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July 2006
News this month Children with active lifestyles sometimes rely on sports or energy drinks to recharge or rehydrate after exercising. However, a study conducted by the University of Maryland revealed that regular long-term use of these beverages may cause irreversible damage to dental enamel – the thin, outer layer that helps preserve the tooth’s structure and prevent decay. According to the study cited in General Dentistry, the Academy of General Dentistry’s clinical, peer-reviewed journal, enamel damage caused by non-cola andsports beverages was 3 to 11 times greater than cola-based drinks.
“A study by the University of Maryland revealed that regular long-term use of these beverages may cause irreversible damage to dental enamel – the thin, outer layer that helps preserve the tooth’s structure and prevent decay.”
Lead author Dr. Anthony von Fraunhofer, professor of biomaterials science at the University of Maryland Dental School, exposed tooth enamel from cavity-free molars and premolars to a variety of popular sports beverages including energy drinks, fitness waterand sports drinks and cola and non-cola beverages – such as bottled lemonade and canned iced tea. The tooth enamel was steeped in the drinks for a total of 14 days, and weighed every 24 to 48 hours. The solution’s acidity was checked, and solutions were changed daily. The exposure timewas intended to simulate the effects of normal beverage consumption over about 13 years. While all the drinks produced some enamel damage, von Fraunhofer found the most wear occurred, in descending order, from lemonade, energy drinks, sports drinks, fitness water (often with citrus flavors), ice tea and cola. Von Fraunhofer said most cola drinks contain acids, but energy and sport drinks also contain other organic acids that can speed up damage to the enamel.
“Most wear occurred, indescending order, from lemonade, energy drinks,sports drinks, fitness water(often with citrus flavors), ice tea and cola.”
“The integrity of the tooth is dependent on having the enamel there,” said Dr. von Fraunhofer. “Once the enamel is gone, it is gone.” The American Academy of General Dentistry, which publishes the journal, does not have an official standon specific beverages and their potential for damaging enamel. But the sports–drink industry says there’s no link between the beverages and dental problems. “The study from Maryland uses an experimental approach that takes the tooth out of the mouth and uses a non-real-world situation to see if beverages have an impact on tooth weight,” said Craig Horswill, senior research fellow at the Gatorade Sports Science Institute. He pointed to another study, published in the European journal Caries Research in 2002, that found no relationship between sports-drink consumption and dental erosion in more than 300 athletes.
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 In vitro exposure cannot confirm correlation between sports drinks and tooth decay. The study conducted by Dr. Anthony von Fraunhofer and reported on in General Dentistry, alerts readers to the dangers of the “acids” present in sports drinks and other popular beverages often used for fluid replenishment after exercise or exertion. While von Faunhofer’s conclusions are logical, they do not confirm a correlation between sports drinks and human tooth decay because the study used extracted teeth – thus the results cannot be directly extrapolated to the actual experience of tooth decay in a person. “This study does draw attention to the definite effects of acid on tooth structure and the need to use caution in deciding how to replenish lost fluids following excercise.”
Measuring the change in weight of a whole tooth after in vitro acid exposure only suggests loss of tooth structure, or decomposition, due to the acid. Without accurately mimicking the real human oral environment in an artificial environment — or actually doing a study with humans —one cannot suggest meaningful conclusions about the contribution of sports drinks to tooth decay. To its credit, this study does draw attention to the definite effects of acid on tooth structure and the need to use caution in deciding how to replenish lost fluids following exercise. Preventive care and oral hygiene “Good consistent oral hygiene is the best way to prevent or minimize tooth decay.”
The combination of food, oral bacteria and bacterial acid by-products form dental plaque. The composition and age of dental plaque is a major contributor to dental diseases such as tooth and gum disease. The frequency of exposure to food – the number of times one eats per day – not the amount of food, is the primary contributor to tooth decay and gum disease. For every bit of cariogenic food (food that produces or encourages tooth decay) that oral bacteria are exposed to, 20 minutes of acid production by these bacteria follows. Therefore, rather than eating multiple times and snacking throughout the day without brushing and flossing, make defined times – ideally three times per day – that children consume all of the food and drink they need for that meal. Brushing after meals and avoiding snacks helps reduce the amount of plaque and subsequent acid production, as well as minimize development of tooth decay and gum disease. “Controlling dental plaque is one of the essential components in prevention.”
Because tooth decay and gum disease have multiple causes – the amount of saliva, the flow of saliva, and genetics all contribute to its development – controlling dental plaque is one of the essential components in prevention. When acids are left in contact with teeth for too long, disturbing the natural balance between remineralization (the restoration of lost minerals to teeth) and demineralization (the loss of minerals from teeth), can cause excess demineralization and cavities. Unless plaque and acids are removed soon after eating by brushing and flossing to allow for remineralization (enhanced by minerals present in saliva and fluoride), the demineralized and decaying teeth will serve as ideal rough surfaces to which additional plaque will adhere, thus increasing the potential for tooth decay. Dr. Singletary is the chief of dentistry at Yale-New Haven Hospital and the Yale-New Haven pediatric dentistry center and assistant clinical professor of surgery and pediatrics at the Yale University School of Medicine. |
