The modern dietary and dental challenge

07 March 2024

Helen Astill examines the impact energy drinks and fizzy beverages are having on young people.

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 per cent of young people consumed one carbonated sugary beverage every day in 2022, a rise from 2018.

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, 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. 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.

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 680m UK units per year, and the European Food Safety Authority identified young people aged 10-17 as the greatest energy drink consumers, with British adolescents outranking all other participating European countries.

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. One in vitro study found well-known energy drinks were more powerful in this regard than a standard soft drink, such as cola.

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

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

An ongoing battle

The rise in popularity among adolescents also occurs at a time when oral health tends to worsen. This is due to more susceptible tooth surfaces, greater independence, and low prioritisation of oral hygiene. 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.

It's important to choose the right products for an effective oral hygiene routine. Patients may find immense benefits from the 100 per cent 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 per cent 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 today's teenagers—and all other energy drink consumers—by reinforcing messages of consistent and effective hygiene controls to maintain a brilliant, bright smile.

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