Researchers from King's College London in the United Kingdom sought to find out which acidic foods and drinks are the worst for tooth erosion, and whether the way in which we consume them has an effect.
Study leader Dr. Saoirse O'Toole — who works in the Department of Tissue Engineering and Biophotonics at the King's College London Dental Institute — and colleagues report their findings in the British Dental Journal.
Tooth erosion — also known as dental erosion or acid erosion — occurs when acids wear away tooth enamel, which is the substance that coats the outer layer of each tooth. Over time, this erosion could give rise to tooth discoloration, sensitivity, and even tooth loss.
One leading cause of tooth erosion is acids in our foods and drinks, and soda and fruit juices are among the biggest offenders.
That said, as Dr. O'Toole and colleagues note, some individuals who consume such foods do not experience tooth erosion, which begs the question: does how we consume dietary acids impact our risk of tooth erosion?
To find out, the researchers primarily drew on data from a previous study, which included 600 adults. Of these, 300 had severe tooth erosion, while the remaining 300 did not.
As part of the study, subjects were asked to report their frequency, timing, and duration of dietary acid consumption. Additionally, participants were asked to report any drinking habits prior to swallowing acidic drinks — for example, sipping hot drinks or swishing them in the mouth.
The researchers also looked at data from other studies to determine which are the worst foods and beverages for tooth erosion.
Acidic foods, drinks worst for tooth erosion
Unsurprisingly, the analysis revealed that acidic foods and drinks posed the greatest risk of tooth erosion.
The team found that the risk of moderate or severe tooth erosion was 11 times higher for adults who drank acidic beverages twice daily, particularly when they were consumed between meals, compared with those who consumed such beverages less frequently.
When acidic drinks were consumed with meals, the risk of tooth erosion was slashed by half.
"It was also observed that one or less dietary acid intakes a day was not associated with erosive tooth wear," the researchers note. "If a patient must go above one dietary acid intake per day, it would be prudent to advise them to consume the acids with meals."
When consumed regularly, fruit teas and fruit-flavored candies — even fruit-flavored medications — may pose a risk for tooth erosion, the team reports, as can vinegars and pickled foods.
Interestingly, the researchers found that adding fruit flavorings to beverages — for example, adding lemon to hot water — made them just as acidic as cola.
What is more, sugar-free soda was found to be just as erosive for teeth as sugar-sweetened soda, and hot drinks were found to have greater erosive potential than cold drinks.
Sipping, swishing drinks may erode teeth
Importantly, however, the scientists found that it's not just the type of foods and beverages we consume that affect our risk of tooth erosion; the study revealed that the risk of tooth erosion is increased when we sip drinks, as well as when we swish, hold, or rinse them in the mouth before swallowing.
'It is well known that an acidic diet is associated with erosive tooth wear. However, our study has shown the impact of the way in which acidic food and drinks are consumed."
Dr. Saoirse O'Toole
The American Dental Association recommend against holding or swishing acidic beverages in the mouth — advice that is backed up by this latest research.
They also explain that drinking water or milk when eating and rinsing the mouth after consuming acidic drinks may help to reduce tooth erosion.
"With the prevalence of erosive tooth wear increasing," adds Dr. O' Toole, "it is vitally important that we address this preventable aspect of erosive tooth wear."
"Reducing dietary acid intake can be key to delaying progression of tooth erosion," she continues. "While behavior change can be difficult to achieve, specific, targeted behavioral interventions may prove successful."