The erosion of enamel at the incisal edge can be an aesthetic and functional problem for patients. It can create grooved or chipped teeth, with the potential for increased translucency which creates a bluish appearance.[i] As erosion progresses, dentine is further exposed, which can facilitate tooth sensitivity.[ii]
There are a variety of causes for dental erosion. One prominent factor is diet, especially relevant with the modern beverage choices. Soft drinks, including carbonated treats and fruit juices, can have a significant impact.i
Both clinicians and patients should be aware of the problems that soft drinks can create in the dentition. This helps patients inform their dietary choices, and begins to equip clinicians for identifying restorative opportunities.
Keep it carbonated
Carbonated drinks are known to have a high erosive potential, but the problem is worsened by the prevalence of these beverages in modern life.i Many patients are trying to seek out ‘healthier’ options – between 2016 and 2021 in the European Union, the proportion of low/no calorie soft drink sales shifted from 23% to 30%, with regular soft beverages decreasing from 77% to 70%.[iii] In spite of this, detrimental effects are still widespread.
Erosion is recognised as a non-carious lesion of the tooth surface, where there is the permanent and continuous loss of enamel and dentine. The acid pH of soft drinks causes changes to the enamel surface; as the oral pH lowers, patients are at a greater risk of harm.[iv] The process doesn’t just rely upon acidic pH alone, as the mineral content of soft drinks and the ability to chelate calcium from foods and beverages can each increase the effects of erosion, alongside the presence of carbonic acid.iv
It’s important to note that most soft drinks commercially available have a higher acidity level than that tolerated by the dentition;iv a study into drinks available to American consumers found some of the most popular brands had drinks that were within 0.15 pH of lemon juice.[v] Patients can enjoy these drinks at their leisure, but their daily consumption is linked to dental deterioration, and the consumption of soft drinks with meals is connected to mild or severe tooth decay.iv Patients should be aware of this, and in turn ensure they have an appropriate intake.
Non-stop risk
One significant issue with modern soft drink consumption is the continuous exposure to harmful acids. The literature has found that acids in the mouth begin to erode enamel when the oral pH is lower than 5.5, sometimes called the crucial pH threshold, and the longer that the dentition are subject to this state, the increased opportunity for caries and erosion incidence.[vi]
Salivary flow helps to avoid this in part. The oral clearance rate of soft drinks has been found to be around 14 minutes,vi which is admittedly a short time for the dentition to be exposed to acidic beverages. However, if, for example, a patient has a soft beverage over the course of an hour, the oral pH may not completely recover so quickly; their teeth are then at greater risk of erosive harm and caries development for longer. For individuals having multiple soft drinks a day, many days of the week, the effects can quickly add up as the exposure increases in longevity.
A sustained effect of soft drinks is all the more likely due to their addictive nature. In one 2020 study, the cessation of sugar-sweetened beverages over just a three-day period led to adolescents experiencing withdrawal symptoms and increased cravings,[vii] which would prompt individuals to keep seeking out these treats and continuing to fall below the crucial pH threshold.
On hand for support
When patients experience erosion in the dentition, most often seen in the palatal surface of the maxillary central incisors and the occlusal surfaces of the lower molars,[viii] clinicians need to be able to support them with confidence. Alongside individualised oral health instruction, with a discussion about the role of diet and soft drink consumption, this support includes providing high-quality restorations.
The 3M™ Filtek™ Easy Match Universal Restorative from Solventum, formerly 3M Health Care, is the versatile solution that supports dental professionals’ expertise and craftmanship. With a naturally adaptive opacity, the restorative creates a brilliant finish throughout the dentition, including an enamel-like translucency on the bevel and incisal edge. It also features excellent wear resistance and strength, to support patients long into the future.
Soft drinks have a substantial impact on the dentition. Improved patient knowledge may influence consumption, but clinicians will always be on hand to provide support.
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[i] Royal College of Surgeons of England, (2021). Clinical guidelines for dental erosion. Diagnosis, prevention and management of dental erosion. (Online) Available at: https://www.rcseng.ac.uk/-/media/files/rcs/fds/guidelines/erosion-guidelines_2021_v4_mj.pdf [Accessed May 2025]
[ii] Vevers, S., Frank, C., (2022). What to know about dentin hypersensitivity. Medical News Today. (Online) Available at: https://www.medicalnewstoday.com/articles/dentin-hypersensitivity [Accessed May 2025]
[iii] Walton, J., & Wittekind, A. (2023). Soft drink intake in europe—a review of data from nationally representative food consumption surveys. Nutrients, 15(6), 1368.
[iv] Inchingolo, A. M., Malcangi, G., Ferrante, L., Del Vecchio, G., Viapiano, F., Mancini, A., … & Patano, A. (2023). Damage from carbonated soft drinks on enamel: a systematic review. Nutrients, 15(7), 1785.
[v] Reddy, A., Norris, D. F., Momeni, S. S., Waldo, B., & Ruby, J. D. (2015). The pH of beverages available to the American consumer. Journal of the American Dental Association (1939), 147(4), 255.
[vi] Virk, J., Malhan, S., Sandhu, G. K., Sood, H., & Prabhakar, D. (2024). To assess the effect of selected locally available beverages on salivary pH, flow rate, and oral clearance rate among adults. Journal of Conservative Dentistry and Endodontics, 27(8), 833-837.
[vii] Falbe, J., Thompson, H. R., Patel, A., & Madsen, K. A. (2019). Potentially addictive properties of sugar-sweetened beverages among adolescents. Appetite, 133, 130-137.
[viii] Longurova, N., Snezana, I., Kovachevska, (2017). The Impact of Carbonated Drinks on the Onset of Dental Erosions in the First Permanent Incisors and Molars in Examinees at the Age from 10 to 29 Years, IOSR Journal of Dental and Medical Sciences. DOI: 10.9790/0853-160204121128 Available at: https://eprints.ugd.edu.mk/17582/1/IOSR%201.pdf [Accessed May 2025]
