Impact Of High-Sugar Energy Drink Consumption On Salivary Ph And Dental Erosion Risk In Teenagers

Abstract

Background: High-sugar energy drinks combine substantial free-sugar loads with strong acidity, yet the simultaneous relationship between habitual consumption, acute salivary pH recovery, and clinically detectable erosive tooth wear in teenagers remains insufficiently characterized. Objective: This study evaluated the association of high-sugar energy drink consumption with salivary pH dynamics and dental erosion risk among teenagers. Methods: A school-based analytical cross-sectional study included 420 teenagers aged 13–18 years, classified as low/rare (≤1 serving/month), moderate (1–3 servings/week), or high (≥4 servings/week) consumers. Habitual intake was assessed using a beverage frequency questionnaire and a 7-day diary; unstimulated saliva was analyzed at baseline and at 1, 5, 10, 20, and 30 minutes after a standardized 100-mL high-sugar energy drink challenge, while erosive tooth wear was recorded using the Basic Erosive Wear Examination (BEWE). Results: Mean baseline salivary pH declined across the low, moderate, and high consumption groups (7.08 ± 0.30, 6.87 ± 0.34, and 6.63 ± 0.38; p < 0.001). The 1-minute pH nadir was 5.34 ± 0.32, 5.10 ± 0.35, and 4.86 ± 0.38, respectively, with significantly delayed recovery among high consumers (group × time interaction, p < 0.001). Mean cumulative BEWE scores were 1.38 ± 1.55, 3.18 ± 2.25, and 5.21 ± 2.66, and BEWE-defined erosion risk (BEWE ≥3) affected 19.2%, 54.4%, and 77.6% of the groups, respectively (p < 0.001). High consumption independently predicted BEWE ≥3 (adjusted OR = 5.42, 95% CI: 3.11–9.44), together with prolonged sipping and a 5-minute pH <5.5. Conclusion: Frequent high-sugar energy drink consumption was associated with a deeper and longer salivary acidification response and markedly greater erosive tooth wear risk, supporting preventive strategies that reduce frequency, prolonged sipping, and bedtime use.