Seltzer waters like San Pellegrino, Perrier, and La Croix, once considered pretentious, are now the most popular drink-of-choice. We love to have spirited debates about which flavor is the best and how to pronounce names like Pamplemousse. With a zero-calorie count and touted mineral ingredients, they’ve become an accepted alternative to sodas, fruit juices, and beverages with added sugars. We’ve quickly turned to seltzer waters as our thirst-quenching staples—the much preferred cousin of boring regular water for its fruity, refreshing flavors and satisfying effervescent experience.

However, professors and researchers at the Department of Cariology and Comprehensive Care at New York University’s College of Dentistry have begun to worry if seltzer waters, like soda and fruit juice, can also be damaging to one’s oral health and cause cavities.

A bubbling drink with lemon like an Pellegrino, Perrier, and La Croix. We’ve quickly turned to seltzer waters as our thirst-quenching staples but dentists have begun to worry if seltzer waters, like soda and fruit juice, can also be damaging to one’s oral health.

Understanding Erosion: Acid and Tooth Enamel

Enamel is the outer layer of our teeth. Enamel is hard to withstand biting and chewing forces, and though it’s brittle, it can actually withstand a significant amount of cracking before it becomes seriously damaged. What tooth enamel is weak against is acid. Many acids in foods and beverages–including seltzer water–can remove minerals from tooth enamel and may even completely erode the enamel.

We measure acidity with the pH scale. pH represents acidity by the negative logarithm of the concentration of hydrogen ions. In neutral water, this concentration is 1 per 10,000,000 water molecules. This is 10 to the power of negative 7, so neutral water has a pH of 7. If an acid has 1 ion per 1,000,000 water molecules, it has a pH of 6–every reduction of 1 in the pH scale represents a tenfold increase in the concentration of acid.

Tooth enamel starts to break down at a pH of 5.5. Technically, anything with a pH of 5.5 or less can erode your tooth enamel. However, studies of tea drinking have shown that a drink with a pH of about 5 causes the pH at the tooth enamel to drop below 5.5 very briefly after mixing with saliva, so we commonly define food and drink as being erosive if its pH is less than 5.

Acid Content in Seltzer Waters Is Bad News

Seltzer waters are a better choice than sugary drinks, so if you’re craving something sweet and bubbly, reaching for one of these is the more responsible option. But like any carbonated drink,  they’re acidic.  How acidic? That’s a hard question to answer. On its FAQ page, La Croix dodges the question and quotes an ADA spokesperson: “the health risks of sugarless, naturally carbonated waters like La Croix and Perrier are nowhere near those of sugary sodas, despite their textural similarities. There is no scientific evidence that sparkling waters are any more dangerous or damaging to the teeth than regular water.” While seltzer waters aren’t as damaging as other indulgent drinks because they have a lower acidic content, drinking too many cans of La Croix in a day can compromise your teeth’s resiliency.

We haven’t found any published tests of La Croix’s pH, but a recent compilation of beverage acidity published by the American Dental Association includes a number of different waters. This includes two naturally carbonated waters San Pellegrino (pH 4.96) and Perrier (pH 5.25), which seems to support the statement La Croix quotes.

But it’s not just the carbonation that gives seltzer waters acidity. Flavors in seltzer waters can dramatically increase the acid content. A citrus-flavored version may be 100 times more acidic than a regular flavor. You can see that in the ADA data. Dasani water has a pH of 5, but grape, lemon, and strawberry flavors all have a pH of about 3. Another study looking at the pH of sparkling waters showed that the pH of flavored waters ranged from 2.74 to 3.34. So while naturally carbonated waters are not harmful to your teeth, if you pick flavored versions, you are exposing your teeth to acidity stronger than Diet Coke (pH 3.1).

Cut Back on the Quantity

How much seltzer you drink is the real factor. Just like drinking too much soda, fruit juice or coffee can have negative effects on your oral health, so can drinking too much seltzer water. Of course, the negative effects are to varying degrees but the consensus is to keep consumption to a healthy minimum. If you find yourself reaching for a can of seltzer water two or three times a day, try swapping it out for plain water—you may just be thirsty and everyone knows the benefits of drinking water! Drinking more water will help reduce the amount of carbonation you ingest and satisfy your craving for something cold and refreshing.

Don’t Nurse that Drink

Your mouth has an incredible ability to self-heal within a half hour of coming into contact with acidic content—the saliva in your mouth helps the enamel on your teeth to harden back up. So the real problem occurs when you adopt the habit of nursing a carbonated drink. Say you’re at work and you open a bottle of San Pellogrino. You occasionally sip from the bottle over the course of a couple hours. While you might be savoring the enjoyment of the fizzy experience, you’re actually soaking your teeth in an acid bath for hours. Rather than allowing the seltzer to sit, make sure you consume the beverage in about five to ten-minute bursts so you can give your enamel time to harden again and disrupt the acidic process of softening. Again, if you’re looking for something to sip, plain water is a great choice (but maybe not raw water).

Tooth wear and decay is often something can be prevented with a proper care and healthy lifestyle habits. However, if your teeth have been damaged by excessive acidic exposure, reconstructive dentistry can help restore the look and feel of your natural smile. If you are looking for reconstructive dentistry in Fairfax County, please call 703-349-4277 today for an appointment with Burke, VA reconstructive dentist Dr. Pamela Marzban.