Search for any of the popular sparkling water brands and your teeth and you will find a bounty of articles claiming it’s the worst thing ever for your teeth, that it has no real effect on your teeth, or that it might be bad or might not be. So, where does the truth lie? What do we know about how carbonated flavored (or unflavored) water interacts with tooth enamel? Here’s a quick rundown of the good, the bad, and the ugly (in reverse order):
First, The Ugly
In one of the few studies on carbonated water’s impact on enamel health (as opposed to the numerous studies on soda’s impact on enamel health), enamel hardness was effected by low or high levels of carbonation in water. Highly carbonated water, regardless of the presence of calcium, stripped a considerable amount of minerals from the enamel surface.
Etched enamel surfaces were even more vulnerable to damage from carbonated water. Although this was a study of teeth in simulated conditions (an in vitro study) instead of teeth in real world conditions (an in vivo study), there’s enough evidence to suggest that teeth that are already weakened are far more susceptible to damage from drinking carbonated water than healthy teeth.
Onto the Bad
Carbonated water has a lower pH than plain water, and low pH can speed mineral loss from tooth enamel. Some experiments looking at pH levels of carbonated waters found that plain or flavored, seltzer dips more toward acidic and away from neutral levels. They also point out that mineral levels in the mouth and starting pH are important factors in how much tooth surfaces are effected by consuming seltzer. If you have a relative calcium deficiency, carbonated drinks will be more dangerous to your teeth.
The American Dental Association has also stated that flavored seltzer tends to be harder on the enamel than plain seltzer. So, if the flavor compels you to drink seltzer drinks, you may be worse off. Also, people who drink carbonated water tend to hold it in their mouths longer, which is the worst possible choice for long term enamel health.
Finally, The Good
The good news is that, overall, there’s no evidence that drinking a flavored carbonated water with meals will put too great a pressure on your enamel health. It’s a reasonable occasional indulgence. Also, when researchers looked at low carbonated water with calcium added, the impact on the minerals in tooth enamel was mitigated. It was close to the levels of plain water. If you do not have active cavity disease, seltzer water is unlikely to cause your teeth undue stress with meals.
The consensus of the studies, again, seems to be moderation. Enjoying the occasional La Croix is probably fine. Drinking a case a day is likely to cause you real tooth pain, especially if you already suffer from caries disease. If you prefer to drink seltzer, try swishing with water or a pH correcting rinse after indulging.