Energy drinks beat up tooth enamel

When your mother told you that drinking that soda would rot your teeth, she knew nothing of energy drinks.

The high-caffeine, high-sugar beverages that some teens gulp like water are three to 10 times worse for your teeth than colas, according to a study published in dental journals.

A professor at the University of Maryland Baltimore Dental School soaked teeth in energy drinks, fitness water, sports drinks and other beverages for 14 days, measuring the decay. According to reports in General Dentistry and other trade publications, lemonade and energy drinks did the most damage.

The professor, Dr. Anthony von Fraunhofer, found that those drinks contain high levels of acids that can destroy enamel.

Efforts to reach the American Beverage Association, which represents the manufacturers of sodas, colas, energy drinks and sports drinks, were unsuccessful. The organization has been critical of the study, which was meant to replicate 13 years of normal beverage consumption, saying its methodology is flawed. Consumers of the drinks wouldn't see that sort of damage unless they held the liquids in their mouths without swallowing it, the organization has said.

But Dr. John Ruby, a professor in the dental school at the University of Alabama at Birmingham, has done research that reached similar conclusions.

Ruby measured the pH levels, or acidity, of dozens of beverages. Energy drinks have such high levels of acid that he recommends consumers not even allow them to touch their teeth. If you must drink them, he said, use a straw.

"Sip those all day, and you're not going to have any teeth left," he said.

Drink manufacturers put acid into beverages to balance the sweetness of the sugar. A can of Coke includes 10 teaspoons of sugar, for example, Ruby said. Put that much sugar in a cup of coffee, and "you'd be gagging," it would be so sweet, he said. The acid makes it palatable.

A low pH level means high acidity, and a high level means the acidity is low. A pH below 4 is enough to dissolve teeth, and all the energy drinks tested at UAB had levels of 3.3 or lower. Some sports drinks, including Powerade and Gatorade, were even worse. Wine also scored poorly, with pHs in the 3s, Ruby said.

"Wine tasters actually can erode their teeth," he said.

Beer fared much better, with a pH higher than 7. Among sodas, root beer was best, with a pH of 4.

Energy drinks, sports drinks and sodas contain a variety of acids, most commonly phosphoric acid, typically found in dark colas, and citric acid, typically found in clearer ones. Damage caused by those acids is basically irreversible, Ruby said.

In the Maryland study, the amount of enamel destroyed by the beverages was highest in KMX energy drink and Snapple Classic Lemonade. Close behind were Red Bull and lemon-lime Gatorade. The most destructive beverages seem to be those with citric acid, Ruby said.

The pitting that results can be filled, just like a cavity. But if the damage is closer to the roots, a crown is necessary. More severe damage means lost teeth.

To minimize the damage, Ruby recommends that people who consume energy and sports drinks:

Use a straw. Anything that keeps the liquid from coming in contact with your teeth helps. If you don't have a straw, open wide and pour it down, he said. "Try to drink it so it goes straight down the hatch."

Follow the energy drink with water. Rinsing will help remove what remained in your mouth after drinking that Red Bull, and will lessen the amount of acid that comes in contact with your teeth.

Use sports drinks for their intended purpose. An athlete who gulps down Gatorade after a workout isn't the one whose teeth are likely to suffer. It's the office worker who keeps a jug on his desk because he likes the taste.

Dr. W. Timothy Brooks, a Huntsville dentist and spokesman for the Alabama Academy of General Dentistry, said working dentists are seeing more instances of damage from energy drinks because they are becoming more popular. Young people especially, who are the target market for the beverages, are ending up in the examination chair.

Brooks recently saw a college basketball player who was found to have significant enamel loss when his braces were removed. The young man consumed large quantities of sports and energy drinks and not much water, and it was easy to see the link, Brooks said. "He had thinned out his enamel."

The young man was given fluoride to strengthen his teeth, but "they'll always be rougher and softer than before," Brooks said.

Ruby, Brooks and other experts said they tell patients to avoid sports and energy drinks if possible, and to be careful how they consume them if they do.

"There's nothing better than water," Brooks said.

E-mail: sdiel@bhamnews.com