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Dietary acid haunts candy and drinks

Halloween has long been ruled by the popular sugar goblin in all its many forms. Although a contributor to obesity and diabetes, sugar is not the only hazard encountered in trick or treat bags. If sugar is the treat, than acid is the trick as the development of sour acid candies has led to the erosion of candy-lovers’ tooth enamel for several years now.

While many people are aware of the dental dangers of eating candy, they don’t realize that those destructive acids lurk in many of their favorite drinks, which are twice as damaging when combined with candy. The danger lies in the fact that once gone, enamel cannot be replaced. Without that thin but hard protective coating, teeth are left exposed to heat and cold as well as acids and sugars.

Erika Feltham, a local dental hygienist, has been working for over 12 years to increase the awareness of the damage caused by sour acid candy. In the process, she has discovered that those same kinds of acids are also present in drinks that are regularly consumed by many, especially young people.

According to Feltham, who has extensively researched the problem, the acids are worse than sugar. She has seen an increase in enamel erosion, even in patients who have excellent oral hygiene. In an article for the California Dental Hygienists’ Association Journal, she wrote, “These irreversible changes are probably caused by an increased frequency of the consumption of sour candy. Some patients accelerate tooth erosion by washing down sour candies with sodas, sports/power drinks, fruit-flavored bottled waters and iced teas – all low pH beverages. This is a powerfully destructive combination.”

The problem is more severe for children and adolescents as their immature tooth enamel is more susceptible to erosion. They also tend to eat more sour candy which contains acids including ascorbic, acetic, adipic, citric, fumaric, lactic, malic and tartaric.

Feltham said that the candy companies have started using other label names to disguise the use of those acids, so parents should look out for ingredients such as natural or artificial flavors, organic fruit juice extracts, pure juice concentrates, juice purees and juice pastes/pulp extracts. The most common acids found in drinks are citric and phosphoric. [While fresh fruit also contains those and other acids, they are usually eaten more quickly than candy and so have less effect on teeth.]

Some beverages are worse for teeth than others and while the public is slowly becoming aware of the hazards of these acids, dental researchers have been studying them for several years.

A news release from the Academy of General Dentistry (AGD) back in February, 2005 reported on a study of drinks and acids: “This study revealed that the enamel damage caused by non-cola and sports beverages was three to 11 times greater than cola-based drinks, with energy drinks and bottled lemonades causing the most harm to dental enamel,” said J. Anthony von Fraunhofer, FRSC, FADM, lead author, Professor of Biomaterials Science at the University of Maryland Dental School.

At the end of the release, then AGD spokesperson Bruce DeGinder, DDS, said, “These findings are important and suggest that caution should be exercised when consuming popular sports beverages over long periods of time. We recommend altering or limiting the intake of soda and sports drinks and choosing water or low fat milk instead, to preserve tooth enamel and ultimately protect teeth from decay.”

For older youths, these drinks are more popular than sour acid candy, but cause the same problem. An AGD news release from Feb, 2008 stated that Raymond Martin, DDS, MAGD, AGD spokesperson, said he treats more patients in their teens to 20s for tooth erosion.

“They drink a great deal more sodas, sports drinks, and energy drinks. The results, if not treated early and if extensive, can lead to very severe dental issues that would require full mouth rehabilitation to correct,” said Martin.

Feltham adds canned iced teas and boutique, flavored waters to the list of worst offenders for causing erosion in enamel while including wine, grapefruit and orange juices in the acidic group. She also warns her patients to be careful with fruit-flavored cough drops and children’s chewable vitamins as she has found them to also have a low pH level (which means they are acidic).

With the great amount of candy available at Halloween time, and October being National Dental Hygiene Month, Feltham likes to use the holiday to spread the word that sour candy is not good for anyone’s teeth. Since she has also found those destructive acids in many popular drinks, she reminds everyone that “Early diagnosis and prevention of the effects of tooth erosion are fundamental to keeping teeth healthy for life.”

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Tips to combat dietary dental erosion

• Drink acidic fluids with a straw positioned at the back of the mouth

• Do not suck, chew or park sour candies for long periods of time.

• Swish or rinse mouth immediately with water after eating sour candies.

• Consume milk or hard cheese after eating sour candies to help neutralize the acid.

• Avoid natural/artificial fruit-flavored gum.

• Wait 30 minutes to one hour after eating sour candies to brush teeth to avoid scratching the acid softened tooth surface.

• Use a fluoride or an enamel enhancing toothpaste with low abrasiveness.

 

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