It IS the morning ritual for millions of people, among them Beyoncé and Jennifer Aniston: starting the day with a glass of hot water and lemon.
They do it in the belief that it’s ‘good’ for the liver and boosts the digestive system. Many also go on to sip water flavoured with lemon and other fruit slices throughout the day.
Yet not only is there little — if any — medical evidence to support these ideas but drinking hot water and lemon, and lemon-infused water, could actually undermine your efforts to be healthy.
‘Hot water and lemon is repeatedly mis-sold as a cure-all for multiple health conditions,’ says dentist Hannah Woolnough, a spokesperson for the British Dental Association. ‘But what’s so alarming is the damage this habit can do to your teeth — which in many cases is permanent and cannot be reversed.’
Dentist Nilesh Parmar, who runs Parmar Dental in Essex, agrees: ‘I know so many patients who drink water and lemon and I really wish they wouldn’t. They do it in the mistaken belief that they are choosing a healthy option because that’s what they hear.’
Drinking hot water and lemon, and lemon-infused water, could actually undermine your efforts to be healthy
And like the other dentists Good Health spoke to, Nilesh Parmar suspects it’s this fashion for hot water and lemon (or sipping fruit-based drinks), rather than fizzy drinks, that’s driving the rise in dental decay they’re now seeing.
Yet not only can it be damaging for teeth, there is nothing to support the idea that drinking hot water and lemon will ‘cleanse’ or ‘detox’ the liver as claimed, says Professor David Lloyd, a consultant liver surgeon at Leicester Royal Infirmary.
‘To ‘detox’ the liver — as the phrase mistakenly goes — or rather heal damage to the liver, you have to stop doing the things that make it work so hard and cause problems in the first place such as drinking alcohol or taking drugs [unless needed to treat health problems].
‘That, together with drinking about two litres of water a day, will keep the liver healthy. A glass of hot water and lemon can’t achieve this. What’s more, the liver’s job is to detox, there’s no such thing as ‘detoxing’ the liver itself.’
The evidence is equally scant to support using hot water and lemon as a digestive aid, says Dr Steven Mann, a consultant gastroenterologist at the Royal Free London NHS Foundation Trust.
He roundly dismisses the idea suggested by some ‘natural health experts’ that hot water and lemon will stimulate gastric juices, and help push things along (by stimulating the wave-like muscle contractions, known as peristalsis).
‘There is no evidence for extra gastric secretions or enhanced peristalsis,’ he says, adding, that lemons have no particular benefits over other plant-based foods.
‘The only thing water and lemon is good for is replacing fluids, necessary to keep the body hydrated — but that’s down to the water, not the lemon,’ he says.
‘Furthermore, people susceptible to reflux — where acid and other stomach contents are brought back up into the throat — will find lemon water exacerbates the issue because it is acidic.’
Hot water and lemon may sound like a social media-inspired trend, but it first became popular in 1941 when a dietitian in the U.S., Stanley Burroughs, created The Master Cleanser, a diet that set out a ‘liquid cleanse’ — including water and lemons — as a natural way to flush the body of toxins, pesticides and other impurities.
The ongoing popularity of the drink, however, is partly because the lemon provides vitamin C — needed to protect cells from damage, help with wound healing and to maintain healthy blood vessels and cartilage; to some people this gives it healthy credentials.
But when it comes to teeth, hot water with added lemon is anything but healthy — not least because the highly acidic lemon juice can over time dissolve the hard protective enamel surface.
‘The worn-away enamel can then open the door to bacteria which can cause cavities or infection,’ adds Hannah Woolnough. ‘It also makes teeth discoloured as enamel, which is white, is worn away to expose the dentine layer underneath, which is yellow.’
Damage to the enamel can also cause pain and sensitivity as it exposes nerve endings below.
Once enamel is worn away, the only option is to treat the damage with some form of covering such as fillings, veneers and crowns.
If decay is so extensive it reaches the tooth pulp — the innermost layer of the tooth — and especially if there is an infection, this may lead to root canal treatment or even removal of the tooth.
It is the acid together with the heat from hot water and lemon that produces ‘the perfect storm to encourage erosion and lead to decay,’ says Nilesh Parmar.
That’s because acidic lemon provides a better environment for harmful bacteria to live in and these bacteria produce further acid to decalcify the teeth.
‘Hot water can exacerbate this effect by causing the enamel to expand and contract rapidly, further increasing the risk of enamel erosion leading to sensitivity, decay and even tooth loss,’ explains dentist Alan Clarke, of Paste Dental in Belfast.
Once enamel is worn away, the only option is to treat the damage with some form of covering such as fillings, veneers and crowns
Saliva can act as a buffer to the acid to a certain extent, not least as it contains a form of calcium that can mitigate some of the damage caused by acid — essentially ‘remineralising’ the enamel.
‘But it can only do so much when there is repeated and prolonged exposure,’ says Alan Clarke.
Indeed, a lot of people don’t limit themselves to a single hot water and lemon in the morning.
‘The problem is that since it’s seen as a healthy drink, people will also fill a water bottle with pieces of lemon and sip it throughout the day,’ says Nilesh Parmar.
‘However, in doing so they are constantly exposing their teeth to acidic water — and it is this prolonged exposure (i.e. the amount of time that acid sits in the mouth and coats the teeth) that leads to most damage.’
In fact, a 2018 study by King’s College London found that those who drank water with a slice of lemon or hot fruit-flavoured teas between meals were more than 11 times more likely to have moderate or severe tooth erosion than those who didn’t.
The UK has significant problems when it comes to dental health. Almost one in three adults has tooth decay — sipping acidic drinks can only make the situation worse.
If you really must drink water and lemon, ‘minimise damage by mixing the lemon with cold or lukewarm water instead [of hot water]’, says Alan Clarke, adding it’s worth using a straw ‘to help reduce the contact between the acidic drink and your teeth, reducing the risk of enamel erosion’.
After having your drink rinse your mouth straight away with plain water, says Hannah Woolnough. This will wash the acid away from the mouth.
‘Or rinse with fluoride mouthwash as this will harden the enamel,’ she says.
She also suggests chewing sugar-free gum after drinking lemon water: ‘This stimulates saliva flow, which will buffer the acid attack and put calcium — through the saliva — back in your mouth.’
Given hot water and lemon is often consumed in the morning, any harm to teeth is compounded if you then brush them straight after. That’s because acid exposure temporarily softens the enamel and brushing can scrape away at the protective surface.
‘That’s why it’s best to leave at least an hour between drinking hot water with lemon and brushing,’ says Alan Clarke.
‘When you do brush, make sure you use a good fluoride toothpaste to remineralise the enamel.’
Above all, remember that exposure to any dietary acid can cause irreversible tooth damage, warns Nilesh Parmar.
‘Of course, fruit contains acid, but there are other benefits to eating fresh fruit since it is needed as part of a healthy balanced diet — this is a demonstrable benefit. Though it’s still better to have it at mealtimes.
‘There just isn’t any reason or need to add things like lemon to water. It has the potential to cause too much harm.’
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