A few years ago, Dr. Jim Landers had a 15-year-old patient whose teeth were so rotted that virtually all of them had to be extracted. The boy and his mother both sat in Dr. Lander's office – with 64-ounce sodas in their hands – and insisted the boy's soft drink consumption had nothing to do with his dental problems.

Dr. Landers begs to differ. In fact, he is begging schools to take soda pop out of their vending machines so that kids have even less access to it. Dr. Landers is a member of the Wyoming Dental Association, and at his urging, they have started a "No Pop in Schools" campaign aimed at improving not just dental health but overall health.

"In this day and age with the knowledge and technology available to us, we should have virtually no tooth decay," he says. "Instead, we're seeing more. It's crazy what we're doing to these children, and nobody seems to care that they're ruining their health."

Too Much of a Not-so-good Thing
What Dr. Landers is seeing is caused by kids "sipping" sodas throughout the day. This constant application of highly sugared sodas on the tooth enamel is resulting in a corresponding rise in cavities.

Katie Bark, nutritionist and special project coordinator for the Team Nutrition Program at the Montana State University Department of Health and Human Development, says the amount of soft drinks that children consume these days is unprecedented in history. The Center for Science in the Public Interest reports that the average 12- to 19-year-old male drinks more than two cans of soda per day, while the average female consumes a little more than one can a day. Each of those 12-ounce cans of pop contains 10 teaspoons of sugar – the amount the USDA recommends a healthy person limit themselves to per day.

Worse yet is that these 12-ounce cans of pop are becoming passé. "When we were kids, pop came in cute little bottles with something like 6 or 8 ounces, and we had one occasionally as a treat," says Bark. "Now it's 20-ounce cans, which contain 15 teaspoons of sugar, and these drinks are readily accessible everywhere, all the time."

But the problem isn't just that kids are drinking too much pop, it's also that soda has become a substitute for other healthier drinks, such as milk and water, that children need for growing bodies.

A recent Mayo Clinic study showed the dangers of this type of substitution. It found that forearm fractures are on the rise among both adolescent boys and girls. The study's primary investigator, Dr. Sundeep Khosla, a Mayo Clinic endocrinologist, theorizes that the increase in soda pop consumption may be partially responsible – for more reasons than one.

"The most likely reason is that the soda replaces milk consumption, leading to lower calcium intake," says Dr. Khosla. "There is an ongoing debate about whether the phosphate load from drinking soda may, in itself, be bad for bone."

What it is definitely bad for is weight. At the end of 2003, many news organizations picked childhood obesity as the story of the year. This means it topped war, terrorism and high-profile celebrity court cases. It would be naïve to think soda pop wasn't one of the culprits.

Melinda Sothern, an exercise physiologist and author of Trim Kids™: The Proven 12-Week Plan That Has Helped Thousands of Children Achieve a Healthier Weight (HarperResource, 2001), also worries about how those constant sugar "spikes" are going to affect a child's behavior and development.

"Sugar alters the normal glycemic response and insulin response and gives these kids constant revolving insulin peaks," she says. "There are many unanswered questions about how that affects them behaviorally and in terms of their long-term health."

Must Be the Money
Why would any sane, adult school administration expose their student body to these unhealthful drinks? The answer: because they get paid.

"Schools no longer have any discretionary income," says Dr. Landers. "Then these big soda companies come in and offer them a million bucks to put a few machines around the school, and the school boards roll over. For the soda companies, it's all about establishing brand loyalty at a very young age. For the school boards, it's about having that cash. The only losers are the kids."

What has really surprised Dr. Landers in his fight to ban pop in schools is that some parents object to banning the soft drinks in schools, saying their children need to be able to make their own choices.

"That's fine if they have choices that are reasonably healthy," says Landers. "But if it's a choice between four flavored sports drinks, that's no choice at all. These kids' choices are being narrowed down by corporations who want their money and their loyalty and don't give a damn about their health."

Cutting Colas
Probably the most critical thing that parents need to understand is that children aren't drinking soft drinks to quench thirst even if they reach for one when they're thirsty. Kids drink soda because of habit, because it's there and because their peers do it.

Sothern says parents shouldn't ban soft drinks entirely from their children's lives because then they become the holy grail, but she does believe that pop does not belong in schools. Soda should be an occasional treat. Parents should primarily offer their children water and milk. Other choices that would be preferable to sodas are flavored milks, flavored waters and juices that have a high proportion of juice rather than sugar. However, these liquids should not take the place of a primary fluid intake of water and milk.

"If you have a car full of kids you're taking home after a soccer game and it's traditional to stop at a convenience store for a soda, don't make your child stand out by forbidding it," says Sothern. "Rather, buy him a small drink and think of it as a treat. Better yet, encourage him to be a leader and make good choices. His friends may just follow him."

Diet pop isn't off the hook either. As Sothern and Bark both point out, no one knows the long-term effects of either the chemicals or the artificial sweeteners. In addition, diet soda has absolutely no nutritional value. If it has caffeine, it doesn't even have hydrating value because the caffeine cancels that out.

The bottom line is that soda should be a treat. Give kids healthy drink choices at home and in school, and then encourage them to make healthy choices when they're out in the world – without being an alarmist or a nag. Parents can't eliminate kids' bad choices altogether, but they can try to minimize the damage done. Their growing bodies will thank us later.

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• Talk about it!