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POP AND CAVITIES
CAVITIES IN A CAN

Drink sugar free!

People who drink 3 or more sugary sodas daily have 62% more dental decay, fillings and tooth loss!**

The average American drinks more than 53 gallons of carbonated soft drinks each year, more than any other beverage, including milk, beer, coffee or water.^

Does Soda Pop Cause Cavities?

Mountain Dew-20 oz is the worst pop, it contains 19 tsps of sugar and 93 milligrams of caffeine.......nearly equivalent to adult dose of NoDoz.****

    Pop is sweetened, acidic, often caffeinated carbonated drink.  There is "regular" pop that is sweetened with different kinds of sweeteners and "diet" pop that is sweetened with artificial sweeteners.  45 gallons of pop is consumed per person/per year by the average American. Even adults are just as prone to decay even though they have fairly good enamel and well-calcified enamel.

     Double trouble for teeth.  It's not just sugar that's bad for teeth, but the acids included in many popular drinks are said to "eat" away enamel and make teeth more prone to . The pH of regular and diet pops ranges from 2.47-3.35. The PH in our mouth is normally about 6.2 to 7.0 slightly more acidic than water. At a PH of 5.2 to 5.5 or below the acid begins to dissolve the hard enamel of our teeth.  Phosphoric and citric acids contribute to the acidity of pop.  Below is a look at how some soda pops compare to water as well as to battery acid.

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The average American today drinks over 600 servings of pop a year.***

Product Acid
Low=BAD
Sugar
per 12 oz
Pure Water 7.00 (neutral) 0.0
Barq's 4.61 10.7 tsp.
Diet Coke 3.39 0.0
Mountain Dew 3.22 11.0 tsp.
Gatorade 2.95 3.3 tsp
Coke Classic 2.63 9.3 tsp.
Pepsi 2.49 9.8 tsp.
Sprite 3.42 9.0
Diet 7-Up 3.67 0.0
Diet Dr. Pepper 3.41 0.0
Surge 3.02 10.0
Gatorade 2.95 3.3
Hawaiian Fruit Punch 2.82 10.2
Orange Minute Maid 2.80 11.2
Dr. Pepper 2.92 9.5
BATTERY ACID 1.00 0.0
Source: Minnesota
  Dental Association *
The threshold pH for enamel dissolution is 5.5.  

     Regular pop is potentially cavity causing due to its high sugar content.  Diet pops do not contribute to cavities.  However, the acid in regular and diet pop has the potential to contribute to enamel breakdown and when combined with sugar can contribute to rampant decay!

     Regular pops provide between 150-180 calories per 12oz can.  Current dietary recommendations for added simple sugar are 10% of total energy.  

One can of regular pop per day contains the maximum recommended intake of sugar a day!

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     Excessive intake of regular pop can contribute to excessive calories leading to obesity and/or decrease intake of foods that have a  high nutrient value leading to  deficiencies.  

    The actual effects of pop on oral health are a direct result of: Quantity-rapid drinking of any quantity of regular pop, particularly with meals is unlikely to affect your risk toward cavities.

Sip All Day Get Decay interactive website for teens about pop and decay, click on the Sip All Day icon on the upper right side of the page.

Soft Drinks in Schools

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Promoting sugar free pop

"Root beer appears to be the "safest" for health of dental enamel"***

Recommendations to reduce the affects of sugar and acid on your teeth:

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Pop should be consumed at meals to limit your teeth's exposure to sugar and acid.

bullet

Limit regular pop to 1 can per day

bullet

Neither regular nor diet pop should replace nutrient dense foods or beverages.

bullet

Excessive intake of pop is detrimental to health.

bullet

Drink pop through straws to reduce the direct contact to the teeth.

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Rinse your mouth with water after consuming pop.  It is important to do this prior to brushing your teeth after you just drank a pop.  Rinsing first will help to neutralize the acids.  Brushing in a high acid environment will erode tooth enamel.

bullet

Select pop cans over re-sealable bottles.  This limits the consumption of the pop to one sitting rather than sipping bottles and re-sealing them over a longer period of time.

