’d love to hear what you have to say in the comments section below.  Thanks for reading!

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Acid Dissolves Teeth
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In 1942, the average American drank the equivalent of 60 12-ounce cans of soda per year.  In 2004, that number increased nearly 10-fold to 576 12-ounce cans of soda per year. That averages out to 1.6 12-ounce cans every day for each man, woman, and child in the United States. (Source) Although soda pop is the most well-known substance that contains  teeth-dissolving acid, different types of acids are found in many different foods. However, there’s more to an acidic beverage or food than just its pH.  How much damage the acid you eat and drink does to your teeth depends on four different factors.

Four Factors That Determine If Acids Will Dissolve Your Teeth

1 – How Much Contact the Acid Has With Your Teeth

Acidic Drinks Can Dissolve TeethIf you like to savor your acidic vinaigrette salad dressing or enjoy swishing your soda around in your mouth before swallowing, the acid will do more damage to your teeth because it stays in contact with your teeth a lot longer.

Want to enjoy your soda pop while minimizing damage to your teeth? Read How to Drink Soda Pop and Keep Your Teeth Happy.

2 – The pH of the Acid

The pH of a substance indicates how acidic it is.  The lower the pH, the more acidic.  The higher the pH, the less acidic.  If you’re wondering about the pH of many popular drinks, read the article Nine Drinks that Can Dissolve Your Teeth.

If you’re wondering the exact pH when teeth start to dissolve, check out the article What Happens In Your Mouth Every Time You Eat or Drink.

3 – The Buffering Capacity of the Acid

The buffering capacity of the acid is best explained by the following example:  If you drink some sparkling water, your saliva can quickly neutralize the acid and bring your mouth back up to a pH that won’t dissolve teeth.  However, if you drink oragne juice, it will take much longer for your saliva to neutralize the acid.  Orange juice has a high buffering capacity while sparkling water has a low buffering capacity. The fact that saliva can neutralize acids in your mouth is just one of the many reasons why saliva is important. Ole Fejerskov https://ampills.com explains this point in the textbook Dental Caries, “Low pH products such as Coca Cola, and tonic water at pH 2.5 are more aggressive than orange juice at pH 4.  However, the high content of fruit acids in orange juice gives it its ability to keep pH low, allowing it more time for dissolution.” This means that although orange juice isn’t as acidic as soda pop, the high buffering capacity of the fruit acids allows it to keep the pH in your mouth low for a longer period of time which allows it to dissolve more of your teeth.

4 – Calcium, Phosphate, and Fluoride Ion Content

In the textbook mentioned above, it mentioned that orange juice with added calcium and phosphate did much less damage to teeth than regular orange juice.  Calcium, phosphate, and fluoride ions are all friends to our teeth.  The more of these ions that are in our mouth, the stronger our teeth will be.

Conclusion – Don’t Let Acid Dissolve Your Teeth!

Now that you know the factors that affect whether or not an acid will dissolve your teeth, it’s time to put it into practice and keep your teeth strong and healthy. This article gives some good advice on what you can do.  It states:

Patient education on the causes and prevention of dental erosion are essential to prevent progression [of dental erosion]. In addition to reducing or eliminating exposure to acidic soft drinks and juices, modified acid beverages with reduced potential to cause erosion can be recommended to patients. Frequent application of high concentration topical fluoride may be of some benefit in preventing further demineralisation and increase the abrasion resistance of erosion lesions.

Some other things you can do to prevent acid from dissolving your teeth are:

  • Rinsing your mouth out after eating or drinking acid-containing foods
  • Chewing gum after consuming acids
  • Not brushing your teeth immediately after consuming acids – give your saliva some time to remineralize your teeth.

Do you have any questions, comments or concerns about the effects of acid on your teeth?  I’d love to hear them in the comments section below.  Thanks for reading!

6
Drink Soda Pop and Keep Your Teeth Healthy
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Some dentists might say that in an ideal world, nobody would drink soda pop. In my view, in an ideal world, everyone would drink soda pop — it just wouldn’t hurt your teeth!

Of course, we don’t live in that ideal world and it’s important to know that soda pop does pose a serious threat to your teeth (read this article for more information.)

With that said, if you are going to drink soda pop, here’s four tips you can use to minimize the damage that it does to your teeth.

