Energy Drinks Are Erosive To Tooth Enamel


Posted on Jul 12, 2024 by William J. Claiborne, DDS MS

In the U.S., over one-third of adults ages 18 to 29 admit to being regular consumers of energy drinks. For those in the 30 to 49 age group, that number jumps to nearly 42%.
https://www.statista.com/forecasts/228168/energy-drinks-consumption-usa

While many adults like having an afternoon pick-me-up readily available through a beverage, there is growing concern regarding the potential of these drinks to erode tooth enamel.

To begin, most energy drinks are high in sugar as well as highly acidic. The acidity is a particular problem because acid is destructive to tooth enamel as soon as it makes contact. Its damage begins as soon as it reaches enamel and continues with each sip.

The American public is likely unaware of just how acidic these energy drinks are. To acknowledge the extent of acidity in these beverages, the pH levels typically range from 1.5 to 3.3, which is exceptionally acidic. These include common brands such as TNT Energy Drink®, Red Bull®, and Monster Energy®.

Comparatively, fairly neutral levels for foods or beverages range 6 to 8 pH. The closer to 0, the more acidic, meaning the 1.5 – 3.3 levels of energy drinks are cause for concern. Because the pH level of the mouth is directly affected by the foods and drinks we eat, oral pH levels directly effect the health of teeth and gum tissues.

“Normal” saliva pH is generally 6.2 – 7.6. When the pH levels in your mouth go below 5.5, the higher acidity starts to break down the protective enamel on teeth, leaving you at a higher risk of developing cavities.
https://periodontalhealthcenter.com/blog/how-energy-drinks-affect-teeth-and-gums/t

As acidity of a liquid increases, the pH number rises. For example, water and milk have a pH of 7.0, very low acidity. Lemon juice has a pH of around 2.0. Battery acid has a pH of 0.0. With the numbers of energy drinks in the 1.5 to 3.3 range (Red Bull has a pH of 3.3 and Monster Energy has a pH of 2.7) erosion of tooth enamel is almost a given for regular consumers.

Because of the erosive effects to teeth from energy and sports drinks, a study was recently conducted to evaluate the true severity.

In the analysis, pH values, titratable acidity, and buffering capacity of energy beverages were measured. For the erosive test, specimens were immersed in the beverages for 30 minutes at room temperature with gentle shaking (to mimic consumption). Loss of surface hardness was calculated at various points of the time period.

The energy drinks had pH values ranging from 2.36 to 3.41 (with the lowest acidity for Monster Energy® and the highest for TNT Energy Drink®). All the energy drinks were shown to be erosive to tooth enamel with TNT Energy Drink® showing the worst behavior.

Journal of Clinical & Experimental Dentistry
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8601704/

It’s not unusual for some people to consume up to four energy drinks a day, which creates a flood of acid coating teeth several times in extended periods (since these drinks are typically consumed over a period of time rather than downed quickly). When you consider that these drinks can be as corrosive as battery acid, it’s easy to see how tooth enamel can be vulnerable.

Ninety-six percent of tooth enamel is mineral content. Tooth enamel is the outer protective coating of teeth. Tooth enamel is the hardest substance in the body and has the most minerals in the body.

Signs that your tooth enamel is damaged and eroded are:
• Sensitive teeth
• Teeth turning yellow
• Transparent tips of teeth
• Teeth developing cracks or dents
• Cavities

Tooth enamel is irreplaceable. Once it’s gone, it’s gone forever. Protecting your teeth and gums requires more than just a couple of brushings per day. Good dental hygiene depends on several factors including what you eat/drink, genetic make-up, lifestyle, personal hygiene and susceptibility to dental problems in general. However, subjecting your teeth to frequent onslaughts of acid washes is going to eventually catch up to you in ways that are expensive and time-consuming to repair.

And, before rushing to the sink after downing an energy drink to ward off potential damage, hold off a bit or you may simply add to the damage. If you brush your teeth after consuming anything acidic (including citrus, colas, coffee, tea, tomatoes), the bristles of a tooth brush and abrasive substance of toothpaste against weakened enamel will merely add to the destruction.

Wait at least 20 minutes after eating and drinking so you don’t damage the enamel. This allows the acid levels to re-elevate. It is wiser to drink a glass of water to wash away food residue and acid remaining on teeth or in your mouth.

