Dentists Say Sports Drinks
Pose Tooth Decay Danger
by Linda Wilson Fuoco

"There has been some controversy about the erosive effect of carbohydrate electrolyte drinks (sports drinks) on tooth enamel ..." says an article in the summer 2006 edition of Word of Mouth, produced by a company called Patient News Publishing. "It is our position that there is enough evidence to advocate avoiding, or at least limiting, your consumption of these drinks."

The seven-paragraph article concludes, "Water is the refreshment of choice: it's sugar-free, has no calories ... and frankly, it does what you need it to do ... hydrate!"

The newsletter mentions "research" but doesn't cite specific studies. A spokesman for Patient News Publishing, which has offices in Niagara Falls, N.Y., Ontario and London, referred a reporter to the Web site of The Academy of General Dentistry, which published a report in the January/February 2005 issue of its journal, General Dentistry.

Organic acids and other additives in sports beverages can erode dental enamel and ultimately result in severe tooth decay, writes J. Anthony von Fraunhofer, lead author of the study, and professor of biomaterials science at the University of Maryland Dental School.

Sports Drinks

The warnings about sports drinks may be especially troubling when they come from pediatric dentists.

What's a parent to do? Heed the dentists? Follow the advice of coaches who often encourage young athletes to use sports drinks? And then there's the example set by professional and Olympic athletes -- from football players to NASCAR drivers to swimmers -- who seem to guzzle sports drinks by the gallon.

The study -- and the warnings about sports drinks -- has supporters and detractors.

"I consider sports drinks to be like pop," said Dr. Deborah Studen-Pavlovich, chair of pediatric dentistry at the University of Pittsburgh School of Dentistry. "The low-pH acids can dissolve tooth enamel. Once it's dissolved, nothing can bring it back. Obesity is also an issue" and sports drinks have high sucrose syrup, she noted.

"The athletes will burn off calories. A lot of people just drink sports drink as a drink of choice" and that's a concern for people who are not burning up a lot of calories. "Drinking water would be healthier," she added.

"Sometimes water is not enough," said Leslie J. Bonci, director of sports medicine nutrition at the University of Pittsburgh Medical Center. While water hydrates, sports drinks hydrate and supply carbohydrates and electrolytes.

"Children and adolescents are more vulnerable to dehydration" than adults, Ms. Bonci said. "Some children really need to be using sports drinks. They need something to fuel them," especially hard-driving athletes who are working out and competing many hours per week.

But the need is not limited to athletes. A middle school student who has a 10:30 a.m. lunch hour may need a sports drink to get through a school day that extends to 3 p.m. -- and beyond, if there are after school activities, Ms. Bonci said.

"We want people to pay attention to oral hygiene but that's just one part of your body," Ms. Bonci said.

"Dentists have been getting a lot of press" on this issue, and they've been getting audiences with school board members who are urged to take sports drinks out of school cafeterias and vending machines, Ms. Bonci said.

The sports drink debates "comes up every year or two," said Robert Murray, director of the Gatorade Sports Science Institute. He has a Ph.D. in exercise science. There are other studies -- which he obviously prefers -- which say that sports drinks do not cause enamel erosion or tooth decay.

The latest round of debate seems to stem from the Maryland study.

Cavity-free teeth were immersed in various drinks for 14 days, which the study says is comparable to approximately 13 years of normal beverage consumption. Actually, sports drinks weren't the biggest offender.

"The study findings revealed that there was significant enamel damage" with all the beverages tested. Results, listed from greatest to least damage to dental enamel: lemonade, energy drinks, sports drinks, fitness water, iced tea and cola.

The organic acids in sports drinks "are potentially very erosive to dental enamel because of their ability to break down calcium, which is needed to strengthen teeth and prevent gum disease," the Maryland study says.

Dr. Murray quotes a 2002 study of more than 300 athletes at Ohio State University. The level of dental erosion in athletes regularly using sports drinks was 36 percent vs. 40 percent erosion in people who did not use sports drinks. That study was published in the journal Caries Research. One of the lead researchers was Dr. Paul Casamassimo, a dentist at Children's Hospital in Columbus.

Dr. Murray points out that the Ohio study used live teeth while the Maryland study used "dead" teeth continuously immersed in sports drinks.

"Nobody has sports drinks in their mouth 24 hours per day," Ms. Bonci said. She suggests drinking water after a sports drink.

Dr. Studen-Pavlovich agrees that can be helpful.

"Drinking water would buffer" the acid and sugar deposited on teeth by sports drinks. "Chewing sugarless gum" would stimulate saliva production "and clear the liquids" from the teeth, the pediatric dentist said.

When dealing with school officials who are considering taking sports drinks out of schools, the Gatorade company "is trying to provide them with education based on science," Dr. Murray said. "We never position or advertise Gatorade as a social beverage."

Gatorade was developed in 1965 at the request of football coaches at the University of Florida who were troubled by a high number of heat-related health problems in college athletes.

Dr. Murray said every year student athletes die from heat-related issues, including at least five high school football players last summer.

And those sports drink-swilling NASCAR drivers?

"It's 120 to 130 degrees inside those cars," Dr. Murray said.

Why are Olympic swimmers -- who spend countless hours immersed in water -- using sports drinks?

"Swimmers sweat and they can dehydrate,'' he said.

Copyright 2006 P.G. Publishing Co.

Pittsburgh Post-Gazette (Pennsylvania) October 18, 2006, BYLINE: Linda Wilson Fuoco, Pittsburgh Post-Gazette, Linda Wilson Fuoco can be reached at lfuoco@post-gazette.com or 412-263-3064.