4 Tips You Can Use to Drink Soda Pop and Keep Your Teeth Happy

Drink Pop and Keep Your Teeth Healthy1 – Drink soda pop through a straw.  By drinking the soda pop through a straw, you will minimize the soda pop’s contact with your teeth and quickly whisk it away down your throat.

2 – Drink soda pop during meals.  If you drink the soda pop while you eat a meal, you will be able to wash away the sugar from the soda more quickly.  For example, if you drink some pop and then eat some salad, you will get rid of a lot of the sugar in your mouth when you swallow the salad.  The goal is to not let the sugar hang out in your mouth for too long.

3 – Don’t sip the soda pop slowly, drink it all at once.  Every time you eat or drink sugar, the bacteria in your mouth produce acid waste that dissolves your teeth.  It takes a good 15 to 30 minutes for your saliva to neutralize the acid and start repairing your teeth.

If you sip on soda pop all day, you might never give your saliva a chance to repair your teeth and could eventually start a cavity.

For more information and to view a graph of this process, read What Happens In Your Mouth Every Time You Eat or Drink.

4 – Rinse out with water rather than brushing after you drink soda pop. After you drink soda, you can get rid of a lot of the sugar in your mouth simply by rinsing out with water.  Some oral health experts have warned against brushing after drinking acidic drinks because the abrasive action of brushing can damage the tooth enamel before the saliva has a chance to repair it.Drinking Cola Little Girl

Conclusion

Like all foods that aren’t the greatest for us, soda pop shouldn’t be consumed excessively.

The reason soda pop is so bad for your teeth is because it is acidic and sugary.  By quickly drinking your soda pop and minimizing the amount of time that the sugar spends with your teeth, you’ll be doing your teeth a big favor.

Do you have any questions, comments, or any other suggestions to add about soda pop and oral health?  Please leave a comment below!  Thanks for reading!

1
Ways Your Teeth Get Worn Down
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When teeth first come into the mouth, they are in pristine condition and come complete with mamelons, remnants of the tooth’s development.  Over time, our teeth get worn down.  Some people wear their teeth down more than others.

There are four main ways that we wear down our teeth: Abrasion, Attrition, Erosion, and Abfraction.  If you’re not sure what those words mean, keep reading and I’ll explain!  The man in the picture below is wearing down his teeth in one of those four ways.

Wearing Away Teeth: Abrasion, Erosion, and Abfraction

Abrasion

Abrasion happens when objects come into contact with our teeth that mechanically wear them away.  A common way people wear away teeth is by using their teeth as tools, like chewing through tags on clothes or using your teeth to open packages.  Some other examples of abrasion are:

  • When you brush your teeth, the grit in the toothpaste can slowly wear away tooth structure.  Under normal circumstances, this won’t wear away enough tooth structure to be noticeable, but some people who brush their teeth a LOT will wear away a noticeable amount of tooth structure.  This is one of the reasons that our teeth get more yellow as we get older, we are slowly wearing away the enamel and seeing the yellow dentin underneath.
  • Chewing on pencils or any other foreign object.
  • Chewing on food.
  • Chewing tobacco.

Attrition

Attrition is defined as wearing away tooth structure from tooth-to-tooth contact.  Some attrition is normal, it’s how mamelons get worn away.  Attrition gets to be a problem if you are routinely clenching and grinding your teeth.  Many people grind their teeth at night, often without being aware.  We make night guards at our dental school which people can wear to prevent them from grinding their teeth at night.  If you grind your teeth, talk to your dentist about getting a night guard.

In Peter Dawson’s book Functional Occlusion he states, “When wear penetrates enamel into softer dentin, wear increases seven times faster.”  That means that it’s best to get your grinding problem taken care of as soon as possible, because it will only get worse once you grind through the enamel.

Erosion

Erosion occurs when you eat or drink acidic beverages.  The reason we get cavities is because plaque living on our teeth produce acid that over time can dissolve our teeth.

Any time acid comes into contact with our teeth, it can dissolve the crystals that make up our teeth.  Here are some ways that acid comes into contact with our teeth:

  • Eating or drinking acid-containing foods and beverages.  If you’re interested in some related reading, here’s 9 drinks that can dissolve your teeth, and a guide to identifying acids in foods.
  • When we throw up, either from the flu or from an eating disorder such as bulimia, the acidic contents of the stomach wash over our teeth and slowly dissolve them.
  • If you have gastroesophageal reflux disease (commonly known as GERD), your mouth will become acidic due to the acids from the stomach making their way back into your mouth.
  • Putting acidic pills or medications in your mouth.  Some people suck on vitamin C tablets.  Others try to put aspirin on a toothache to make it feel better.  Both of these pills are acidic and can cause tooth erosion.

