Three Energy Drinks a Day, and Teeth Going Transparent at the Edges

Quick answer: Acid erosion dissolves enamel chemically, without any bacteria involved. It is not decay, it does not show as cavities, and it is irreversible — enamel does not regrow. The damage stops the day the acid exposure does.

The call

His mother had booked the appointment. He had come because he was made to, and said almost nothing for the first five minutes, which is standard for sixteen.

What she had noticed was that the edges of his front teeth had gone see-through, and that they looked shorter than they had in photographs from a year or two before.

What we found

Erosion, and a textbook pattern of it.

The biting edges of the upper front teeth were translucent and thinned — you could see light through them. Enamel had been lost from the outer surfaces of the upper front teeth, leaving smooth, shallow, cupped depressions with rounded margins rather than the sharp edges you get with a cavity.

On the back teeth, the cusps showed cupping: shallow craters in the biting surfaces, with fillings standing slightly proud of the surrounding tooth. That last sign is diagnostic and unmistakable — the filling material does not dissolve, so as enamel around it erodes, the filling is left raised like an island. Nothing else produces that.

He had sensitivity to cold, mild but increasing.

The history, once he engaged: two to three energy drinks a day for about two years, plus a cola most evenings. He sipped them over long periods, often while gaming.

Why this is not decay. Decay is bacterial: plaque bacteria ferment sugars into acid, which dissolves enamel from within a localised spot, producing a cavity. Erosion is chemical: acid from the diet dissolves the enamel surface directly, over broad areas, with no bacteria required. You can have severe erosion with excellent brushing and no cavities at all — he did.

Energy drinks and colas are strongly acidic. The sugar content matters for decay; the acidity matters for erosion, and diet versions are no better on that count. What multiplies the damage is duration — sipping over an hour keeps the mouth acidic almost continuously, where drinking the same volume in five minutes lets saliva restore neutrality.

The other multiplier is brushing straight afterwards. Enamel softened by acid is abraded away by a toothbrush. He brushed immediately after his evening cola.

What we did

Study casts and photographs first. Erosion is a progressive condition and the only way to know whether it is still progressing is to have a baseline to compare against. That measurement matters more than any treatment at this stage.

No restorations. His enamel loss was moderate, not yet into dentine over any wide area, and the correct treatment for that is to stop the cause and monitor. Restoring teeth while the acid attack continues means restoring them repeatedly.

Diet, negotiated rather than dictated. Cutting to one drink a day, taken in one sitting with a meal rather than sipped, through a straw, followed by water. He was not going to stop entirely at sixteen and pretending otherwise would have lost him.

Do not brush for an hour after acid. Rinse with water or milk instead. This single change matters as much as the diet one.

High-fluoride toothpaste and varnish to harden what remained.

The outcome

At twelve months the casts showed no measurable further loss. At two years, still stable. Sensitivity resolved.

The enamel already lost has not come back and will not. He will likely need composite restorations to the biting edges in his twenties for appearance — but the progression stopped, which was the whole objective.

What to do if this happens to you

1. Look for fillings standing proud of the tooth surface. It is the clearest sign of erosion.
2. Cut frequency and duration, not just quantity. Sipping is the damaging part.
3. Use a straw and follow acidic drinks with water.
4. Do not brush for an hour after anything acidic.
5. Ask for casts or photographs as a baseline. Without them, nobody can tell whether it is progressing.
6. Delay restorations until it has stopped, unless there is pain or a real cosmetic need.

Teeth looking shorter or see-through at the edges? Ramat Beit Shemesh Urgent Dental Care measures erosion before treating it. 055-985-8845 · WhatsApp https://wa.me/972559858845 · Harav Kook 28/1, Beit Shemesh

This is a composite clinical story. It reflects a presentation we see regularly in Beit Shemesh and Ramat Beit Shemesh; the name and details are illustrative and are not those of a real patient.