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Include bottled water and fruit juices in vending machines.

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The use and the abuse of acidic drinks may damage dentin and increase the risk for dentin hypersensitivity. [J Periodontol 2003;74:428-436.]

By Teresa Marshall, Marsha Cunningham from Iowa Dental Journal, July 2000 as published in NDA 01/01.

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Pop, Kids and Obesity
(Click on this topic above to learn more)

Diet Soda Drinkers Beware!

Drinking carbonated soft drinks regularly can contribute to the erosion of tooth enamel surfaces.

Soft drinks, which contain sticky sugars that break down into acids, adhere easily to tooth surfaces. 

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These acids can soften tooth substance and promote formation of plaque, which erodes the enamel. 

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Enamel breakdown leads to cavities. 

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If erosion spreads beneath the enamel into the dentin, pain and sensitivity may result

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Which may result in root canal surgery.

Because saliva helps neutralize acids and wash your teeth clean, the worst time to drink soda pop, ironically, is when you are very thirsty or dehydrated due to low levels of saliva. 

The larger the volume of intake, the more impact pop has on your teeth

"Diet sodas are part of the problem. Women especially like to drink them throughout the day and between meals because they have no calories, yet the higher frequency and volume is putting their teeth at risk."

Try to:

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 Drink soda pop only with a full meal.

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 Be sure to brush and floss soon after drinking and/or eating.

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 Also, resolve to quench your thirst with water.

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 If you drink pop alone or between meals, chew sugarless gum afterward to increase your saliva flow.

© 1996-2000 DentalNotes Academy of General Dentistry. 

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Soft Drink Cancer Link  The consumption of fizzy drinks isn't just bad for your teeth,  research suggests a link between the rise in the consumption of carbonated drinks and the rise in oesophageal cancer  The numbers of those suffering from cancer of the oesophagus has risen by 66 percent in the UK over the past 30 years, whereas in countries like China and Japan, where not as many fizzy drinks are consumed, there has been no rise. Dr John Toy, Cancer Research UK's Medical Director, is more open to the research. He said, `The increase in incidence of oesophageal cancer in recent years in alarming and somewhat puzzling. `Reflux of the acidic gastric juices from the stomach into the oesophagus is a suspected culprit. `People who are obese are more prone to this reflux and they have an increased risk of cancer. Carbonated drinks cause burping and some reflux. These drinks are also acidic and will bathe the lining of the oesophagus as they are swallowed.

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Kick Kidney Stones
Kicking a cola habit might help keep recurring kidney stones in check.

Studies suggest that certain beverages may be associated with an increased risk of developing kidney stones. In one study, kidney stone sufferers who customarily consumed a great deal of cola were much less likely to experience a recurrence when they cut their cola consumption in half.

RealAge Benefit: Actively patrolling your health can make your RealAge as much as 12 years younger  9/03

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News Updates

Acidic Beverages Can Erode Exposed Root Surfaces, New Study Claims

Soda, apple juice and other acidic drinks can erode exposed root surfaces, according to research presented at the 2006 AmericanAssociation of Dental Research meeting in Orlando.

The new laboratory study, conducted by researchers from theUniversity of Iowa, evaluated the erosive potential of five acidic beverages on enamel and root surfaces of extracted tooth samples.For this evaluation, the extracted teeth were coated with fingernailpolish, and small "windows" (1 x 4 millimeters) of enamel or rootsurface were left exposed for microscopic analysis. The preparedtooth samples were submerged for 25 hours in one of five popular
beverages—Gatorade®, Red Bull®, Coke®, Diet Coke® or apple juice—and then sectioned into thin slices to measure the erosion depth.

Although the study did not replicate real-life exposure to softdrinks (due to the length of time of exposure), it did reporterosion to the root surfaces of the extracted tooth samples.Previous studies have found that acidic beverages can soften dentalhard tissues (enamel), and similar dental erosion (based on leveland extent of acidic exposure) would be expected for the thinner,more soluble root surfaces.