Abfraction

Abfraction is wear at the gumline that has a controversial origin.  Some dental experts say that it comes from stress on the tooth when biting and others say that it comes from abrasion due to the grit found in toothpaste.  In Dawson’s book mentioned above he says, “What we have been calling abfraction lesions are really the result of toothpaste abuse.”

Abfraction lesions are wedge-shaped and usually appear on the cheek/lip side of the teeth.  The book Oral and Maxillofacial Pathology by Neville describes abfraction lesions as “defects that are deep, narrow, and v-shaped…often affect[ing] a single tooth with adjacent unaffected teeth.  In addition, occasional lesions are subgingival, a site typically protected from abrasion and erosion.”

Conclusion

As you can see, there are many ways that we wear away our teeth.  Many of the causes of excessive wear — consuming acidic foods and drinks, using our teeth inappropriately, and using abrasive toothpastes — are preventable.  Even attrition, which results from grinding your teeth, is easily treated by your dentist.   Hopefully, you can take steps to reduce the wear on your teeth now that you are aware of the causes.

If you have any questions or comments, please leave them in the comments section below.  Thanks for reading!

Oh, and if you’re wondering how the man in the photo above is wearing away his teeth… it’s by abrasion!

14
Teeth Getting Hurt This Cold and Flu Season
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Three weeks ago I got a cold. I was just getting over it when we went up to Maine, and right when we got back I got sick again.  I’m finally getting better, but my oral hygiene has been less than stellar over the past few weeks!

Fever Can Affect Oral HealthNow that the days are getting colder and shorter here in the northern hemisphere, it’s a good time to talk about how the common cold can affect your oral health.

I’ve actually come up with a variety of ways that the cold and flu can mess up your oral health.  Here they are.

6 Ways the Common Cold & Flu Can Hurt Your Teeth

1 – We tend to drink acidic beverages when we’re sick. Water doesn’t sound very good when you’re sick.  Many people drink lots of orange juice and soda pop (such as ginger ale) when they’re sick.

When I was little, my mom would always make me nice hot cups of what we called honey lemon water.  It’s a slight variation on this recipe of  honey lemon tea.  I still drink it when I’m sick!

You can lessen the effect of acidic drinks on your teeth by drinking them quickly and then either drinking or rinsing your mouth out with water when you’re done.

Read more about which drinks are acidic and can dissolve your teeth here.

2 – When you’re sick, you really don’t feel like brushing or flossing. When you’re sick, the first thing on your mind is getting better, not brushing and flossing.  However, by taking a couple of minutes each day to take care of your teeth, you can prevent the build-up of tartar, which is a type of hard mineralized plaque that forms on your teeth if you don’t remove plaque daily.

3 – Inflammation of the sinuses can make your teeth and gums hurt.  If you’ve got a cold and you’re stuffed up, your sinuses might not feel very good!  The maxillary sinus is located right above your upper back teeth and can make them hurt.

There have also been reports of people’s gums hurting when they’re sick.  This probably occurs because many people breathe through their mouths when they’re sick because they have a stuffy nose.  This dries out the gums and irritates them.  Another possible explanation is that your immune system is so busy fighting your cold that it’s harder for it to fight the bacteria in your mouth, thus causing your gums to get irritated.

4 – When you’re sick, your mouth gets dry.  As I mentioned above, your mouth gets dry because you breathe through it more than usual when your nose is stuffy.  Coughing can also dry out the mouth.  A dry mouth allows sugar to hang around in your mouth and contributes to tooth decay.

Try to stay hydrated when you are sick as much as possible!  When possible, reach for plain water instead of juices or soda pop.

To see why a dry mouth is bad for your teeth, read about how wonderful spit is!

Cough Syrup Can Damage Your Teeth5 – Cold medicine isn’t very friendly to your teeth.  Cough syrups such as Dayquil syrup can stick to your teeth and cause cavities.  Here’s an article that talks about how you can reduce the damage that cough syrup does to your teeth.

