Sugar, acid and teeth (2009)

http://www.dbskeptic.com/2009/04/05/sugar-acid-and-teeth/

by jondot • 14 years ago

165 102 14 years ago

jws• 14 years ago

Where "worst" is defined by a function of pH and sugar content pulled out of the air by a dentist.

skylan_q2• 14 years ago

It's a very, very simplistic view of dental health. There's much more to it than what comes into contact with your teeth.

dasil0032• 14 years ago

How do you know the dentist pulled it out of thin air? A dentist would seem to have a decent likelihood of being familiar with the science.

skylan_q2• 14 years ago

If the dentist is being scientific, it's up to him to back up his claims about sugar and acid being the most (or only) important indicators for what's bad for teeth.

EDIT: For example, there's been some interesting work discussed here: http://wholehealthsource.blogspot.ca/2009/03/reversing-tooth...

cmatteri• 14 years ago

Their function 10^(5.5-pH) * (mg/cl sugar + 1) does seem to imply that sugar and acidity have a synergistic effect, where the +1 in the sugar term is a hack to keep the result from being 0 if the sugar is 0. This doesn't make sense, as a modest increase in sugar, say from 0 to 1 would double the result regardless of the pH.

SoftwareMaven• 14 years ago

What the equation says to me is that acidity sets the stage for tooth damage, but as bad as that is, once you start feeding the bacteria in that set stage, you are in real trouble.

However, the entire article is a hypothesis. It is a best guess by somebody with scientific knowledge, but there is no reason to believe the real formula shouldn't be 10^(5.5-ph)+10(mg/cl sugar) or something completely different.

However, my son and daughter both need a science fair project soon. I wonder if there is a way to formalize this a little.

Royal• 14 years ago

Their function also improves the results if the drink is more basic. A drink with a pH of 13 would have an amazing score on here.

If you normalize the pH above 5.5 since it has "little to no effect" things on the lower end of the results are better, with milk being worse than water, and chocolate milk being worse than milk.

squarecat• 14 years ago

Seems having only a dentist on hand for that "experiment" is akin to having a mechanic as your only expert for analyzing a car wreck? As the author even concedes, an abundance of anecdotes is not evidence.

Was it so hard to find a chemist way back in aught-9? (Go down to the nearest uni and find a chem major at least...)

The wide distribution of oversimplified, media-sanitized, pseudo-science is likely one of the affectations of Western culture that has kept it from progressing further for a solid 60 years--since television gave the ability for snake oil salesmen to multiply their effectiveness. The internet exponentially increased that ability.

casca• 14 years ago

Interesting, but their choice of weighting of sugar and pH is not based on any evidence.

Also, would the amount of time that the drink is in contact with your teeth not have an impact? Perhaps wine would have more of an impact because you might keep it in your mouth longer, offset by the small likelihood you you drinking as much of it?

bmelton2• 14 years ago

Similarly, I read something recently (no link, sorry) that stated something like the following (poorly paraphrased):

  Juice is fine to drink as it's generally healthy,
  but if you're going to drink it, do so quickly 
  instead of sipping on it for long periods.

The premise being exactly what you surmised, that chugging a small glass of OJ is much better for your teeth than sipping it and putting your teeth into contact with it for so much longer.

scott_s2• 14 years ago

It may be better for your teeth, but I wonder if chugging it will spike your insulin more.

mtts2• 14 years ago

Juice is for most intents and purposes no healthier dan soda. It's mostly sugar and acid. The fact that said sugar and acid used to reside in a piece of fruit makes no difference at all.

If you want the health benefits of fruit, eat a piece of fruit.

davidw• 14 years ago

I didn't get the impression they looked at serving size. In other words, the Merlot's average serving size is smaller than that of the Guiness, even though the latter is "better".

pre• 14 years ago

I wonder how much serving size would even matter? I'm told the damage comes after the drink really, when your teeth sit around covered in it.

I'm sure it'd make some difference, it takes longer to drink a pint than a shot there'll be a bigger concentration there during those initial minutes, but I doubt it'd be linearly proportional.

I'd guessed a red-wine. My dentist certainly goes on about my drinking booze more than me downing Ribena by the pint. I wonder if alcohol can have some unmeasured effect apart from sugar content and PH.

nealabq• 14 years ago

One hears that Bulimia and certain drug addictions (Crack, Meth) are very bad for your teeth. Bulimia because of the strong acid, and drugs because they interfere with the mouth's self-cleaning instinct.

