The modern dietary and dental challenge

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  Posted by: Dental Design      16th March 2024

Day in, day out, the practice is guaranteed to see people who indulge heavily in fizzy drinks. They have become a regular part of the everyday lunchtime meal deal, a common choice when eating at restaurants, and are increasingly loved by teenagers especially. In the UK, around 12% of young people consumed one carbonated sugary beverage every day in 2022, a rise from 2018.[i]

Despite the efforts of oral health professionals and healthcare policies, we continue to see a concerning prevalence of fizzy beverages in the average diet. Most recently, energy drinks have entered the fray and gained popularity, creating another dietary problem for clinicians to tackle.

Big actions with big results

The detrimental effects of many fizzy drinks haven’t gone unnoticed over the years, at a public and governmental level.

In the UK, the ‘Sugar Tax’ introduced in 2018 was aimed at tackling childhood obesity,[ii] however it may have also brought further attention to the effect of sugary soft drinks on the enamel to the wider public. The World Health Organization called for a first-ever global tax on sugar-sweetened beverages in 2022, citing the successful implementation in the UK as an example.[iii] Dental cavities were a key factor behind the recommendation, alongside other general health issues such as type 2 diabetes, obesity and heart disease.

More than 5,500 childhood hospital admissions due to tooth extraction may have been averted every year since the levy was introduced in the UK.[iv]

However, there are still unfavourable signs that damaging habits are not yet removed from the public psyche.

Trouble for the sweet tooth

Generally high in caffeine and sugar, energy drinks have become a staple in the shopping carts of many people in the UK. Despite the sugar levy, this market has only continued to grow.

Sales have ballooned over the past decade to reach around 680 million UK units per year, and the European Food Safety Authority identified young people aged 10-17 years as the greatest energy drink consumers – with British adolescents outranking all other participating European countries.[v]

These are of great concern partly because of their acidic properties. Exposing teeth to such a substance creates the opportunity for changes in the structural integrity and physical properties of the dentition, incurring tissue loss over time.[vi] One in vitro study found well-known energy drinks were more powerful in this regard than a standard soft drink, such as a cola.v

Citric, Lactic and Malic acids are commonly found in energy drinks, dependent on the specific product. They are useful as flavourings and preservatives. However, they have been found to consistently decrease enamel hardness and cause demineralisation of the teeth.[vii]

High levels of caffeine are also concerning, with the ability to reduce salivary flow rate and decrease saliva production, leading to dry mouth symptoms.[viii] This could mean patients feel more dehydrated, or uncomfortable when swallowing.[ix] If salivary flow drops too far, tooth decay may increase,[x] which may be exacerbated by the acidity of ensuing energy drinks.

An ongoing battle

Clinicians should take note that the rise in popularity amongst adolescents also occurs at a time where oral health tends to worsen. This is due to more susceptible tooth surfaces, greater independence and low prioritisation of oral hygiene.[xi] The two aspects of teenage life could dovetail to detrimental effect.

The fundamental response may simply be to reiterate the need for an effective oral hygiene routine and remind patients of the risks high-caffeine and high-sugar energy drinks present, in a similar manner to excessive fizzy drink consumption. Brushing twice a day and using interdental brushes could go some way to mitigating the effects of energy drinks, but patients should be advised to wait around 30 minutes to an hour after consuming such a beverage to avoid further agitating recently acid-attacked teeth. It could also be useful to immediately rinse the mouth with water to flush out any remaining sugars and acids that are left over.[xii]

It’s important to choose the right products for an effective oral hygiene routine. Not all mouthwashes and toothpastes will achieve the same results. Patients may find immense benefits from the 100% Natural Baking Soda Toothpastes from Arm & Hammer™. These solutions effectively balance the oral pH to neutral levels, thanks to baking soda being naturally alkaline, whilst also helping to remineralise and strengthen enamel. The Arm & Hammer™ 100% Natural Baking Soda range features two options that are catered towards effective gum protection and whitening benefits, so your patients can choose the solution to suit their specific needs.