Cherry Alka Seltzer Cold MedicineMany cold medicines, such as Alka-Seltzer, are acidic.  Acidic drinks can dissolve the calcium that makes up the enamel of your teeth.

Cough drops are another culprit, but they don’t have to be.  Just eat sugar free cough drops and you’ll be fine.  Both Hall’s and Ricola make great tasting sugar-free cough drops that are much better for your teeth than regular cough drops, which contain a significant amount of sugar.

Rather than taking cough syrup, try substituting something in pill form.  For example, DayQuil is available in a gelcap form that doesn’t contain all of the sugar that the syrup does.  If you must have Alka-Seltzer, you might want to rinse out your mouth or drink water afterward to get the acid off of your teeth.

6 – Vomit is acidic and dissolves your teeth.  Hopefully you don’t have to toss your cookies this cold and flu season.  The stomach is the most acidic place in your body and when it’s contents come back up, they will dissolve your teeth.

After vomiting, the best thing to do for your teeth is to rinse out with water.  You might be tempted to brush your teeth with toothpaste to get the acidic taste out of your mouth, but brushing can damage the enamel because it’s already been weakened by the exposure to your stomach acid.

Conclusion

Having a cold can hurt your teeth.  Remember to continue your regular oral hygiene routine even when you don’t feel well.

Try to avoid cold and flu medicine that are syrups or contain lots of sugar.  Pills and sugar-free cough drops are excellent alternatives.

If you do happen to throw up, remember to rinse your mouth afterward with water to wash away the acid.

If you have any other suggestions or any questions, feel free to add them in the comments section below.  Thanks for reading!

25
Alkaline Water and Teeth
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Have you heard of alkaline water?  If not, you might soon hear about it from a multi-level-marketer near you. Earlier this week, I talked with an alkaline water marketer for five or ten minutes about it.  He talked about all of the benefits of alkaline water and even called it “nature’s water” or something similar to that.

Alkaline WaterI wasn’t familiar with alkaline water, so I decided to read up on it. As I browsed several websites, I noticed a trend.  Nearly all of the supporters of alkaline water are selling something, and those who oppose it seem to agree that its supporters are only supporting it to make money.

As I read over some of the claims, some of them were outrageous, and others were completely false.  If I didn’t have a strong background in the life sciences, I might have been fooled. One claim in particular caught my eye.  The author of a website claims that alkaline water can improve your oral health.  Here’s a couple of ways that alkaline water might improve your oral health, and my thoughts about them.

Can Alkaline Water Help Re-mineralize Your Teeth?

If you’ve read my article about the nine types of drinks that can dissolve your teeth, you probably know that acids are harmful to your teeth.  Alkaline water is basic (the opposite of an acid), so it might make sense that alkaline water would help your teeth.  After all, if acidic drinks dissolve your teeth, wouldn’t it make sense that alkaline drinks would re-build your teeth?  Actually, no. When acidic drinks dissolve your teeth, they take away the minerals that make up the enamel.  Thankfully, your body has a built-in mechanism to replace these minerals via your saliva.  Alkaline water can’t re-mineralize your teeth by replacing tooth structure.

Can Alkaline Water Neutralize Acids That Break Down Teeth?

Whenever you eat anything containing sugar or starch, it can be eaten by the bacteria in your mouth.  These bacteria then excrete acid right onto your teeth.  This acid can slowly eat away at your teeth.  If you don’t remove the bacteria daily through brushing and flossing, then the acid that they excrete will eventually cause a cavity in your tooth.  For more about how plaque destroys your teeth, read What Every Human Needs To Know About Plaque. In theory, alkaline water could neutralize the acid that the plaque produce and inhibit a cavity from forming.  However, you would have to swish it around in your mouth a lot to ensure that it was able to contact the acid under the sticky layer of plaque.  Most people when drinking alkaline water probably don’t bother to swish it around in their mouths, they simply swallow it down to their acidic stomachs. Although alkaline water could be used to neutralize acid, it is probably more simple to deprive the acid-producing bacteria of their food source by rinsing your mouth out with water to get rid of the sugar or eating some fresh vegetables to clean your teeth. If you really want to neutralize the acid, try mixing a teaspoon of baking soda into some warm water and swishing it around in your mouth.  This will produce some “alkaline water” at a fraction of the cost.

