Why flavored waters are bad for your teeth

This article was originally published by Ellie Krieger on The Washington Post on April 25th

If sipping flavored water keeps you going throughout the day, I am sorry to burst your bubble. I know you are trying to do the right thing, staying hydrated and avoiding sugar and additives from sodas and other soft drinks. And the variety of fun new flavors on the market make otherwise boring water exciting to drink. If you are hooked, you are not alone.

Sales of LaCroix water, for example, with its splashy packaging and playful flavors such as tangerine and coconut, have more than doubled in the past two years, the Wall Street Journal reported. There has also been an explosion of tasty still waters , with enticing flavors such as strawberry-kiwi, watermelon and raspberry. But the hard truth is that drinking too much flavored water — sparkling or still — could do serious damage to your teeth.

The problem is that these drinks’ flavor essences, mostly citric and other fruit acids, cause significant tooth erosion — “the incremental dissolving away of the enamel on the teeth, which, over time, can affect their structural integrity, making them hypersensitive to temperature and potentially more cavity-prone,” explains Edmond R. Hewlett, consumer adviser for the American Dental Association and professor at the UCLA School of Dentistry.

[We drink too much sugar. Here’s what to know about your favorite beverages.]

A beverage’s pH is the main determinant of its potential to erode teeth. Anything with a pH less than 4 is considered a threat to dental health; the lower the pH, the more acidic a drink is, and the more harmful. Regular tap water typically has a pH between 6 and 8.

Carbonating that (which is adding carbonic acid) lowers its pH to about 5. (Happily, that is well in the tooth-safe zone, so you can go ahead and drink your plain sparkling water without worry.) The trouble starts when flavors are added, and the citric acid commonly used in bottled flavored waters is considered especially insidious because besides lowering pH it also may remove calcium from the teeth. A 2016 report published in the Journal of the American Dental Association found that un-carbonated flavored waters such as grape, lemon or strawberry Dasani had a pH of 3, only somewhat better than RC Cola and Coca-Cola, which were among the most acidic tested, at 2.32 and 2.37 respectively (and which are close to the pH 2.25 of pure lemon juice). On its website, the brand Hint says the pH of its waters range from 3.5 to 4.

When you add carbonation to flavored water, you get a one-two punch of acidity. A 2007 studyin the International Journal of Paediatric Dentistry concluded that flavored sparkling waters, some with a pH as low as 2.7, have the same corrosive potential as orange juice. That’s not to say that either of those drinks are bad choices for your overall health; they are just, in excess, potentially detrimental to your teeth. It’s also worth noting that for those concerned about their body’s overall acid-base balance as it relates to health, just because flavored waters are acidic, it does not mean they make your body more acidic. Many foods and drinks, such as tomatoes and orange juice, for example, are acidic themselves but have an overall alkaline effect once metabolized.

Although the news of the effect on your pearly whites might mean the end of the honeymoon phase between you and your beloved flavored water, it doesn’t have to mean divorce. Flavored water is still way better to drink than soda, which is not only more erosive but also has unhealthy amounts of sugar and empty calories. Instead of taking an all-or-nothing approach, consider these strategies to have your otherwise healthful flavored water in a way that minimizes dental damage.

Enjoying a sparkling mango water now and again isn’t an issue. “It’s frequent, regular consumption that can be dangerous to our teeth,” Hewlett says. “The problem is when people drink these beverages instead of plain water as their main hydration. The best beverage you can drink is plain fluoridated water.” So sip regular water or plain carbonated water to stay hydrated throughout the day, and save the flavored stuff for an occasional treat.

The faster you drink a beverage, the less contact it has with your teeth and the more time saliva is allowed to do its job neutralizing the acid in your mouth and returning it to the proper pH. If you are slowly sipping throughout the day, you are maintaining a consistent and undesirably high acid level. So drink up, then be done with it. And contrary to what you might suspect, “brushing your teeth right after may accelerate the loss of enamel,” Hewlett says, so don’t do that.

Eating stimulates the flow of acid-neutralizing saliva, so save that bottle of strawberry-kiwi water to drink along with a meal or snack to dilute the acid effect.

“There is a habit a lot of people have: holding or swishing carbonated water in their mouth. This can exacerbate the issue,” Hewlett says. And although there are no studies to confirm this, he says, it makes sense that using a straw may help minimize exposure. It couldn’t hurt.