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By Kim Painter, USA TODAY

Some middle-schoolers and teens are showing up at dentists' offices with a problem more often associated with middle age: sensitive, yellowing, pitted teeth that are losing their protective enamel.

Diagnosis: dental erosion, a problem that can be caused by eating disorders and other health problems but that also can be traced to diets heavy in acidic sodas, juices, sports drinks and energy drinks.

"Everyone is seeing this," says Bennett Amaechi, a dental researcher at the University of Texas Health Science Center in San Antonio. Though many dentists suspect that the problem is increasing in children and teens, data are sparse. In an unpublished study of 900 children ages 10 to 14, Amaechi says he and researchers in two other cities, San Francisco and Indianapolis, found signs of erosion in 30%.

Even if the problem is not that common, it is cause for concern, says Keith Morley, president of the American Academy of Pediatric Dentistry.

"I recently saw a very healthy, fit 15-year-old athlete who had extensive erosion of his teeth," says Morley, who practices near Toronto. "He was consuming copious amounts of citrus juice as well as several power drinks each day."

Like many children and teens, Morley's patient was consuming far more of those beverages than health experts recommend. The American Academy of Pediatrics says infants should drink no juice and older children should have no more than 6 to 12 ounces of 100% juice each day. Nutrition experts generally frown on "juice drinks," sodas and other sweetened beverages, except as occasional treats. Calories (which contribute to obesity) and sugar (which contributes to obesity and tooth decay) are the usual reasons for worry.

But dental erosion is caused by another ingredient in those beverages: acid. Soft drinks and juices can contain several different kinds, including carbonic acid, citric acid and phosphoric acid.

In general, citrus juices and citrus-flavored sodas (such as Mountain Dew and 7-Up) cause more damage than colas do, says Raymond Martin, a family dentist in Mansfield, Mass., and a spokesman for the Academy of General Dentistry. And drinks aren't the only culprits: Acidic foods such as pickles, lemons, yogurt and some candies can be troublemakers, too, he says.

But sodas and other acidic drinks are a special concern, he says, because "there are kids who walk around with a soda in their hands all the time." The more time teeth spend bathed in acid, the greater the risk, he says. And preteens and adolescents are especially vulnerable to tooth erosion because their enamel hasn't fully matured, he says.

How to slow the damage

Teeth in the earliest stages of erosion often have a glossy appearance. Later, as the enamel thins, the yellow underlying tissue, called dentin, shows through. Teeth also become more sensitive to heat and cold.

In early stages, treatment with fluoride rinses and toothpastes, along with extra fluoride treatments at a dentist's office, can slow the damage. Patients also are urged to cut consumption of acidic foods and beverages and to consume them more safely — by, for example, drinking soda or juice only at meals.

In later stages, patients may need major dental work to repair and disguise eroded teeth.

Damaged teeth also are more vulnerable to cavities, which are caused by bacteria. The latest data show cavities are increasing in U.S. preschoolers, though not in older children and teens. Drinks — too much soda and juice and not enough milk and fluoridated water — also are chief suspects in the rise of cavities in preschoolers, which was reported by the Centers for Disease Control and Prevention in 2007.

It's hard for some children and adults to change their tooth-damaging habits, Amaechi says. But sometimes, an appeal to vanity works.

"We show them pictures" of eroded teeth, he says. "It looks very ugly."