I'd guess the best teeth live in a mouth with: 1. Active high-volume saliva glands 2. A population of healthy bacteria

How do you encourage that?

jbigelow76• 14 years ago

How about encourage them not to become crack heads or bulimics in the first place? It's a strategy that probably has benefits beyond mere dental health.

Alex3917• 14 years ago

The reason why amphetamines are bad for your teeth is that they prevent your mouth from making saliva, which allows bacteria to multiply and causes other bad things to happen as well. Obviously it's probably not a good idea to be using meth in the first place, but if you're going to use any sort of drug that causes dry mouth then at the very least you should brush, floss, and use mouthwash and flouride rinse beforehand.

hnriot• 14 years ago

This should not be so much surprise to anyone really. It's pretty widely known that sugar and acids are bad for your teeth. The degree to which any drink with these contributes to dental damage is probably more complicated but everyone knows that its best to drink water. Not only will it not ruin your teeth but it will also not make you fat, like sodas and juice boxes.

steve89183• 14 years ago

I have deep grooves in my teeth right above my gums on both sides of my mouth from drinking 3-6 cokes a day for 10+ years. For some reason, I have a habit of swishing the drinks on the bottom of my mouth and I think this is the reason why my teeth are so jacked up. In the past year, I've largely stopped drinking Coke, partly because of this, and because of the other health problems associated with drinking so much soft drinks. I've switched to water and have a sugary drink maybe once or twice a week.

peterwwillis4• 14 years ago

Besides being bad for your teeth it's a nightmare on your body. That insulin dump from the onslaught of sugar will make you much more likely to develop diabetes, and some studies have shown a long-term metabolic effect where your body prefers sugars for energy instead of fats. That and the empty calories will lop-side your diet and make it harder to lose weight or gain muscle.

There are lots of ways you can drink something tasty and not have such a huge impact on your body. Sometimes i'll buy a two-liter of green tea ginger ale or cranberry juice, and make a 50/50 or 25/75 mix of the drink and tap water.

You can also just cold-brew tea or coffee and mix in a little sweetener or other flavor to change it up. It's cheaper than soda and (after you stop drinking soda every day) tastes much better because you're not getting hit over the head with truckloads of sugars. Ask a European about how sweet all our foods and drinks are.

steve89183• 14 years ago

I 100% agree. Actually I have done almost exactly that, switched to tea, or ice tea. I'm not completely off the sugary drinks, but I'll drink things like Honest Tea with a lot less sugar than Coke, or just plain Tea.

The thing I'm actually most worried about is pancreatic cancer. I'm not even sure if there's a link between that and soft drinks, but I read one study where having 2-3 soft drinks a week doubled your risk of getting it. Well I was having 20 a week, which scared the crap out of me. And more and more people appear to be contracting and dying of it, so it's my secret fear.

TillE• 14 years ago

Unsweetened tea and coffee are definitely your best bets next to plain tap water for generally healthy drinks. Though I have found that drinking loads of black tea stains your teeth (it was cleanable), and switched to green tea.

http://www.hsph.harvard.edu/nutritionsource/healthy-drinks/

conroe64• 14 years ago

Nightmare, onslaught, much more likely, lop-side, huge impact, truckloads of sugar... How can you use such scary descriptions without any giving any evidence backing up what you're saying?

brianbreslin• 14 years ago

My uncle who is a dentist told me i got loads of cavities from gatorade. His rationale aside from the high sugar content was that because I was exercising, my mouth was drying out w/the gatorade residue in it. So the sugars eat away at your teeth faster. So there is that factor to weigh in as well (how your mouth is reacting at the time of the liquid consumption, or post consumption residue).

eaurouge• 14 years ago

Interested in hearing what people think of Xylitol and its positive effects on saliva pH.

beagle38• 14 years ago

Xylitol's major positive effects on teeth health come from a different path: The bacteria responsible for cavities will try to eat it (cause it's close enough to sugar) but fail to digest it (cause it isn't), which will interfere with their ability to prosper and even kill them.

