Monday, March 28, 2011

Chew your calories and drink water: Industrial beverages and tooth erosion

Dental erosion is a different problem from dental caries. Dental erosion is defined as the removal of minerals from the tooth structure via chemicals. Dental caries are the result of increased site-specific acidity due to bacterial fermentation of sugars.

Still, both have the same general result, destruction of teeth structure.

Losing teeth probably significantly accelerated death among our Paleolithic ancestors, as it does with modern hunter-gatherers. It is painful and difficult to eat nutritious foods when one has teeth problems, and chronic lack of proper nutrition is the beginning of the end.

The table below, from Ehlen et al. (2008), shows the amount of erosion that occurred when teeth were exposed to beverages for 25 h in vitro. Erosion depth is measured in microns. The third row shows the chance probabilities (i.e., P values) associated with the differences in erosion of enamel and root. These are not particularly enlightening; enamel and root are both significantly eroded.

These results reflect a broader trend. Nearly all industrial beverages cause erosion, even the “healthy” fruit juices. This is due in part, but not entirely, to the acidity of the beverages. Other chemicals contribute to erosion as well. For example, Coke has a lower pH than Gatorade, but the latter causes more erosion of both enamel and root. Still, both pHs are lower than 4.0. The pH of pure water is a neutral 7.0.

Coke is how my name is pronounced, by the way.

This was a study in vitro. Is there evidence of tooth erosion by industrial beverages in people who drink them? Yes, there is quite a lot of evidence, and this evidence dates back many years. You would not guess it by looking at beverage commercials. See, for example, this article.

What about eating the fruits that are used to make the erosion-causing fruit juices? Doesn’t that cause erosion as well? Apparently not, because chewing leads to the release of a powerful protective substance, which is also sometimes exchanged by pairs of people who find each other attractive.


Leslie A. Ehlen, Teresa A. Marshall, Fang Qian, James S. Wefel, and John J. Warren (2008). Acidic beverages increase the risk of in vitro tooth erosion. Nutrition Research, 28(5), 299–303.