Coke and Your Teeth: What South Africa's Favourite Cooldrink Is Doing to Your Smile

Coke is everywhere in South Africa. It is on the table at the braai, next to the pap and chicken at the family lunch, in the lunch box and in the fridge at the garage. I will not pretend I have never enjoyed one. But as a dentist, I look at Coke very differently from how most people do. When I look at it, I see what it does to enamel. Today I want to tell you what is really in that bottle, and how to protect your teeth without giving up everything you enjoy.

Hit Number One: The Sugar

In South Africa, Coke contains about 7.5 grams of sugar in every 100 millilitres. That adds up quickly. A normal 330 millilitre can has about 25 grams of sugar. That is around six teaspoons. A 500 millilitre bottle has about 37 grams, which is more than nine teaspoons. A 2 litre bottle has around 150 grams, which is about 37 teaspoons. This is why Coke falls into the group of drinks that are taxed under the health promotion levy. The bacteria in your mouth love sugar. They feed on it and make acid, and that acid is what slowly eats holes in your teeth.

Hit Number Two: The Acid

This is the part that surprises most people. Coke does not only harm your teeth through its sugar. The drink is acidic by itself, because it contains acids such as phosphoric acid. These acids can soften and wear away enamel directly, without the bacteria having to do anything at all. So a sugary cola gives your teeth two attacks at once. The acid softens the enamel, and the sugar feeds the bacteria that make even more acid. One laboratory study tested many popular drinks on enamel. A well known cola caused the most surface loss of all of them. Both the cola and most of the sports drinks softened enamel by around 30 to 50 percent in that study. Plain water caused no loss at all.

What About Sugar Free Versions?

Many of my patients tell me they have switched to a sugar free cola, so they are fine. It is certainly better for your waistline and for the sugar part of the problem, but your teeth are still not completely safe. Because sugar free colas are still acidic, they can still wear down enamel. The same study I mentioned found no significant difference in the erosion caused by sugary and sugar free soft drinks. Sugar free is the lesser evil, not the safe option.

It Is How You Drink It That Matters Most

Just like with Halloween sweets, how often and how long you drink matters even more than the amount. Every time you take a sip, your teeth are bathed in acid and sugar for a while afterwards. Your saliva needs time to wash it away and repair the enamel. A can of Coke finished with a meal in fifteen minutes is far kinder to your teeth than a bottle that you sip at your desk or in the car for three hours. The person who sips all day never gives their teeth a break.

Signs That Your Enamel Is Struggling

Enamel wears down slowly, so you may not notice at first. Look out for teeth that feel sensitive to hot, cold or sweet things, teeth that look yellower than before because the enamel is thinning and the layer underneath is showing, edges of the front teeth that look thin or see through, small rounded dents on the biting surfaces, and new cavities appearing.

Once enamel is gone, your body cannot grow it back. That is why prevention matters so much.

How to Enjoy a Coke and Still Protect Your Teeth

I will not tell you to never drink it. Here is what I tell my patients. Have it with a meal, not on its own. The extra saliva you make while eating helps to clear the sugar and acid. Finish it in one sitting. Please do not sip on it for hours. Use a straw. It helps the drink go past the front teeth instead of washing over them. Rinse your mouth with water afterwards. This helps wash away the acid and sugar.

Wait before you brush. Your enamel is soft just after the acid, and brushing straight away can scrub some of it off. Many dentists suggest waiting around half an hour. Keep it for treats. Make water your everyday drink and Coke the drink for special occasions. Brush with fluoride toothpaste twice a day, and floss every day. Do not give it to babies and small children, and never put it in a bottle. Their teeth are even more fragile.

The Bottom Line

Coke is a big part of South African life, and I am not here to take the braai away from you. But please know what is in the bottle. It hits your teeth with sugar and with acid, and the sugar free version still carries the acid.

The best change you can make is simple. Drink less of it, drink it with food, and never sip on it all day. Your teeth will thank you.

If your teeth have become sensitive, or you are worried about what a lifetime of cooldrinks has done to your enamel, come and see me. We can check your teeth and make a plan together, and I promise there will be no judgement.