(Unfortunately, that's also true for dogs: DO NOT feed your dog xylitol. It is toxic for them: two xylitol-swettened gums are potentially enough to kill a small dog, and cause irreversible damage to larger dogs!)

https://en.wikipedia.org/wiki/Xylitol is a treasure trove

ericd• 14 years ago

That sounds like something I don't want to be eating either, if it's so toxic to both bacteria and fairly similar mammals. Have there been any long term xylitol studies? It seems likely that it would screw with the bacteria in one's gut.

myhf• 14 years ago

Wow, I never realized Diet Coke was less acidic than Diet Dr Pepper.

deltaqueue• 14 years ago

I wish he would have provided more explanation behind the dentist's algorithm. Here's an actual study measuring enamel loss, which seems much more definitive:

http://faculty.philau.edu/ashleyj/General%20Dentistry%20Arti...

Perhaps the most important snippet:

Regression analysis indicated no correlation between enamel dissolution and beverage pH (r = 0.477, p > 0.05); in addition, the enamel dissolution showed no difference (p > 0.05) between the regular and diet versions of cola and non-cola beverages from the same manufacturer (Fig. 2 and 3). It was noted that the enamel dissolution was similar for all cola drinks over the 14-day test period (approximately 3.0 mg/cm2).

And again:

The data suggest that enamel aggressivity is determined by beverage composition rather than by beverage pH.

nathanb4• 14 years ago

Or how about experimental science? Get some human teeth (probably not difficult or expensive for a dentist), weigh them, plunk them in each liquid, let them sit for a week, see which ones lost the most mass.

Obviously scientific rigor would require several experiments to smooth out the variances in individual tooth quality and original composition, but it seems like that would come to a more definitive conclusion.

splat• 14 years ago

I think the presence of saliva has a major effect on inhibiting tooth decay. I'm not sure how applicable in vitro experiments would be.

nsxwolf2• 14 years ago

Teeth continuously remineralize in living humans, so this experiment wouldn't tell us anything useful.

ender7• 14 years ago

A human tooth submerged in Pepsi will actually dissolve completely in less than a week.

jsdalton• 14 years ago

I agree with your sentiment, but a large factor in tooth decay is bacteria that live in your mouth: http://en.wikipedia.org/wiki/Dental_caries

This seems like what the article gets wrong as well. What you drink and eat impacts the environment in your mouth where bacteria flourish which in turn impacts tooth decay. There just isn't such a direct cause/effect relationship between pH/sugar and tooth decay, although they are certainly strongly correlated.

As a result, I'd take this article as a loose framework rather than a true scientific ranking.

lyso2• 14 years ago

p>0.05 does not mean that a correlation has been disproven, just that the authors are unable to reject the null hypothesis (potentially due to lack of statistical power).

solox3• 14 years ago

To couple pH with 'badness', you need to couple it with volume. It takes less effort to neutralize 1L of pH3 stuff than 10L of pH4 stuff.

stuaxo• 14 years ago

Hm, but what about the effect of the bacteria consuming said drinks; surely this will change the results ?

tocomment3• 14 years ago

I've never understood if sugar affects gum disease. Does anyone know? Does the gum disease bacteria eat sugar or directly eat your teeth and gums?

I tried looking it up once but I only found information about sugar and cavities.

artemus2• 14 years ago

Bacteria consume sugar, which produces acid as a waste-product, which erodes enamel. Gum disease is primarily an inflammatory response to the presence of external irritants like dental plaque (which contains bacteria as well).

tocomment3• 14 years ago

So there's no specific gum disease bacteria? It's just the same bacteria that causes cavities?

kokey2• 14 years ago

From a very basic investigation by myself, I have found whiskey and water to be the alcoholic drink that's the least acidic.

gdw2• 14 years ago

My dentist explained it this way: Bacteria eats sugar and pees acid.

nsxwolf2• 14 years ago

As a child, my dentist also warned me about Mountain Dew and gave a specific reason - the presence of ethylenediaminetetraacetic acid (EDTA), used as a stabilizer.

His theory was that it would chelate the calcium out of your tooth enamel.

Sounds like a bit of dentist lore that gets passed around. Maybe because they use EDTA during root canals to prep the area.

JabavuAdams2• 14 years ago

So a cookie should be much worse than any sugary drink.

Basically, if you eat more than 0 sweets per day, it seems ridiculous to worry about sugary drinks.

If you get a raspberry seed stuck between your teeth, it should be much worse than a sugary drink.

