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It is well known that sugar causes tooth decay by feeding harmful bacteria in the mouth.

An article on webmd states that "sipping soda through a straw may cut cavities":

Using a straw when you drink soda may help avoid cavities and tooth decay.. say Temple University professors

Doing so will limit the amount of time the beverage is in contact with the teeth

While this statement seems logical, are there any direct studies demonstrating this effect?

S.O.S
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1 Answers1

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It won't prevent, it can reduce the harm of drinking soda, but only in a specific usage, which is not the common one, using a straw in the "wrong" way would cause more damage to the teeth.

The article in question cites the article Influence of drinking patterns of carbonated beverages on dental erosion which reviews two case studies of teens (16 and 18 years old), the very bad state of their teeth and the high amount of soda that they intake. I couldn't find the full text of the article, but in the abstract of the study the authors state:

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.

The clinical and radiographic evidence presented in this report cautions against the use of nonspecific terms, such as "cup versus straw," and instead suggests implementing a more precise description of the suggested method.

This article is also cited in a later review article Insights into preventive measures for dental erosion which again cautions against using a straw:

Special drinking habits, such as holding or moving the liquid in the mouth prior to swallowing, sucking from a straw or nipping from a bottle, lead to an increased acid contact time in the oral cavity and, thus, to prolonged duration of an acidic pH-value in the environment of the teeth.

However, as the article in the question suggests if used properly, specifically, if the straw is placed in such a way that the straw is positioned behind the teeth it leads to less contact between the teeth and the acids in the soda, as was described in the article A videofluoroscopic comparison of straw and cup drinking: the potential influence on dental erosion.

Fourteen patients avoided fluid contact with both incisors and molars when using a straw. Compared with the cup, significant differences were found with the narrow straw (P = 0.03, 95% confidence interval of 22.6% to 31.6%), the narrow straw repositioned (P = 0.008, 95% confidence interval of 12.3% to 47.1%) and the wide straw repositioned (P = 0.03, 95% confidence interval of 3.1% to 37.5%). Contact time of fluid with anterior teeth was also significantly reduced. CONCLUSIONS: Drinking through a straw positioned toward the back of the mouth may reduce the erosive potential of soft drinks.

Conclusion, while it's true that using a straw may reduce the harm from sodas and other acidic liquids, it needs to be used in a position which is not common by most people. And if used in the common way, will lead to more harm. Because of this, the articles don't recommend giving non-specific advice such as "use straw over cup".

SIMEL
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  • While it is the title of the article, you really should explain the horrible or even idiotic usage of "carbonated": namely that it is *not* about carbonic acid at all, but here meant to describe *sugary* drinks (and this would include beer or juices, sweetened tea and whatnot. Mineral water is carbonated and tooth friendly.) – LangLаngС Nov 25 '18 at 11:46
  • And I think "prevents" should be differentiated more clearly from "perhaps reduces incidence". Drinking sugar water always increases caries incidence, question is therefore really, by how much when using straw, how using straw? – LangLаngС Nov 25 '18 at 11:51
  • But [straws are killing everything in the ocean](https://skeptics.stackexchange.com/a/41829/11643). Jk. –  Nov 26 '18 at 01:12
  • @LangLangC, I agree with your distinction about "prevent" and I edited the opening to reflect this. However, I don't agree regarding the distinction of sugar vs. acid. The articles all talk about acids and the ph level. See specifically in the second article where is has nice tables with the recommended behaviour: "Reduction in the intake of acidic drinks and snacks" and "Acidic beverages should be drunk quickly and cooled". – SIMEL Nov 26 '18 at 08:17
  • Oh that seems to be a misunderstanding. I agree on acid as well, just not that carbonic acid is one of concern for teeth. Carbonated really means: Pure water with CO2 is not that low in pH for enamel to get weak or eroded. "Carbonated" *is used* as 'sugar plus citric acid added'.Citric acid is erosive etc. – LangLаngС Nov 26 '18 at 11:23
  • *it needs to be used in a position which is not common by most people*, are you sure the described position is not common? – gerrit Nov 26 '18 at 11:44
  • What I mean is that this is a language problem, on display in the article you cited. Weak acid that is often buffered in reality and quickly rises in pH once in the mouth is no danger. Look at some of many posts on that over at [MedSc, egi](https://medicalsciences.stackexchange.com/a/13623/11231). In other languages *agua con gas* for example causes much less confusion, although this americanism is 'infecting' other languages. 'Carbonated' the word does not mean "sugars and stronger acids added', only one pervereted unscientific usage in one part of the world does. – LangLаngС Nov 26 '18 at 12:10
  • @gerrit, it's implied heavily from the articles as they state if you just tell people to use a straw they will use it in the wrong way and that specific instruction as to the proper way to use. – SIMEL Nov 29 '18 at 07:48