If you have not received regular dental care or have concerns that your oral health is at risk (perhaps due to the effects of what you eat, your overall health, or things like smoking, etc.), it is recommended that you have a thorough periodontal examination.

A periodontist is a dentist who has continued in education to specialize in the diagnosis and treatment of all areas of the tissues in the mouth. In addition to treating all phases of periodontal (gum) disease, we are uniquely qualified to reshape gum tissues. We also have advanced training in the diagnosis and placement of dental implants.

Although gum disease can begin without obvious signs or symptoms, the most common are:

• Red, swollen or tender gums
• Seeing blood in the sink when brushing
• Receded gums
• Loose or separating teeth
• Pus pockets on gum tissues
• Sores in the mouth
• Persistent bad breath

If you are experiencing symptoms of gum disease or have not received regular dental care, call 828-274-9440. We’ll arrange a periodontal exam in our comfortable Asheville periodontal office. Oral and I.V. sedation (“twilight sleep”) are available and safely administered.

If you have already experienced tooth loss, let’s discuss replacing missing teeth with dental implants. Designed to last a lifetime, dental implants are the ideal tooth replacement option and restore the natural look feel and function like that of natural teeth.

Our Western NC periodontal dental office offers some of the industry’s most advanced technology in dentistry including that to diagnose and select (and guide) ideal implant placement angles and depths.

You can also begin with a consultation appointment to get to know us and learn about our advanced technology, often saving our patients treatment time while enhancing comfort.

If financial constraints are a concern, ask about our easy payment plans. These can break treatment fees into monthly payments that are manageable to most budgets.

 

 

The “Risk vs. Reward” of Oral Health


Posted on Jun 25, 2024 by William J. Claiborne, DDS MS

Risk versus reward.

This is a phrase that’s often associated with decision-making, such as stock market investments. While certain strategies can increase the potential for “reward,” there is still an element of “risk” in losing part or all of the investment.

As a periodontist in Asheville, I see this in how it relates to decisions in dentistry. This is the case in replacing lost teeth. As a periodontal specialist, I place many dental implants in patients who’ve lost teeth that likely could have been kept had the patient made different decisions.

I also see this is in the decision of patients to have a crown (“cap”) placed on teeth. When a dentist recommends a crown, it is typically to keep the existing tooth structure intact and protected. So, when a tooth that’s been filled and needs yet another filling, the dentist may advise crowning the tooth instead. This preserves the remaining structure by avoiding the “risk” of tooth from breaking off.

Or, when a tooth shows signs of fracture(s), crowning may prevent the tooth from the need for removal. This is because a tooth that eventually breaks below the gum line can no longer be saved. Once removed, tooth replacement brings on an entirely new set of decisions, and costs.

Your general dentist’s goal, like yours, is to help you achieve and maintain a healthy smile. He or she wants you to keep your natural teeth or, if tooth loss does occur, replace them in a way that supports your overall oral health. A periodontist can be a strong team player in this goal.

A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease and in the placement of dental implants. A periodontist is also a specialist in reshaping gum tissues, for reasons that may include esthetics as well as maintaining oral wellness.

I place many dental implants and am a proponent of them as a superior tooth replacement option. However, as ideal as an implant is, there is nothing as good for your oral health as natural teeth. This is why it’s so important to keep them. This may, for certain teeth, require the placement of a crown.

A periodontist may be involved in certain aspects of treatment to optimize a patient’s results and success level while minimizing discomfort. For instance, a periodontist may work with your general dentist to help save a tooth from removal when a tooth has broken close to the gum line. This is accomplished through crown lengthening procedures where gum tissues are removed to expose more of the tooth. This may be able to make sufficient tooth structure available to support a crown.

Crown lengthening is also beneficial in sealing gum tissues surrounding a tooth at its base. By securing the tissue around the tooth or crown, bacterial entry is avoided and the risk for periodontal (gum) disease decreased. This is especially beneficial in cases where gum tissues have receded, exposing sensitive tooth root sections that are easily affected by oral bacteria.

In some cases, gum tissue height can be corrected by careful removal in a procedure known as a gingivectomy. To enhance the appearance of a smile with an esthetically-pleasing smile line, combined with the placement of crowns, the tooth-to-gum ratio is rebalanced.

