Rx For Readers: The things you drink imperil your dental health

It’s not just sweetened drinks – plain soda water may also be chomping at your teeth.

By JUDY SIEGEL-ITZKOVICH
Sparkling water (photo credit: INGIMAGE)
Sparkling water
(photo credit: INGIMAGE)
I am a 35-year-old woman. As I don’t drink coffee, tea, juices or sweetened soft drinks (especially cola!); but I do drink plain soda (carbonated water without sugar or artificial sweeteners) quite a lot.
I was wondering whether such an acidic liquid causes harm to the teeth with its carbon dioxide gas. Does it?
— V.G., Tiberias
Retired Jerusalem dentist Dr. Steve Sattler comments: The enamel that covers the dentin of the teeth (primary and adult teeth) is a living barrier against damage to the dentin and the root of the tooth. It is constantly losing and gaining calcium and fluoride atoms.
The saliva – the important liquid that flows across the teeth, the gums and down the throat – is the reservoir of calcium and fluoride (and other) atoms that replace the lost atoms in the mineral structure of the enamel.
Saliva has a pH of about 7.4 (clean water is 7), and is thus slightly alkaline.
For many years it was thought that enamel is “dead” and inactive, but this has been found to be incorrect.
Soda water (a simple carbonic acid) has a pH of 3 to 4. Lemon juice is about 2 and cola is 3 to 4.
The answer to your question is no... and maybe yes. If your teeth are naturally strong and your saliva flow is normal, then probably your teeth will suffer no damage.
Thus, any acid we put into our mouth frequently and daily, such as cola, lemon juice, soda, tea, fresh fruit, juices and wines will cause the very important calcium atoms to leach out of the enamel.
Saliva has the natural task of constantly washing the teeth and bathing it with new calcium and fluoride atoms.
So if we don’t brush and floss our teeth well and frequently, we get a layer of plaque on our teeth that is only one to two millimeters thick. The plaque also has a pH of about 7.2. If we constantly drink acidic liquids, the plaque become acidic. This acidic layer (about pH 5) is constantly touching the enamel.
Thus the enamel is in a constant acidic environment, and the calcium atoms leach out and weaken the natural strength of the enamel. Then the teeth need constant attention by a dentist – large fillings, crowns, root canal and the occasional extraction.
As to your specific question, the carbon dioxide gas is not the problem. The acid solution – the hypochloride molecule – could chemically eat away at the exposed enamel. If your teeth are weak – from illness, multiple pregnancies or from genetics, or your saliva flow is inadequate or very thick – then the acid that envelopes the teeth for a few hours a day every day will probably cause the enamel to lose calcium. Then your chances of having broken or crumbling teeth or dental decay are much higher.
So don’t go overboard; drink a lot of plain water to wash out your mouth.
There is a simple test anybody can do. Put a child’s milk tooth in lemon juice for a few days and watch the acidic juice eat away at the tooth. But these are not the same conditions as in the mouth. So you are advised, if you drink a lot of carbonated water, to drink it through a straw so the acidic liquid passes directly to the throat.
I am a 64-year-old overweight man. I have in recent years had pains in my knee, and the orthopedist, who sent me for an X ray and MRI, said I needed surgery to replace the joint due to erosion of cartilage. But since then I have lost 13 kilos, from my 107 kilos, and have been walking extensively, some 15 kilometers a week, and have strengthened my legs. I felt no pain until a few days ago, when I made a bad movement and my knee started to hurt.
I went to a different (rather elderly) orthopedist from my health fund, who said that running (which I don’t do) is “very bad” for me and walking is also “not good” – but less harmful than running.
Using an elliptical machine would be better, he advised. But he said there is “no cure” or way to alleviate pain or restore cartilage, so that I would inevitably need a knee replacement. I’d like to know whether walking, which has really helped me, is “bad” for such a problem, and whether I can continue doing it if it makes me feel well. I would prefer not to have surgery, as my knee does not hurt me now. Do you recommend walking with Nordic poles to relieve knee pain in my case?
— L.M., Haifa
Prof. Meir Liebergall, head of orthopedic surgery at Hadassah University Medical Center in Jerusalem’s Ein Kerem, comments: It’s very difficult to respond without examining you and looking at X rays and scans. It’s clear that it’s good to lose weight to reduce the burden on knees.
Physical activity is very good, but make sure you don’t overdo it.
You must first get out of the acute stage of pain and then return to moderate physical activity. At the same time, you may eventually need surgery to have a knee joint replacement. I don’t see a problem with Nordic walking poles, which have been shown in clinical studies to reduce pain in knees, hips and the lower back, but I wouldn’t recommend such activity without an examination and understanding exactly what you suffer from.
Our three-and-a-half-year-old son started going to kindergarten in September. He is healthy and happy, but we have noticed that he has begun to defecate four times a day when it used to be once or twice a day. He seems to eat about the same as before. He suffers from neither diarrhea nor constipation. Is this anything to worry about?
— R.L., Jerusalem
Prof. Shimon Reif, chairman of the pediatrics department at Hadassah University Medical Center in Jerusalem’s Ein Kerem, replies: The pattern of stool – either its consistently or frequency – can be changed during time. As long your child seems okay, happy and well-functioning you do not have to worry about it. It may related to alteration in his diet at the kindergarten.
Just follow the growth and development of your child, enjoy him and try to ignore his bowel movements.
Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting.
Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 9100002, fax your question to Judy Siegel-Itzkovich at (02) 538-9527 or email it to jsiegel@jpost.com, giving your initials, age and place of residence.