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      Influence of Various Acidic Beverages on Tooth Erosion. Evaluation by a New Method

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          Abstract

          Material & Methods

          We have analyzed the loss of enamel and dentine after exposure to different non-alcoholic drinks with a simple new method using bovine teeth. 100 enamel and 100 dentine specimens from freshly extracted bovine incisors were randomly attributed to 10 groups (n=10 for enamel and dentine each). Prior to the start of the experiment all specimens were weighed using a precision balance. The mean initial masses (SD) were 35.8 mg (7.2) for enamel and 24.7 mg (7.0) for dentine. No statistically significant differences were found between groups for initial masses (p>0.05, ANOVA with Bonferroni post hoc test). Thereafter, all specimens of one group were simultaneously placed in 200 ml of the following fluids: Coca-Cola, Coca-Cola light, Sprite, apple juice, Red Bull, orange juice, Bonaqua Fruits (Mango-Acai), tap water, chlorinated swimming pool water, and lemon juice. Fluids were continuously ventilated at 37° C for 7 days. Thereafter the specimens were weighed again and the mean mass loss was calculated.

          Results

          The values were (enamel/dentine): Coca-Cola 7.5 mg/6.6 mg; Coca-Cola light 5.2 mg/3.5 mg, Sprite 26.1 mg/17.7 mg, apple juice 27.1 mg/15.2 mg, Red Bull 16.6 mg/17.0 mg, orange juice 24.3 mg/20.2 mg, Bonaqua Fruits (Mango-Acai) 17.8 mg/16.2 mg, tap water -0.2 mg/-0.3 mg, swimming pool water -0.3 mg/-0.2 mg, and lemon juice 32.0 mg/28.3 mg. From all drinks, Cola and Cola light showed the least erosivity (p<0.001, ANOVA with Bonferroni post hoc test) whereas lemon juice showed statistically significant higher erosivity than all other drinks except Sprite and apple juice (p<0.01, ANOVA with Bonferroni post hoc test).

          Conclusions

          In conclusion, erosivity of common non-alcoholic drinks varies widely. For example, Sprite, apple juice, and orange juice are about five times more erosive than Coca-Cola light. The findings from the present study should be taken into account in choosing a diet that provides satisfactory nutrition while minimizing tooth erosion.

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          Most cited references22

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          What is the critical pH and why does a tooth dissolve in acid?

          This paper discusses the concept of critical pH for dissolution of enamel in oral fluids. The critical pH does not have a fixed value but rather is inversely proportional to the calcium and phosphate concentrations in the solution. The paper also discusses why teeth dissolve in acid, why remineralization of white-spot caries lesions is possible and why remineralization of teeth eroded by acid is not possible.
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            Estimated prevalence of erosive tooth wear in permanent teeth of children and adolescents: an epidemiological systematic review and meta-regression analysis.

            The main purpose of this systematic review was to estimate the prevalence of dental erosion in permanent teeth of children and adolescents.
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              Erosive tooth wear: a multifactorial condition of growing concern and increasing knowledge.

              Dental erosion is often described solely as a surface phenomenon, unlike caries where it has been established that the destructive effects involve both the surface and the subsurface region. However, besides removal of the surface, erosion shows dissolution of mineral within the softened layer - beneath the surface. In order to distinguish this process from the carious process it is now called 'near surface demineralization'. Erosion occurs in low pH, but there is no fixed critical pH value concerning dental erosion. The critical pH value for enamel concerning caries (pH 5.5-5.7) has to be calculated from calcium and phosphate concentrations of plaque fluid. In the context of dental erosion, the critical pH value is calculated from the calcium and phosphate concentrations in the erosive solution itself. Thus, critical pH for enamel with regard to erosion will vary according to the erosive solution. Erosive tooth wear is becoming increasingly significant in the management of the long-term health of the dentition. What is considered as an acceptable amount of wear is dependent on the anticipated lifespan of the dentition and is, therefore, different for deciduous compared to permanent teeth. However, erosive damage to the teeth may compromise the patient's dentition for their entire lifetime and may require repeated and increasingly complex and expensive restorations. Therefore, it is important that diagnosis of the tooth wear process in children and adults is made early and that adequate preventive measures are undertaken. These measures can only be initiated when the risk factors are known and interactions between them are present.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                2 June 2015
                2015
                : 10
                : 6
                : e0129462
                Affiliations
                [001]Dept. of Operative and Preventive Dentistry, School of Dentistry, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, Witten, Germany
                Glasgow University, UNITED KINGDOM
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: SZ GK MBi MBe. Performed the experiments: GK MBe. Analyzed the data: SZ. Contributed reagents/materials/analysis tools: SZ GK MBe. Wrote the paper: SZ MBi.

                Article
                PONE-D-15-03604
                10.1371/journal.pone.0129462
                4452714
                26035729
                83fbbd33-94be-47b2-a3b0-c7ae4b262a50
                Copyright @ 2015

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

                History
                : 8 February 2015
                : 9 May 2015
                Page count
                Figures: 1, Tables: 1, Pages: 8
                Funding
                The authors received no specific funding for this work.
                Categories
                Research Article
                Custom metadata
                All relevant data are within the paper.

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