Dental erosion may be caused by intrinsic and extrinsic factors(e.g., environment, diet, medications), and the erosive process isnot solely dependent on soft-drink consumption. While there is a growing body of evidence linking acidic food and drinks to dental erosion, biological modifying factors, such as low salivary flow, bulimia, acid reflux disease and other gastrointestinal conditions, can also affect tooth erosion. Saliva plays a protective role by diluting and neutralizing potentially erosive agents, especially the phosphoric and citric acids that contribute to the acidity of soda. In this way, saliva may serve as a natural defense to reduce exposure to the acids that can demineralize enamel and root surfaces.

Dentists are encouraged to monitor patients for observable tooth erosion and to educate parents, caregivers and children about the potential risks of prolonged acidic exposure to the dentition. Proper oral hygiene instruction should be offered to all patients for the promotion of good oral health. At-risk patients (e.g., individuals with bulimia, binge-eating disorders and related conditions) may require referral to physicians or appropriate health
professionals for assessment, treatment and counseling.


Footnotes
1 Mundell EJ. Popular drinks eat away at tooth enamel. HealthDay News. March 9, 2006. Availabl at: "http://www.healthday.com/view.cfm?id=531449 ." Accessed March 10, 2006.

2 DeNoon D. Gatorade tough on teeth? WebMD. March 9, 2006. Available at: "http://www.webmd.com/content/Article/119/113482.htm? Accessed March 15, 2006.

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Sodas in Schools: A Sticky Situation

First, the health problems associated with soft drinks, sports beverages, and juice drinks extend far beyond the elementary school years. Obesity isn’t the only concern. Osteoporosis and tooth decay are also related to nutrient-poor food and beverage choices, so preventive strategies must extend throughout childhood and adolescence...to read more see:  Sodas In School. 3/06

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Influence of drinking patterns of carbonated beverages on dental erosion

As a hard tissue dental disease, dental erosion has a multifactorial etiology. The majority of dental erosion that originates from extrinsic sources is the result of dietary intake, particularly acidic beverages. Several preventive means have been proposed to minimize the damage to the dentition, including a reduction in the consumption of causative beverages and the adoption of a specific method of drinking, utilizing a straw instead of a cup.

General Dentistry Mohamed A. Bassiouny, DMD, MSc, PhD Jie Yang, DMD, MMS, MS June 2005

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New Study Indicates That Popular Sports Beverages Cause More Irreversible Damage to Teeth Than Soda

While sports and energy drinks help athletes re-hydrate after a long workout, if consumed on a regular basis they can damage teeth. These beverages may cause irreversible damage to dental enamel, potentially resulting in severe tooth decay.  

This study revealed that the enamel damage caused by non-cola and sports beverages was three to 11 times greater than cola-based drinks, with energy drinks and bottled lemonades causing the most harm to dental enamel.

The study continuously exposed enamel from cavity-free molars and premolars to a variety of popular sports beverages, including energy drinks, fitness water and sports drinks, as well as non-cola beverages such as lemonade and ice tea for a period of 14 days (336 hours). The exposure time was comparable to approximately 13 years of normal beverage consumption.

The study findings revealed that there was significant enamel damage associated with all beverages tested. Results, listed from greatest to least damage to dental enamel, include the following: lemonade, energy drinks, sports drinks, fitness water, ice tea and cola. Most cola-based drinks may contain one or more acids, commonly phosphoric and citric acids; however, sports beverages contain other additives and organic acids that can advance dental erosion. These organic acids are potentially very erosive to dental enamel because of their ability to breakdown calcium, which is needed to strengthen teeth and prevent gum disease.

We encourage you to try altering or limiting the intake of soda and sports drinks and choosing water or low fat milk instead, to preserve tooth enamel and ultimately protect teeth from decay.

January/February 2005 issue of General Dentistry, the Academy of General Dentistry 's J. Anthony von Fraunhofer, FRSC, FADM, lead author, Professor of Biomaterials Science at the University of Maryland Dental School.

