Pittsburgh dentist Peter Masterson is seeing an alarming increase in horribly decayed teeth and eroded enamel in the mouths of teen-agers and young adults, and he's not alone.
His colleagues across the country are seeing the same thing. So common is the condition that dentists have a name for it: Mountain Dew Mouth.
While all soft drinks can cause tooth decay, dentists consider Mountain Dew to be the worst because it contains high amounts of sugar and caffeine. Doing the Dew with a 20-ounce bottle will give a child 19 teaspoons of sugar and 93 milligrams of caffeine, which is nearly equivalent to an adult dose of NoDoz.
"We are getting kids from 15 into their early 20s with blown-out mouths in terrible condition," said Masterson of Cantor and Masterson Dental Associates. "It didn't take us long to find out that these kids were heavy soda drinkers, Mountain Dew in particular. We're all noticing it."
And that's the reason Masterson and other dentists nationally are against the growing trend of local school districts selling what are called "pouring rights" to soft drink companies.
It works this way: In exchange for money - usually millions - that goes directly into school coffers, a soft drink company installs pop machines in schools. Schools have money for extras such as sports scoreboards and soda companies have captive and usually thirsty teen-age customers. Or, as Masterson sees it, sitting ducks.
"I think there would be a great public outcry if we put cigarette machines in cafeterias to raise money," he said. "There may be a difference here, but I don't think it's a great difference. I believe we are putting kids at risk. I believe it can and does do them harm."
Last fall, the American Dental Association passed a resolution opposing such agreements, then formed a research panel that will present a paper on the effects of soft drink consumption at its annual session in October.
But 62 percent of schools nationally already have soft drink contracts, according to a recent study funded by the National Soft Drink Association.
With ready access to soft drinks, children tend to drink them all day. That, combined with no opportunity to brush, leads to disaster, dentists say.
Tooth decay occurs when bacteria inside the mouth feed on sugar, producing highly acidic waste that removes minerals from the tooth's surface. That process gets a dangerous boost from carbonated soft drinks, which bathe the teeth in phosphoric acid that slowly erodes the protective enamel. Natural minerals in saliva can re-mineralize teeth, but only after the acid is reduced by brushing and flossing.
"We are seeing enamel disappear, especially in the swishers," Masterson said. "This could lead to loss of teeth or very expensive reconstructive dentistry. I have several patients like that in their early 20s and I don't know how we are going to put them back together, but we are going to try."
But Sean McBride, director of communications for the National Soft Drink Association, said many factors lead to tooth decay and that it's unfair to single out soft drinks. He points to two recent studies that show regular soft drink consumption did not lead to increased cavities in children and young adults under 25.
That is true, said Keith Heller, primary investigator of the University of Michigan study that examined data from 30,000 people in the Third National Health and Nutrition Examination Survey. But he added that presenting the findings that way may be misleading.
"We expected them to make hay of our results," Heller said. "But it should be clear that we are not giving a clean bill of health to soda pop."
While children fared well, possibly because of fluoridated water and toothpaste, adults over 25 did not. Heavy adult soda drinkers had 62 percent more decayed, missing and filled teeth than their peers who drank less, leading researchers to believe there may be a cumulative effect.