Sports and energy drinks are fueling a silent epidemic of irreversible tooth erosion among American adolescents, according to a new study.
“Young adults consume these drinks assuming that they will improve their sports performance and energy levels and that they are ‘better’ for them than soda,” says Poonam Jain, BDS, MS, MPH, lead author of the study in a press release. “Most of these patients are shocked to learn that these drinks are essentially bathing their teeth with acid.”
"This study completely disproves that, because they erode or thin out the enamel of the teeth, leaving them more susceptible to decay and sensitivity."
The American Beverage Association scoffs at the study, according to Tracey Halliday, a spokesperson, WebMD reported. An ABA statement reads, in part: "This study was not conducted on humans and in no way mirrors reality."
“This type of testing simulates the same exposure that a large proportion of American teens and young adults are subjecting their teeth to on a regular basis when they drink one of these beverages every few hours,” says Dr. Jain.
Researchers examined the acidity levels in 13 sports drinks and nine energy drinks. They tested six drinks for their effects on tooth enamel and found both types caused damage. Energy drinks, however, were twice as bad. Damaged tooth enamel cannot be fixed.
The study is published in the May/June 2012 issue of General Dentistry, the peer-reviewed clinical journal of the Academy of General Dentistry.
Sports Drinks, Energy Drinks, and Teeth: Study Details
The drinks are especially popular among teens and young adults. Up to half of U.S. teens and young adults drink energy drinks, and more than half have at least one sports drink a day, according to the researchers.
WebMD states that the researchers tested the acidity levels of all 22 drinks. They found the levels of acidity in the drinks vary between brands and between flavors of the same brands.
Gatorade Blue had the highest acidity among sports drinks. Next was Hydr8.
Among the energy drinks with the highest acidity:
Red Bull Sugarfree
MDX had the lowest acidity of the energy drinks, WebMD reported.
Energy Drinks, Sports Drinks, and Tooth Enamel
Jain's team immersed enamel samples from extracted human teeth into three sports drinks and three energy drinks.
The sports drinks tested were:
The energy drinks tested were:
According to the press release, the enamel samples were immersed in the drinks for 15 minutes. The researchers transferred the enamel to artificial saliva for two hours.
This cycle was repeated four times a day for five days. The beverages were replaced with fresh ones every day.
Contrary to the beliefs of the beverage industry, the cycle was meant to simulate real life, Jain says, as some teens and young adults drink the beverages every few hours.
And the most shocking result was this: enamel loss was evident after five days of exposure, Jain says.
The average enamel lost with sports drinks was about 1.5%, while the average loss with energy drinks was more than 3%. Jain says she cannot pinpoint what percent of enamel loss would cause problems.
“Teens regularly come into my office with these types of symptoms, but they don’t know why,” says AGD spokesperson Jennifer Bone, DDS, MAGD, according to the press release.
“We review their diet and snacking habits and then we discuss their consumption of these beverages. They don’t realize that something as seemingly harmless as a sports or energy drink can do a lot of damage to their teeth,” she said.
“Bacteria convert sugar to acid, and it’s the acid bath that damages enamel, not the sugar directly,” said Dr. David Katz, director of the Yale Prevention Center, ABC news reported. “So by incorporating a high acid load in a drink, we are just cutting out the middleman on the way to tooth decay.”
These drinks are glorified sodas, with as much or more sugar, said Katz.
Beverage Industry Not Buying It
According to ABA, the four drinks a day simulated by the study is above average. So, too, is the length of time the enamel was exposed.
"People do not keep any kind of liquid in their mouths for 15-minute intervals over five day periods," the statement says.
Susceptibility to dental problems depends on personal hygiene, lifestyle, total diet, and genetic makeup, according to the ABA.
"Furthermore, it is irresponsible to blame foods, beverages, or any other single factor for enamel loss and tooth decay."
The makers of 5-hour Energy says this study has nothing to do with their product.
"This report is wholly irrelevant to 5-hour Energy because our product is an energy shot, not an energy drink." Elaine Lutz said, a spokesperson for 5-hour Energy, in a released statement to WebMD in response to the study.
And furthermore, the volume in the product, she says, is eight times less than what is found in other energy drinks. For that reason and others, she says, the results would not apply.
Besides, the product is marketed only to adults, she says.
What you can do to protect your teeth
Dr. Bone recommends that her patients minimize their intake of sports and energy drinks. She also advises them to chew sugar-free gum or rinse the mouth with water following consumption of the drinks.
“Both tactics increase saliva flow, which naturally helps to return the acidity levels in the mouth to normal,” she says.
Also, patients should wait at least an hour to brush their teeth after consuming sports and energy drinks. Otherwise, says Dr. Bone, they will be spreading acid onto the tooth surfaces, increasing the erosive action.