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Sports drinks

A high percentage of people consume soft drinks that contain sugar or artificial sweeteners, flavorings, and various additives. The popularity of sports (energy) drinks is growing and this pilot study compares enamel dissolution in these and a variety of other beverages. Enamel blocks (approximately 7.0 x 5.0 x 2.5 mm) were
sectioned from sound extracted human premolars and molars, measured, weighed, and immersed in the selected beverages for a total of 14 days. The pH of all beverages was measured. The enamel sections were weighed at regular intervals throughout the immersion period with the solutions being changed daily; all studies were performed induplicate. The data were subjected to one-way ANOVA with post hoc Scheffe testing.

Enamel dissolution occurred in all the tested beverages, with far greater attack occurring in flavored and energy (sports) drinks than previously noted for water and cola drinks. No correlation was found between enamel dissolution and beverage pH. Non-cola drinks, commercial lemonades, and energy/sports drinks showed the most aggressive dissolution effect on dental enamel. Reduced residence times of beverages in the mouth by salivary clearance or rinsing would appear to be beneficial.

Operative Dentistry - JADA 2005 Jan/Feb Effects of sports drinks and other beverages on dental enamel
J. Anthony von Fraunhofer, MSc, PhD Matthew M. Rogers, DDS

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Sports Beverages Cause More Irreversible Damage to Teeth Than Soda

New Study Indicates That Popular Sports Beverages Cause More Irreversible Damage to Teeth Than Soda
While sports and energy drinks help athletes re-hydrate after a long workout, if consumed on a regular
basis they can damage teeth.
These beverages may cause irreversible damage to dental enamel, potentially resulting in severe tooth decay according to a study reported in the January/February issue of General Dentistry, the Academy of General Dentistry.

This study revealed that the enamel damage caused by non-cola and sports beverages was three to 11 times greater than cola-based drinks, with energy drinks and bottled lemonades causing the most
harm to dental enamel.
A previous study in the July/August issue of General Dentistry demonstrated that non-cola and canned iced teas can more aggressively harm dental enamel than cola.

The study continuously exposed enamel from cavity-free molars and premolars to a variety of popular sports beverages, including energy drinks, fitness water and sports drinks, as well as non-cola beverages such as lemonade and ice tea for a period of 14 days (336 hours). The exposure time was comparable to approximately 13 years of normal beverage consumption.

The study findings revealed that there was significant enamel damage associated with all beverages tested. Results, listed from greatest to least damage to dental enamel, include the following: lemonade, energy drinks, sports drinks, fitness water, ice tea and cola. Most cola-based drinks may contain one or more acids, commonly phosphoric and citric acids; however, sports beverages contain other additives and organic acids that can advance dental erosion. These organic acids are potentially very erosive to dental enamel because of their ability to breakdown calcium, which is needed to strengthen teeth and
prevent gum disease.
It is recommend altering or limiting the intake of soda and sports drinks and choosing water or low fat milk instead, to preserve tooth enamel and ultimately protect teeth from decay.

 

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Effects of soft drinks and tooth brushing with fluoride  toothpaste on the wear

A study of the combined effects of soft drinks and tooth brushing with fluoride toothpaste on the wear of dentine.
The aim of this study was to measure loss of dentine produced by soft drinks alone and combined with tooth brushing with and without toothpastes. Groups of flat human dentine specimens were exposed for 10 min and then 30 min to orange juice (OJ), carbonated cola (CC) or modified blackcurrant (MB) drinks alone or after the exposures brushed with a fluoride toothpaste for 10 s. Further groups were exposed to OJ as before but brushed with water or non-fluoride toothpaste or placed in slurries of fluoride paste. OJ and CC produced similar erosion and significantly more than MB. Compared with drinks alone, dentine loss was reduced by fluoride toothpaste brushing but increased by water and non-fluoride toothpaste brushing. Fluoride toothpaste slurry had no significant effect on soft drink erosion.  It is concluded that fluoride toothpaste could provide protection, albeit
small, against erosion.
The data again support the concept of brushing before meals.