The energy drink boom is not yet looking like it will slow down, despite interventions such as the 2018 ‘Sugar Tax’. Dental professionals are best suited to helping the teenagers of today – and all other energy drink consumers – by reinforcing messages of consistent and effective hygiene controls to maintain a brilliant, bright smile.

For more information about the carefully formulated Arm & Hammer toothpaste range, please visit

https://www.armandhammer.co.uk/ or email:

ukenquiries@churchdwight.com

Helen Astill is qualified as a dental hygienist and holds a BSc (Hons) in applied science / nutritional therapy. She Currently works at two dental practices in Dorset along with working part time as a registered vaccinator and a professional educator for Waterpik.

 Arm & Hammer oral healthcare products can now be purchased from Boots, Amazon, Superdrug, ASDA, Sainsbury’s, Tesco, Morrison’s, Waitrose & Partners and Ocado.

 [i] Hulbert, S., Eida, T., Ferris, E., Hrytsenko, V., Kendall, S. (2023). HBSC England National Report: Findings from the 2001-2022 HBSC study for England. University of Kent.

[ii] HM Treasury, (2018). Soft Drinks Industry Levy comes into effect. GOV.UK. (Online) Available at: https://www.gov.uk/government/news/soft-drinks-industry-levy-comes-into-effect [Accessed November 2023]

[iii] World Health Organisation, (2022). WHO calls on countries to tax sugar-sweetened beverages to save lives. (Online) Available at: https://www.who.int/news/item/13-12-2022-who-calls-on-countries-to-tax-sugar-sweetened-beverages-to-save-lives [Accessed November 2023]

[iv] Rogers, N. T., Conway, D. I., Mytton, O., Roberts, C. H., Rutter, H., Sherriff, A., … & Adams, J. (2023). Estimated impact of the UK soft drinks industry levy on childhood hospital admissions for carious tooth extractions: interrupted time series analysis. BMJ nutrition, prevention & health, e000714.

[v] Vogel, C., Shaw, S., Strömmer, S., Crozier, S., Jenner, S., Cooper, C., … & Barker, M. (2023). Inequalities in energy drink consumption among UK adolescents: a mixed-methods study. Public Health Nutrition, 26(3), 575-585.

[vi] Meira, I. A., & Sampaio, F. C. (2021). Influence of energy drinks on enamel erosion: In vitro study using different assessment techniques. Journal of Clinical and Experimental Dentistry, 13(11), e1076.

[vii] Clapp, O., Morgan, M. Z., & Fairchild, R. M. (2019). The top five selling UK energy drinks: implications for dental and general health. British Dental Journal, 226(7), 493-497.

[viii] Srivastava, R., Tangade, P., Priyadarshi, S., Agarahari, P., & Kumari, T. (2023). The brewed connection: A comprehensive review of the relationship between caffeine and oral health. International Journal of Dental Research, 5(2), 68-74.

[ix] Oral Health Foundation, (N.D.). Dry Mouth, (Online) Available at: https://www.dentalhealth.org/dry-mouth [Accessed November 2023]

[x] Husseinzadeh, Z. (2022). The relationship between saliva and the prevalence of tooth decay: A mini review. Academic Journal of Health Sciencies: Medicina balear, 37(3), 46-50.

[xi] Tsai, C., Raphael, S., Agnew, C., McDonald, G., & Irving, M. (2020). Health promotion interventions to improve oral health of adolescents: A systematic review and meta‐analysis. Community dentistry and oral epidemiology, 48(6), 549-560.

[xii] Schaefer, A., Frank, C., (2018). How Does Drinking Soda Affect Your Dental Health? Healthline. (Online) Available at: https://www.healthline.com/health/dental-oral-health/what-does-soda-do-to-your-teeth [Accessed November 2023]


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