This is what is often referred to as a “gummy smile.” Crown lengthening is a common method that teams your general dentist with a periodontist to create a smile that looks natural and is beautifully flattering.

Another look at the risk-reward consideration, the “risk” of not caring properly for oral health can easily upend the “reward” of having a healthy smile. Regular dental check-ups and a thorough at-home oral hygiene regimen can prevent the development of cavities and periodontal disease.

When oral bacteria levels in the mouth are not managed, the teeth and gums pay the price, often through the need for costly treatment that may have been prevented. Periodontal disease is the nation’s leading cause of adult tooth loss.

Research has also found that the inflammatory bacteria of gum disease can enter the bloodstream, triggering or worsening a long list of serious health problems. These include heart disease, stroke, high blood pressure, diabetes, arthritis, memory loss, some cancers, impotency and Alzheimer’s disease.

Although gum disease can exist without obvious signs or symptoms, the most commonly noticed are:

• Red, swollen or tender gums
• Seeing blood in the sink when brushing
• Receded gums
• Loose or separating teeth
• Pus pockets on gum tissues
• Sores in the mouth
• Persistent bad breath

As a periodontist in Asheville, we want everyone to know the benefits of a healthy, confident smile. Maintaining healthy gums and keeping your natural teeth is important to every individual.

If your gum health needs improvement or there are signs of gum disease, we can structure a program that restores healthy gums and helps you maintain your oral health between visits.

For those who have already experienced tooth loss, we are happy to discuss the process to replace them with dental implants. These are the closest thing to the natural teeth you had and will restore stability and dependable biting and chewing. Too, dental implants are designed to last a lifetime, making them an excellent investment.

With proper measures, you can enjoy healthy gums and natural teeth throughout your lifetime. Call 828-274-9440 to schedule a periodontal examination or ask for a consultation to get to know us. A referral to our office is not required.

If dental fear or anxiety has kept you from receiving regular dental care, please ask us about oral or I.V. sedation (“twilight sleep”). Both are administered safely with patient comfort always a priority.

Females & Males – Oral Health Differences


Posted on Jun 05, 2024 by William J. Claiborne, DDS MS

As a periodontist, I have an intense understanding of how oral health impacts the overall health of both males and females. However, my specialized skills also allow me to understand the unique factors that affect the oral health of our female patients.

As a result of hormonal fluctuations, females can face particular challenges when it comes to oral wellness. For example, pregnancy gingivitis is not uncommon in women during pregnancy. If not treated and resolved, however, it can develop into periodontitis (advanced periodontal disease) and subsequent tooth loss.

A good illustration of how women face unique oral health challenges was noted in findings shared recently on Fox News. (https://www.foxnews.com/health/women-experience-dental-health-issues-men-experts-say-heres-what-do-about)

Using a pH meter, the pH levels in saliva were tested on multiple people over the course of many years. The researchers found the pH of women’s saliva was frequently 5.5 or 6 – a lower saliva flow rate than men.

Saliva’s ideal pH rate is between 7 and 7.4. If the pH of saliva constantly drops below 5.5, the tooth enamel gets demineralized, which means it will be more prone to tooth decay. Because the aging process causes a lower flow of saliva, a drier mouth weakens teeth due to the slower remineralization or buffering capacity.

Below are some of the different phases of life that can be accompanied by various challenges to a female’s oral health:

Puberty: Estrogen and progesterone hormones produced during puberty increase blood flow to the gums. This changes how the gums respond to plaque, the sticky film of bacteria in the mouth. With this may be gums that bleed when brushing and become red, tender, and swollen.

Menstruation: The menstrual cycle causes hormonal changes that cause some women to experience symptoms such as swollen gums that turn bright red, canker sores, or gums that bleed easily. Referred to as menstruation gingivitis, this usually occurs just prior to the onset of the period and resolves in a day or so.

Oral Contraceptives: Taking birth control pills that contain progesterone cause some women to have gum tissue inflammation. This occurs from heightened sensitivity to the toxins produced from the overload of bacteria that form plaque. While many women have less gum reactions after the first few months, some medications can lower the effectiveness of oral contraceptives. This reinforces the need to keep your dentist updated on all medicines you take.