[Ponduri S, Macdonald E Addy M  A study in vitro of the combined effects of soft drinks and tooth brushing with fluoride toothpaste on
the wear of dentine  International Journal of Dental Hygiene 2005;3 (1):7.]

 

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Impact of modified acidic soft drinks on enamel erosion

From each of 144 bovine incisors one enamel sample was prepared. Labial surfaces of the samples were ground flat, polished and covered with adhesive tape, leaving an exposed area. The samples were distributed among four  groups for treatment with A: Coca-Cola, B: Sprite; C: Sprite light, D: orange juice. Either 1.0 mmol l1 calcium (Ca) or a combination (comb.) of 0.5 mmol l1 calcium plus 0.5 mmol l1 phosphate plus 0.031 mmol l1 fluoride was added to
the beverages. Samples of each group were subdivided into three subgroups (-original; -Ca and -comb.) for treatment with original and modified drinks. Surface loss of the specimens was determined using profilometry after test procedure.In all subgroups, loss of enamel was observed. The enamel loss recorded for the samples rinsed with original Sprite and original orange juice was significantly higher compared with all
other solutions 
Modification of the test soft drinks with low concentrations of calcium or a combination of calcium, phosphate and fluoride may exert a significant protective potential with respect to dental erosion.
Impact of modified acidic soft drinks on enamel erosion
T Attin, K Weiss, K Becker, W Buchalla, A Wiegand 2/05

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Dark soda better for teeth

11/10/04-Dark soda better for teeth (AGD News) According to J. Anthony von Fraunhofer, MSc, PhD, of the University of Maryland Baltimore Dental School, light colored soda and canned ice teas are worse for the teeth than its darker colored competitors. According to his study, non-cola soft drinks caused two to five times
the damage to tooth enamel as darker drinks.
Dr. von Fraunhofer believes the cause is the citric acid content in the beverages that can leave heavy drinkers at greater risk for cavities and decay. The average person in the U.S. drinks about 16 ounces of soft drinks daily, according to Dr. von Fraunhofer. The study appeared in the
July/August issue of General Dentistry, the peer-reviewed journal of the Academy of General Dentistry.

 

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Soda Attack

Sugar and acidity can be lethal to teeth!

Sweetened drinks harm the protective enamel around teeth.  Over time, exposing dental enamel to carbonated beverages weakens and permanently destroys enamel.  This new study found that non-colas and canned iced tea were especially harmful.  They contain flavor additives, such as malic, tartaric and other organic acids which are more aggressive at eroding teeth.

Root beer, contains the least amount of flavor additives was found to the the "safest soft drink to safeguard dental enamel". 

In 1977 12-19 year olds consumed 16 oz of soda a day
    1996 12-19 year olds consumed 28 oz a day

In 1970 22.2 gallons of cola per person per year consumed by Americans.
In 1996 44    gallons of cola per person per year consumed by Americans.
In 1999 56    gallons of cola per person per year consumed by Americans.

Soda consumed at meal times is less injurious than when consumed alone and continuous sipping is more harmful than the whole drink taken at one time.  Drinking soda thorough a straw may help reduce the amount of soda that comes into direct contact with your teeth.  Also rinse your mouth out with water after drinking and use toothpaste that contains fluoride.

Dentalnotes pg 1 Summer 2004

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Soft drink and bones ----------------------------------- Carbonated soft drink intake is linked with lower bone mineral density in adolescent girls, . There was found a significant inverse relationship between total carbonated soft drink intake and bone density for girls only. This association was confined to non-cola and diet drinks. Reference: J Bone Miner Res. 2003 Sep;18(9):1563-9.

The link between consumption of soft drinks - particularly sweetened soft drinks - and dental caries is well established 1. 

Nutritionists have also raised concerns that excess soft drink intake could displace milk and contribute to calcium deficiency, and that the `empty calorie’ sugar in soft drinks is a factor in the rapidly worsening problem of overweight and obesity in our children 2.

 Other potential problems related to specific constituents of soft drinks include the calcium leaching effect of phosphoric acid 3 and the impact of excess caffeine in cola drinks (e.g. in possibly contributing to raised blood pressure) 4 . 

