Sugar-free drinks and candies may erode your teeth - here's how

If you reach for a diet or sugar-free drink hoping to protect your teeth, you may not be getting the desired effect.

While sugar-free soda, sports drinks, and candies do reduce the risk of cavities, they could be slowly chipping away at your tooth enamel - what's called "dental erosion."

A new report from an Australian dental organization analyzed several peer-reviewed studies and concluded that sugar-free drinks and candy can cause dental erosion. The labeling of these products should change, the authors argue, so that consumers can make more informed choices.

The problem is that these drinks and snacks are typically acidic. Acid can soften the surface of teeth, eroding away the enamel over time. In serious cases, this enamel loss can require fillings, veneers, crowns, and even root canals as treatment.

Ingredients to watch out for include phosphoric acid, sodium citrate, citric acid, malic acid, fumaric acid, tartrates, and tartaric acid, the report notes.

While dentists have long focused on cavity reduction, the incidence of cavities is actually declining, while dental erosion seems to be on the rise.

Previous studies looking at the link between eroded teeth and sugar-free drinks have been small, and predominantly conducted outside of the US. Studies have concluded that regular soda can lead to dental erosion, but fewer have studied sugar-free drinks in particular.

The report cites two studies that found that sports drinks and sugar-free sodas in Australian schools did erode the enamel on human molars, but it is not clear what effects these drinks would have in people's mouths under typical consumption patterns. (The authors of the new Australian report included sports drinks in their analysis because "although these drinks are usually not sugar-free, they are often perceived by consumers to be a healthier alternative to traditional soft drinks.")

One review examining the effect of sugar-free candies on dental health concluded that while choosing them over regular sweets may help reduce cavities, things like "tooth-friendly" gum "may generate false security because people may automatically believe that sugar-free products are safe on teeth." People might not be aware, the authors write, that certain kinds of sugar-free candy can "bring another dental health risk, dental erosion, if they contain acidic flavouring."

Another review article cited a study that found a link between dental erosion and sports drinks, but concluded that it's tough to tell whether that one factor is what's causing enamel loss.

"There is no doubt that the acidic nature of sports drinks has the potential to cause dental erosion with animal and in vitro studies supporting this notion," the author wrote. "Combined, these studies indicate that isolating one dietary component as causative of erosion may be simplistic and factors such as drinking habit and salivary production may play a more influential role on the pathology."

One small study found the prevalence of dental erosion was fairly common in the US - 41% of the 129 children surveyed had enamel loss. A larger, nationwide study found that a similar percentage of US teenagers had dental erosion in at least one tooth.

So while reducing the amount of sugar in your diet is certainly good for your teeth (and your health in general), what else can you do to protect your smile? The report authors suggest you:

• Avoid both regular and sugar-free sodas, sports drinks, and candy.
• Drink more water.
• Get your regular check-up at the dentist.
• Swish water in your mouth after eating or drinking sugar-free products to remove some of the acid. Wait an hour before you brush your teeth.
• If you must drink acidic beverages, have them with food to try to reduce the potential for dental erosion.