It may be common knowledge that drinking soda pop and eating candy is bad for your teeth, something many of us have heard since childhood. But their effects on oral health are more complex and insidious than we may realize.

Repeated exposure to sugar, especially when combined with the acid found in many soft drinks, wears down tooth enamel, which leads to decay and, eventually, tooth loss. This sugar-acid double punch poses a danger to Kentuckians of all ages who drink sodas, and particularly to those who constantly sip them every few minutes to get their sugar and caffeine fix.

As part of KET’s ongoing Inside Oral Health Initiative, funded in part by the Foundation for a Healthy Kentucky, our production team talked with several Kentucky dentists about the prevalence of high sugar consumption in the state and how it contributes to tooth decay. Here are some of their tips for minimizing the effects of sugar and acid on the teeth.

Threats to Tooth Enamel

The enamel on our teeth, which covers the visible, outer portion, is the strongest material in the human body and can keep teeth healthy for a lifetime. However, enamel will erode if exposed repeatedly to sugar and acid, and it cannot naturally regenerate.

Maintaining healthy tooth enamel is vital for overall oral health – but in Kentucky, consuming drinks and food with high sugar content makes it hard for many to reach that goal. What’s worse, many of the more popular soft drinks, including colas and Mountain Dew, also have a high acidic content.

“On a scale of 1 to 10, if battery acid is a 1, then most soft drinks are a 2. That’s how acidic they are,” says Dr. Robert Henry, DMD, chief of dentistry at the Department of Veterans Affairs Medical Center in Lexington.

“If you add sugar on top of that, you’re just setting up an environment that’s acidic,” he adds.  “And then the sugar moves in and basically does the rest. It’s literally like throwing kerosene on an open flame.”

The effects of sugar and acid are intensified with repeat exposure. Many people sip on soda throughout the day, and even before bedtime, says Dr. Bill Collins, DMD, who practices in Pikeville and also performs dental outreach at Red Bird Mission in eastern Kentucky.

“If you take one sip of soda, it’s going to take three to four hours for your mouth to go to a pH of neutral,” Collins says. (The numerical figure for neutral is a pH of 7). “So, if you’re sipping every 15 to 20 minutes, your acidic level in your mouth is down to a pH of 1 or 2. And you’re keeping it there, and it basically dissolves the enamel on your teeth.”

Other sugary drinks, such as fruit juice, sports drinks, and the increasingly popular energy drinks, are just as harmful if consumed regularly, according to Dr. Henry. And while diet sodas may be sugar-free, many of them still contain acid.

Practicing in eastern Kentucky, Dr. Collins and Dr. Nikki Stone, DMD, have seen the habit of sipping soda, even in very young children. In the worst cases, children’s baby teeth have had to be removed early due to decay, inhibiting their ability to form permanent teeth in the correct placement.

“Drinking pop is our culture – we have an actual ‘pop culture’ in eastern Kentucky,” says Dr. Stone, who created the Drink Pyramid graphic to instruct kids on healthy habits. “Children are very honest, and they were telling us, ‘I drink four or five soda pops a day.’ And that was just shocking to me. So I tried to begin with the message that pop is a special occasion thing, maybe drink it just on the weekends.”

Tips for Reducing Sugar’s Impact

● If you must drink soda, do it fast, and once a day at most. According to Dr. Julie McKee, DMD, the state dental director, it is actually better to gulp down a sugary soft drink than to sip it. This leaves less time for the sugar and acid to wash over the teeth and cause decay. In general, McKee feels that drinking sodas should be done rarely, if at all. What’s true for children who are following Dr. Stone’s Drink Pyramid holds true for grown-ups, too.

“If you’re going to sip, sip water,” McKee says.

● Never drink soda before bedtime, and clean your teeth thoroughly at night. One common theme among the dentists interviewed was the importance of getting all sugar and acid out of the mouth before going to sleep. Dr. Collins says that a person’s salivary glands become much less active overnight, leading to dry mouth. Sugar and acid thrive in that oral environment, he says.

For his patients in Pikeville and at Red Bird, Collins also has specific advice in regard to rinsing. He says that rinsing with some mouthwashes does not remove plaque and tartar, and that rinsing with water is the very best practice. This should be done before brushing. For heavy soda drinkers, it’s best to rinse as much residue as possible from the teeth before brushing begins.

“I am telling my patients to rinse with water prior to brushing if they consume a lot of soft drinks, especially citric acid soft drinks,” he says. “Some literature states that brushing without rinsing with water may cause the scrubbing of acid into the teeth. So, to err on the side of caution, I tell everyone always to rinse with water before brushing.”

● Avoid added sugar in food. Reducing soft drink intake is only part of a larger nutritional program that more Kentuckians need to follow for good oral health. “Our daily food intake has so much more processed sugar than it did 30 or 40 years ago,” Dr. McKee says. “And that’s also part of the mesh that creates the environment that creates tooth decay.”

“I can’t tell you how many times we see parents who have said, ‘I had perfect teeth growing up and my children have so many cavities, I don’t understand why,” says Dr. Mandy Ashley, DMD, who practices in western Kentucky. “And, there’s so much of it that has to do with diet. Maybe the parent grew up in an era where they weren’t exposed to sugar as frequently, and maybe they didn’t have juice as often.”

● Follow the tried and true “two times two” mantra. The American Dental Association recommends brushing twice a day, for two minutes per session, preferably in the morning and definitely before bedtime. Dr. Henry explains that children brush their teeth, on average, for less than 30 seconds, and adults brush less than a minute. “If you have all of your teeth, it takes you longer to really do it correctly,” he says.

This KET article is part of the Inside Oral Health Care initiative, funded in part by the Foundation for a Healthy Kentucky.