Conclusion

Alkaline water can’t re-build your teeth’s enamel or heal a cavity.  It could theoretically neutralize the acid in your mouth after eating something sugary, but it’s probably not terribly effective.  Unfortunately, I couldn’t find any scientific peer-reviewed articles on this specific subject. Finally, a word to the wise: It’s probably best to get your health information from someone who isn’t trying to sell you something.  If someone claims that their product can solve hundreds of health problems, it’s probably too good to be true.  If you want to see if a claim is backed up by real science, you can try performing a search of scientific papers at PubMed or Google Scholar free of charge. Do you have any questions or comments on alkaline water and oral health?  If so, leave them below in the comments section!

75
Sparkling Water Good for Your Teeth
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Lately, my wife and I have been trying to kick our habit of carbonated beverages with sugar and artificial sweeteners.  To fill the void, we’ve started sampling various types of seltzer water, club soda, sparkling water, and carbonated mineral water.  Our favorite, although a bit expensive for our tight dental student budget is Perrier Lemon carbonated mineral water.

Perrier Lemon Sparkling Mineral WaterSince I’ve recently written a lot about how the acids that we put in our mouths can erode the enamel on our teeth, I decided to do some research and find out if sparkling water can erode teeth.  Luckily somebody else has already done the research!

Although sparkling water contains nothing more than carbonated water (perhaps with a few minerals) and natural flavors, I didn’t expect it to be as acidic as soda pop, which also can contain phosphoric acid.  Unfortunately, sparkling water is still very acidic due to the carbonation which can combine with the water to form carbonic acid.

Yes, Sparkling Water Can Harm Your Teeth

Pellegrino Sparkling Water
Sparkling Water Can Damage Your Teeth

A group of researchers at the University of Birmingham in the United Kingdom wanted to find out if sparkling water can cause enamel erosion.

First, they measured the pH of the sparkling water and found that it has a pH of right around 3.  To compare this with other drinks, you can view this article about the different drinks that erode our teeth.

They took some extracted teeth and placed them in glasses filled with different types of flavored carbonated waters.

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How to Identify Acidic Foods and Drinks
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Food companies are able to sneak acids into lots of the foods we eat.  On Wednesday, I wrote about the three dangers of eating acidic, sticky candy such as Sour Patch Kids.

Danger AcidI listed a small number of acidic candy that it would be wise to consume in limited amounts.  The major problem with that list is that it’s not complete.  If I were to list every single acidic food, it just might break the internet.

With that in mind, I decided to write a post about how you can figure out how much acid is found in the various foods you eat.  As you read this, keep in mind that you don’t need to avoid all acidic foods, but it is important to know that when you consume acidic foods in large quantities, you can dissolve the enamel on your teeth.

How to Identify Acidic Foods and Drinks

There’s no place on the standard Nutrition Facts labeling to specify how acidic a food is.  Luckily, all packaged food sold in the United States is required to list the ingredients that they contain.

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Acidic Drinks Dissolve Teeth
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Although teeth are the hardest parts of our bodies, they do have one weakness: they can be easily destroyed by acid.  Acid is the weapon of choice that  plaque use to ruin our teeth and they can be found in many of the drinks that we consume.

LemonadeThe acidity of substances is measured using the pH scale.  The lower the pH a drink has, the more acidic the it is.  Many common beverages have a low pH, which means that they contain a lot of acid.

Our saliva normally has a pH of right around 6.5, which is a healthy pH for the teeth.  When the pH of our mouth gets to 5.5 or below, the enamel on our teeth starts to dissolve.  When you drink something that has a pH lower than 5.5, it starts to eat away at your teeth.  Of course, you can drink these drinks and still have healthy teeth, there are a lot of factors involved.  I’ll get in to a few of them at the end of the list.  Here they are:

Nine Drinks that Can Dissolve Your Teeth

1. Sports Drinks – While sports drinks are great for re-hydration, their acidic nature can cause them to be harmful to your teeth.  The two leading brand names both have a pH of less than 3.

  • Powerade is the most acidic at a pH of 2.75
  • Gatorade has a pH of 2.95

2. Fruit Juice – Fruit juice is good for you, but if you have the option, it’s always best to eat whole fruits as they are better for your teeth, and contain fiber to help your digestive system.  Here are the pH’s of some common juices:

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