10 June 2019

When hearing the word ‘acid’ we might be likely to recall the various chemicals we saw in glass bottles in science class at school. Or maybe we think of it as the thing that can cause heartburn and indigestion.  However, acids also play an important role in our oral health.

While most of our diet is made up of things with generally low acidity, there are several foods and drinks that are high enough in acid to cause a problem.  High acidity foods and drinks can have serious consequences for our enamel and are the cause of dental erosion.

How acid affects our mouth

Acid is a problem for our teeth as it weakens the enamel of our teeth, leaving them vulnerable to damage. Every time we eat or drink anything acidic, the enamel on our teeth becomes softer for a short while and it loses some of its mineral content.

Our saliva will slowly cancel out this acidity and get our mouth back to its natural balance. However, if this acid attack happens too often, our mouth does not get the chance to recover.  This could result in slowly losing our enamel.

Enamel is the hard, protective coating of our tooth, which protects the sensitive dentine underneath. When the enamel is worn away, the dentine underneath is exposed, which may lead to pain and sensitivity.

The most common types of acid in our food and drink are carbonic acids, citric acids and phosphoric acids. These are the acids that weaken our enamel, leading to dental erosion.

The main culprits when it comes to acidic foods and drinks are the two Fs: Fizz and Fruit.

Fizz

‘Fizziness’ is often a tell-tale sign of an acidic drink.  The most common of these are fizzy drinks, sodas, pops and carbonated drinks. It is important to remember that even the ‘diet' brands are still harmful. Even flavoured fizzy waters can have an effect if drunk in large amounts, as they contain weak acids which can harm our teeth.

Some alcohol is also acidic. Beer, cider, prosecco, white wine and alcopops are all example of alcoholic drinks that are highly erosive for our teeth.

Dr Nigel Carter OBE, Chief Executive of the Oral Health Foundation says: “The best way for us to avoid the damage caused by fizzy drinks is to simply limit our exposure to them.  Only having acidic drinks at mealtimes is a great way to reduce the amount to which our mouth is under an acid attack.

“Another tip is to swallow our drink quickly, without holding it in our mouth or ‘swishing' it around.  Again, it’s all about reducing the amount of time our teeth are being exposed to acid.  An alternative is to use a straw.  This helps drinks go to the back of our mouth and avoids long contact with our teeth.”

Dr Soha Dattani, Director Scientific & Professional Affairs at GSK Consumer Healthcare says: “The drinks market is full of products which are high in acidity and that can play havoc on the enamel of our teeth. As consumers, this often makes it difficult for us to make healthy choices when choosing our drinks. This is true whether we’re in a supermarket, a restaurant, attending events or socialising.

“Plain, still water is the best drink for our teeth.  Milk is also good because it helps to neutralise acids in our mouth.”

Fruit

Fruit forms an integral part of a healthy balanced diet.  However, many fruits contain citric acid which can encourage dental erosion.

The worst offenders are citrus fruits. These have low pH levels, which means they are acidic.  The most acidic fruits are lemons, limes, plums, grapes, grapefruits and blueberries. Pineapples, oranges, peaches and tomatoes are also high in acid.

It would be a mistake to remove these from our diet – after all, they are really nutritious and our body needs them.  For our teeth, there are a few things we can do to limit the harm caused by fruits.

Dr Nigel Carter adds: “The first thing we can do, much as with fizzy drinks, is to keep them to mealtimes. Consuming fruit at breakfast, lunch and dinner should give our body the amount of daily portions it needs while not putting our teeth under unnecessary strain.

“Secondly, always try to consume fruit in its whole format and not as fruit juice.  While most fruit contains natural sugar, many fruit juices also have added sugar. This is not good for our teeth.  Whole fruit is also packed full of vitamins, minerals and fibre.  This is often lost or found in less concentrated forms when producing a fruit juice.”

More tips and advice

The first sign of dental erosion is often having sensitive teeth.  If this happens, we should go and see our dentist.  During an examination the dental team look at what is causing the sensitivity.  They will treat the affected teeth with special ‘de-sensitising' products to help relieve the symptoms.  This may include fluoride gels, rinses or varnishes.

While waiting for a dental appointment, the symptoms of dental erosion can also be managed at home.

“There are many brands of toothpaste on the market made to help remineralise softened enamel after an acid attack,” adds Dr Dattani. “Some toothpastes, like Sensodyne Pronamel are specially designed to help re-harden and protect our tooth enamel while we brush our teeth.  This toothpaste also contains fluoride, which is really important for protecting our teeth against tooth decay.  Brushing should be done for two minutes, twice a day.

“When we then see our dentist, they’ll be able to advise which type of toothpaste is best for our needs.”

For more information check out the Oral Health Foundation and GSK’s digital guide to dental erosion.  

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References

1. Oral Health Foundation (2019) ‘National Smile Month Survey 2019’, Atomik Research, United Kingdom, Sample Size 2,003