Pregnancy: With each trimester of pregnancy, hormonal levels can change. Pregnancy also causes increased progesterone levels, which can increase the risk for plaque formation. This can lead to pregnancy gingivitis, particularly during the second to eighth month of pregnancy. This condition causes the gum tissues to become swollen and bleed easily. Gingivitis is the first stage of gum disease, which is why it is important to have gingivitis fully resolved to prevent its further progress. Because studies have found that gum disease can increase the risk for preterm and low birth weight babies, obstetricians are urging their pregnant patients to be particularly diligent in maintaining good oral health.

Menopause: With age, a variety of changes can take place in our mouths for both males and females. A particular challenge is the decrease in saliva flow, leaving the mouth is less moist. Additionally, the side effects of certain medications can pose challenges to keeping the gums healthy. Without adequate saliva flow to keep the mouth cleansed and efficient in neutralizing the acids from plaque, the risk for gum disease is greater for females in menopausal years. Declining estrogen levels also place women at greater risk for bone loss or osteoporosis as well as inflamed gum tissues around the teeth (called periodontitis). When there is bone loss of the jaw, it can result in tooth loss. Receding gums are a sign of this bone loss since more of the tooth surface is expose to the causes of tooth decay.

Researchers in Romania studied the gender differences in oral health. Through an online survey of 600 adults, the study assessed attitudes, behaviors, and educational understanding related to oral health and dental services.

The results show that women have more positive attitudes towards dental services with higher oral health values, better self-care behaviors, and have higher oral health literacy than men.

While the study indicated that oral care attitudes and behaviors of men had different influencing factors, women were primarily influenced by their level of oral health literacy. The study also noted that differences in oral health attitudes and values for both genders can be based upon education.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604615/

This is a good reason to stay on top of how intricately your oral health is to your overall health. Because the bacteria of periodontitis can penetrate the bloodstream through weak gum tissues, it has been correlated to a long list of serious health problems.

Research has found that periodontal bacteria can trigger the development or worsen the likelihood of heart disease, stroke, some cancers (including pancreatic and lung
cancer), preterm babies, diabetes, arthritis, erectile dysfunction, Alzheimer’s disease and more.

Although gum disease can exist without obvious signs or symptoms, the most commonly noticed are:

• Red, swollen or tender gums
• Seeing blood in the sink when brushing
• Receded gums
• Loose or separating teeth
• Pus pockets on gum tissues
• Sores in the mouth
• Persistent bad breath

In our Asheville periodontal dental office, patients can begin with a private consultation. We are always happy to discuss oral health options with new patients. A referral is not needed.

Call 828-274-9440 to schedule.

Know How Summer Comes With Oral Health Risks


Posted on May 20, 2024 by William J. Claiborne, DDS MS

As an Asheville periodontist, there are two times a year I feel come with higher risks for keeping one’s oral health well-maintained.

One is during the Thanksgiving-Christmas season. During these times, people tend to consume food and beverages that are higher in carbs and simple sugars. And, they eat more frequently. I understand – it’s pretty hard not to sneak a piece of grandma’s fudge with a mid-morning cup of coffee!

Although the hardships to teeth and gums brought on by these indulgences may be diluted by swishing or an extra brushing during the day, summertime has its own set of challenges that are rather similar.

First, understand that any time you eat or drink something (other than plain water), an acid attack begins in the mouth. This acid flows in with saliva, bringing in an acid to break down food as its chewing; the body’s first stage of digestion. These acids are rather potent in that they can even soften enamel for 20-30 mins. Thus, when other acidic elements are introduced in the mouth, the higher levels of acid can leave precious tooth enamel at risk.

Below are things to keep in mind as we go into the official “it’s okay to wear white” season!


Oral acidity – Summer foods and beverages seem to come with a wealth of consumables that are high in acidity – garden fresh tomatoes, lemonade, water or tea with a squeeze of lemon, etc. Just know that they need to be diluted by swishing with water or drinking gulps of water while consuming.


Colas – I can’t say enough bad things about colas when it comes to oral health. While sodas, coffee, tea and wine are all highly acidic, the acidity levels in colas have been compared to nearly that of the levels in battery acid. Colas are highly acidic because they are infused with phosphoric acid, intended to add flavor. Phosphoric acid is so erosive it can remove rust from aircraft carriers and ships.

