As many people are not aware that soft drinks contain acids, which can be troublesome for people in orthodontic treatment, the American Association of Orthodontists (AAO) has released a new educational flier focusing on the pitfalls of orthodontic patients drinking soft drinks. The flier, titled “Soft Drinks + Orthodontic Treatment = A Recipe for Disaster,” lists pH levels of more than 30 soft drinks, including sports and energy drinks, fruit juices, and regular and diet soda.

“It’s tempting to reach for soft drinks. People around us drink them regularly, they are easily purchased in vending machines and at convenience stores, and many are heavily advertised,” says Morris N. Poole, DDS, president of the AAO. “Sugar is known to be bad for the teeth, but sugar-free soft drinks present dangers, as well.

“Consumption of soft drinks during orthodontic treatment puts teeth at risk of decay due to the acid attack on enamel,” says Poole. He hopes a closer look at the science of decay might make that next soft drink a little less appealing. “The acid in soft drinks pulls calcium out of tooth enamel. Repeatedly bathing teeth with acidic soft drinks dissolves enamel, a process called ‘decalcification,’ and that’s a sure path to a cavity. If soft drinks contain sugar, the risk increases. Sugar interacts with plaque and forms yet another acid to further dissolve enamel. When enamel is gone, the loss is permanent.”

Poole notes that water is an excellent drink of choice, especially for orthodontic patients. The pH of water is 7.0, and is considered neutral on the pH scale, which ranges from 0 to 14. Liquids below 7.0 are on the acidic side of the pH scale. Tooth enamel begins to dissolve at a pH level of 5.5. As listed in Soft Drinks + Orthodontic Treatment = A Recipe for Disaster, the majority of the soft drinks in AAO-commissioned testing fell below the threshold of 5.5 pH. The lower the pH level, the more acidic the beverage.

“I like to tell patients that a single sip of a soft drink is the catalyst for an attack on tooth enamel, and the attack is renewed with each new sip,” says Poole. Decalcification can leave white spots or lines on teeth. The portion of a tooth covered by a bracket is protected, but decalcification around the perimeter of the bracket can leave the tooth with a permanent outline of where the bracket had been. “This is a huge disappointment to patients and their orthodontists,” says Poole, and, he notes, is one of the reasons that orthodontists insist that patients brush and floss as recommended. “Consider, too, that the pH level of soft drinks varies. It just makes sense that acidic drinks can’t be good for your teeth, let alone your overall health.”

The AAO recommends that orthodontists advise orthodontic patients to:

  • Never consume soft drinks while wearing clear aligners or clear retainers.
  • Drink fluoridated water and use a fluoride toothpaste.
  • Always follow their orthodontist’s instructions on oral hygiene (brushing, flossing, and regular professional cleanings).

If orthodontic patients consume soft drinks, there are important measures to follow to minimize damage to tooth enamel:

  • Drink soft drinks through a straw.
  • Have soft drinks with a meal.
  • Drink the soft drink quickly; avoid sipping over a long period of time.
  • Brush right away after consuming soft drinks, including sports and energy drinks, fruit juices, and regular and diet soda pop. If you can’t brush right away, at least rinse with water.

“Realistically, we recognize that patients may indulge in soft drinks from time to time,” says Poole. “While we don’t begrudge anyone the occasional sweet treat, it is imperative that for good oral health, the indulgence is immediately followed by thorough brushing and flossing. We want the very best outcomes for our patients.”