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Youngsters’ tooth enamel imperiled by sour treats

Sour candies, some aimed at toddlers, can be devastating to tooth enamel. 
 (File Associated Press / The Spokesman-Review)
Sour candies, some aimed at toddlers, can be devastating to tooth enamel. (File Associated Press / The Spokesman-Review)
Anna Velasco Newhouse News Service

Most people know that sweets are bad for their teeth, but far fewer realize there’s a danger with sour treats, too.

Regular and diet soft drinks, candies – especially sour ones – and foods such as lemons are acidic. Repeated and frequent exposure to acid wears away tooth enamel, leaving teeth sensitive, less attractive and vulnerable to decay.

“Once you lose tooth structure, you never get it back,” said Dr. John Ruby, a pediatric dentist and associate professor at the University of Alabama at Birmingham School of Dentistry. “You can’t replace enamel. All we can do is cover it with a restoration.”

Ruby and his students have been cataloging the pH levels, or acidity, of popular drinks and candies and plan to publish the list in a pediatric dental journal.

A pH level of 7 is considered neutral, neither acidic nor alkaline. Ruby and his students have found many common drinks and candies have pH levels below 4 – acidic levels which cause direct tooth erosion.

A soft drink like Coca-Cola packs a double punch because it has heaps of sugar and a proportionate amount of acid to balance the sweetness. Diet drinks don’t carry the same risk of cavities because of artificial sweeteners, but they have plenty of phosphoric acid or citric acid to erode enamel.

Ruby is particularly alarmed by the proliferation of sour candies aimed at young children, and even toddlers. An Australian study published in January in the journal Pediatric Dentistry showed the risk of enamel erosion is even greater in baby teeth than in permanent teeth. Ruby said studies have not yet explored whether enamel erosion in baby teeth causes problems in permanent teeth, but he said young children are establishing bad habits that will be hard to break.

“What we’re really up against are dietary habits that become a way of life,” Ruby said.

One soft drink a day is not likely to cause major damage, Ruby said. But many people don’t stop at one and suck on sour candies throughout the day.

People with esophageal reflux also suffer from enamel erosion because stomach acids are very destructive, with pH levels between 1 and 2.

Ruby and his students found some popular candies are equally acidic. WarHeads Sour Spray drops for children had a 1.6 pH. Altoids Citrus Sours’ pH level was 1.9.

“These types of products are really devastating if you consume them all day,” Ruby said.

Ruby suggests parents who give their children juice stay away from “juice drinks” and offer real orange and apple juices because their pH levels are close to 4. Even so, juice consumption should be limited to 8-12 ounces per day according to the American Academy of Pediatrics, he said.

Drinking acidic beverages through a straw lessens the teeth’s exposure, and chasing the drink or candy with water helps to wash off harmful acid. But nothing works as well as drinking water and avoiding candies, Ruby said.

Worn enamel only gets worse over time, as layers wear more thin and become weaker.

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