When these erosive acids are mixed with the acids that occur naturally in the mouth, there is a significantly higher potential to erode tooth enamel. Dental erosion can cause temperature sensitivity, pain, transparent teeth, cracking and darkening of teeth.

Also concerning is the way colas are consumed. Every time you sip a soda, an acid attack in the mouth is triggered for 20-30 minutes until eating or drinking ceases. Because colas are typically consumed slowly over long periods of time, the acid attack lasts that long plus another 30 minutes before subsiding. For colas containing sugar, this mixes with the acid in the drink and your digestive acids for an even greater level of destruction.


Accidents & injuries to the mouth – Outdoor sports and activities such as skiing, biking and baseball should all be done with a custom-made mouthguard in place. This is important for children and adults. Having a permanent tooth knocked out can be devastating.

If the worst should happen, a periodontist is your specialist in placing dental implants. And, by acting soon after the tooth is lost, you can preserve the natural contours of the gum tissues that arch the tooth. These arches of gums help to create a natural appearance when the replacement tooth is placed along with the “points” that dip slightly between each tooth.

A periodontist has advanced skills in the diagnosis and placement of the implant type best for individual needs. In our Asheville periodontal dental office, we use advanced imaging and implant guidance technology that helps to minimize treatment and optimize comfort with reduced healing time.


Oral Dryness“Dry mouth” promotes oral bacteria by enabling rapid reproduction. When oral bacteria are able to linger in the mouth, they have an ideal warm, dark, moist environment. Without saliva serving as a continual rinsing agent to keep bacteria levels in the mouth under control, oral bacteria accumulate at a rapid pace.

Water intake helps to support saliva in the mouth to rinse bacteria and food particles from the mouth. Sufficient saliva flow helps in neutralizing the acids produced by oral bacteria and aids in preventing tooth decay and the development of periodontal (gum) disease.


By understanding where the risks lie, you can take proactive measures between visits to prevent things like cavities and gum disease.

An overload of oral bacteria initially reveals itself as plaque, at first. This is a sticky film that coats the teeth and gums, which is easily noticeable upon waking up. If not thoroughly removed each day, it can hardened at the base of teeth. This is known as tartar.

Tartar is a cement-hard colony of bacteria, which feed on tender gum tissues. This can cause tender gums that bleed easily when brushing and more frequent bad breath.

This early stage of gum disease is known as gingivitis. If not resolved quickly, it can easily progress. Periodontal disease is an inflammation of the gum tissues that causes bleeding, swelling, persistent bad breath and gum recession. As it worsens, gum disease can enter the advanced stage of periodontitis. In this, infectious oral bacteria attack the area below the gum line, including bone and tissues that support natural teeth.

The bacteria can also enter the bloodstream through tears in diseased gums. The inflammatory nature of this bacteria can trigger a number of serious health problems, including heart disease, stroke, some cancers, diabetes, arthritis, pre-term babies and more. Periodontal disease is also the nation’s leading cause of adult tooth loss.

Summer is a wonderful time for vacations and being more active outdoors. However, don’t let your daily oral care regimen result in costly repairs down the road. Avoid taking “time off” from your twice-a-day oral hygiene routine so bacterial growth doesn’t require dental treatment as a result.

When vacationing, some tips for your oral upkeep include:

• When packing, place your tooth brush, floss and toothpaste in one container separate from other items. Once you arrive at your destination, place this by the sink so they are handy each morning and evening.
• Take along sugarless gum to help you maintain sufficient saliva flow in the mouth. This aids in removing bacteria before it builds into the stick film that forms plaque.
• Brush at least 2 minutes per brushing followed by brushing your tongue to dislodge embedded bacteria.
• If you can’t brush right after a meal, swish with water or chew sugarless gum.
• Drink lots of water throughout the day to keep oral tissues moist.

Call 828-274-9440 if you have questions about your gums or if you are experiencing symptoms of gum disease. This disease will only worsen without treatment. You may also wish to begin with a consultation.

You are invited to visit our website to learn more about dental implants, sedation options (including “twilight sleep”) and advanced technology.

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