Is there some coating effect I'm missing?

njs12345• 14 years ago

There's some effort underway to develop a vaccine against dental caries: http://en.wikipedia.org/wiki/Caries_vaccine

nemo1618• 14 years ago

Indeed, there are some very exciting prospects here. The replacement therapy seems most promising. I developed a number of cavities out of the blue after I began aggressively using mouthwash - my theory is that I had a mostly benevolent strain of bacteria and accidentally killed them off, and they were eventually replaced with a nastier strain. If a harmless strain could be administered through vaccine or chewing gum, the societal effects would be enormous. Seems like the largest problem left (as usual, sadly) is getting it out of the lab.

tocomment3• 14 years ago

Hmm, this makes me wonder; should a low carb diet help cure gum disease and prevent cavities since you're providing so little sugar to the bacteria?

In fact do you need to brush and floss when on a low carb diet?

Has this been studied?

dollarpizza• 14 years ago

So where do coffee, espresso, & teas (black, green) fit into his Harm Matrix?

jarek• 14 years ago

Depends how much sugar you put into them.

barcoder• 14 years ago

"To mitigate the effects of pop consumption, only consume it with meals. Brush soon after eating or drinking anything besides water (including milk or juices)."

Brushing soon after drinking or eating something sugary is not a good idea. Best to wait around 30 minutes and let your body clean your teeth during that time, after the 30 minutes manually clean!

http://well.blogs.nytimes.com/2012/05/21/really-never-brush-...

http://www.hindustantimes.com/Entertainment/Wellness/Brushin...

shalmanese• 14 years ago

Have there been any studies on whether drinking with a straw is better than drinking from a cup/bottle?

magoon• 14 years ago

Root beer is the best soda (pop) for your teeth because it isn't acidic.

humdumb• 14 years ago

Bacteria vs. Human body^1.

1. Specifically, teeth and saliva, but you must always consider the whole organism.

Drink soda pop --> Advantage, Bacteria.

Don't drink soda pop. --> What do you think?

Bacteria need acidic conditions and they are happy to have plenty of sugar. Preserving your teeth means giving your body the best possible chance against bacteria, slowing the process of decay as much as you can. But in the end, on every front, bacteria will always win. It's just a matter of time. If they don't consume you while you're alive, they will after you're dead.

With respect to tooth decay, drinking soft drinks surely helps bacteria, not the human body. But then, maybe people derive other benefits from drinking these concoctions. (Jolt?) Maybe preserving their teeth is not their number one priority?

Factoid: George Washington had wooden teeth?

Detrus• 14 years ago

I never drink any sugary juices or candy. Eat lots of fruits and veggies, also bread, milk and nuts.

And I have terrible tooth decay.

Seems a bit silly to compare pHs of various junk foods. Drinking a better pH won't make much difference. The problem is a tad more complicated.

beagle38• 14 years ago

I had terrible tooth decay when I was younger (I have 16 fillings from ages 10-20). And then, all of a sudden - nothing. I haven't had a hole or a problem since (except for a filling that broke and had to be replaced). There was nothing that I'm aware of that I changed around that time -- I stopped drinking sodas and eating junk food around age 30.

But I have recently read claims (and testimonials) that what you need for healthy teeth is Vitamin D (make sure you take it in the morning if you do!) and Vitamin K2, see e.g. http://www.thedentalessentials.com/The_role_of_vitamin_k2_on... ; If you find this interesting, you'll find a lot more similar stuff on the bulletproof executive forums.

dhughes• 14 years ago

I can't see how second best sorbitol and the best being Xylitol are any better than sugar they're sugar alcohols which have the effects of a laxitive.

How about just not eating so much sugar, and if you're diabetic try stevia that's what my mother, a diabetic, chooses.

baseh• 14 years ago

Thats it. I am switching to Spartan Lower 1/2% milk

jtlienws• 14 years ago

If you must drinks harmful to teeth, It would make sense to me to use a straw, and put the straw deep in you mouth so that the liquid does not come in contact with the teeth.

photorized• 14 years ago

Genetics.

rcxb• 14 years ago

With "skeptic" in the name, I was expecting much, much better. It's a pretty bland application of some rule-of-thumb (perhaps, dogmatic) beliefs about tooth decay, which doesn't hold up to reality.

One of the problems which comes to mind is that mouth wash has NEVER proven effective in preventing tooth decay (and companies that make Scope, Listerene and others would really LOVE to be able to say that it does). Meanwhile, this article blindly asserts that they will work quite well.

This issue throws every other claim into doubt, too, since the bacteria is claimed be be the sole cause of decay, and a mouth wash certainly could kill-off bacteria in the mouth. It seems tooth decay is a far more complex activity than the model used in this discussion.

Sugar, acid and teeth (2009)

Related Stories