A recent paper has proposed that high fructose corn syrup (used to sweeten most soft drinks) has specific metabolic consequences that favored obesity 5, whilst other evidence shows soft drinks can cause sharp insulin responses 6. 

One thing of which there is no doubt is that soft drink intake amongst children is increasing. Recent US estimates, for example, are that consumption doubled over the last two decades and now adds 188 kcal/day to the energy intake of children who drink them 7, 8. 

 Whatever the current status of research on the precise health effects of soft drink consumption, we are in the midst of an obesity epidemic amongst children. It is hard to reasonably deny the need to take steps in schools to make healthy, nutrient-dense foods more available and `empty calories’, including both high fat snacks and sugary soft drinks, less easily available 17.

 References: 

Arbor Clinical Nutrition May 04. 1. Gen Dent. 2003 Jan-Feb;51(1):30-6. 2. Pediatrics. 2004 Jan;113(1 Pt 1):152-4. 3. Rev Invest Clin. 1998 May-Jun;50(3):185-9. 4. Arch Pediatr Adolesc Med. 2004 May;158(5):473-7. 5. Am J Clin Nutr. 2004 Apr;79(4):537-43. 6. Eur J Cancer Prev. 1999 Aug;8(4):289-95. 7. J Am Diet Assoc. 2003 Oct;103(10):1326-31. 8. Am J Clin Nutr. 2003 Dec;78(6):1068-73. 9. Arch Pediatr Adolesc Med. 2000 Jun;154(6):610-3. 10. J Am Coll Nutr. 2004 Feb;23(1):18-33. 11. J Pediatr. 2003 Jun;142(6):604-10. 12. Br J Nutr. 2003 Mar;89(3):419-29. 13. J Nutr. 2001 Feb;131(2):246-50. 14. J Am Coll Nutr. 2003 Dec;22(6):539-45. 15. Lancet. 2001 Feb 17;357(9255):505-8. 16. J Am Diet Assoc. 1999 Apr;99(4):436-41. 17. JAMA. 2002 Nov 6;288(17):2181.

Soda Facts

Help patients understand these alarming soda facts!

soda
bulletSoda is the primary source of sugar in the American diet.
bulletA 12-oz. can of regular soda contains 40 grams of sugar,
which provides about 160 calories but little nutritional value.
bulletLarger servings, e.g. 64 oz. “Big Cup” adds calories and
more damage
bulletAn estimated 20% of 1-and 2-year olds consume about a
cup a day of soft drinks.
bulletTeens drink three times more soda than 20 years ago, often replacing milk.
bulletDiet sodas actually have more acid in them than regular soda, leading to enamel erosion.
bullet“Sports drinks” are no safer when it comes to tooth erosion.

(Source: Gutkowski, Shirley, RDH, BSDH “Ahhhhh … those BUBBLES,” RDH Magazine, 10/2002)

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Stop the Pop: www.modental.org/

Pop & Acid handout: http://resources.modental.org/pdf/Health/STP/Color_Brochure.pdf

Sip all Day and Get Decay: http://www.modental.org/yourdentalhealth/StopthePop.aspx

***-http://www.agd.org/library/2004/aug/vonFraunhofer.pdf

Pop in Schools, AGD Impact 3/04

* Dental Products Report,  pg47-50, September 2001

**Third National Health and Nutrition Examination Survey.

***Nutrition, Diet and Dentistry Today, David Menz Oct 2001 pg7 Nebraska Dental Association.
****AGD Impact November 2001, Vol 29, No. 10, pg 3
^The ADA's "Report on Soft Drinks and Oral Health Effects" presented to the 2001 House of Delegates.

Presentation materials: http://resources.modental.org/pdf/Health/STP/STP_Display_Materials.pdfUp to top

http://www.modental.org/YourDentalHealth/StopthePop.aspx

Color_Brochure.pdf

Soft Drinks are Killing our Kids: http://www.kauhawaii.com/softdrinks.html

February 06, 2008

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          If you have any questions please e-mail me at: drdpeterson@scottsbluff.net
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