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Girl drinking juice with a strawLast month in my When Acid Attacks - Part I article, I discussed some of the dental problems that excess acid can cause. One additional problem I neglected to bring up last month is the impact of a lower pH on mouth bacteria. As acid increases and pH falls, the growth of acid-producing plaque bacteria is promoted. These bacteria then cause an increase in tooth decay and periodontal (gum) disease.

Where does that extra acid come from?

The sources of acid are many, and many of these sources have become more prevalent in our modern diet. These sources would include:

  • acidic foods and beverages
  • lozenges and candies
  • tobacco products
  • medications and drugs that are dissolved in the mouth or are inhaled through the nose
  • acid reflux/GERD
  • vomiting (including self-caused purging)

The effect of acidic foods and beverages is influenced by both their initial acidity (pH) and also by their sustained acidity (titratable acidity- TA). When a food or beverage has a high TA, it means that it has a lot of buffering capacity. That causes the saliva to have a harder time in neutralizing the acid. The result is that the acid stays around in the mouth longer and has more opportunity to cause damage. Foods and beverages with a low pH and high TA are the most damaging of all. I have included charts showing the pH and TA for some common foods and drinks so you can choose which foods and drinks to limit in your diet.

pH acidity_foods_chartTitratable Acidity Chart

What can I do to protect my teeth from acid?

Following is a list of things you can do to limit the effects of acid on your teeth and gums:

  • Reduce or eliminate drinking carbonated drinks and energy and sports drinks. Instead, drink water, tea, or milk - and skip any added sugar.
  • If you do drink acidic beverages, drink them within a short time interval (as opposed to sipping on them over an extended time period), use a straw to force the liquid towards the back of your mouth, and don’t swish the liquid around.
  • Avoid drinking acidic beverages and snacking on acidic foods throughout the day. Instead, drink and eat these items just during meal times to minimize the amount of time you are exposing your mouth to these high acid sources.
  • If you suffer from mouth dryness, chew sugar-free gum to help stimulate more saliva flow, and consider using one of the products for dry mouth (like Biotene) to help replace some of the low saliva flow.
  • Avoid acidic and/or sweetened lozenges, unless used for short-term medicinal uses (such as for a sore throat).
  • Avoid all tobacco products, including cigarettes, cigars, pipes, and chewing tobacco.
  • Seek a medical evaluation for any suspected acid reflux or heartburn symptoms.
  • If vomiting or purging occurs, rinse with water and avoid tooth brushing for at least 30 minutes.
  • Use a soft toothbrush or good quality electric brush, and fluoridated toothpaste.

I know, that’s a pretty long list to remember. For many people, I think the single biggest thing on that bullet list to put into daily practice is to avoid drinking and eating acidic and sweet beverages and snacks throughout the day. If these items are limited, and confined to just meal times, then their potentially harmful effects will be greatly reduced.



J Zhejiang Univ Sci B. 2009 May; 10(5): 395–399.doi:  10.1631/jzus.B0820245 PMCID: PMC2676420
Dental erosion and severe tooth decay related to soft drinks: a case report and literature review

Int J Dent. 2012; 2012: 479850. Published online 2011 Dec 12. doi: 10.1155/2012/479850 PMCID: PMC3238367
Gastroesophageal Reflux Disease and Tooth Erosion
Soda and illegal drugs cause similar damage to teeth: Acids erode enamel

Date: May 28, 2013 Source: Academy of General Dentistry International Journal of Dentistry Volume 2012 (2012), Article ID 632907, 17 pages 10.1155/2012/632907
Review Article
Dental Erosion and Its Growing Importance in Clinical Practice: From Past to Present

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