Erosive Impact of Acidic 'Healthy' Beverages on Dental Enamel: A Systematic Review (2013–2025)

Background: Acidic beverages marketed as “healthy” (fruit juices, smoothies, vitamin waters, kombucha, carbonated waters, sports/energy drinks) may contribute to dental erosion – the nonbacterial, chemical dissolution of tooth minerals. Methods: A systematic search of PubMed, Web of Science, and Scopus (2013–2025) was conducted following best practice reporting guidelines. Inclusion criteria comprised English language studies evaluating enamel or dentin erosion (in vitro, in situ, and clinical) associated with these beverages. Data on beverage pH, titratable acidity (TA), enamel surface loss or softening, and protective interventions were extracted. Results: From 1 120 screened records, 38 studies (17 in vitro, 5 in situ, 16 clinical/observational) met eligibility. All categories of “healthy” acidic drinks produced measurable enamel softening or surface loss. Fruit juices/smoothies (pH ≈ 3–4) and kombucha (pH ≈ 2.5–3.5) often exceeded carbonated soft drinks in erosive potential. Sports/energy drinks (pH ≈ 3.1–3.6; high TA) showed strong associations with erosive tooth wear in active populations. Mitigating factors include salivary flow, consumption patterns, fluoride, and calcium fortification. Conclusions: Beverages perceived as healthy can pose a substantial risk for dental erosion. Dental professionals should apply protective measures. Manufacturers could reduce erosive potential through buffering or calcium addition.