Analysis of the erosive effect of different dietary substances and medications

Abstract

Excessive consumption of acidic drinks and foods contributes to tooth erosion. The aims of the present in vitro study were twofold: (1) to assess the erosive potential of different dietary substances and medications; (2) to determine the chemical properties with an impact on the erosive potential. We selected sixty agents: soft drinks, an energy drink, sports drinks, alcoholic drinks, juice, fruit, mineral water, yogurt, tea, coffee, salad dressing and medications. The erosive potential of the tested agents was quantified as the changes in surface hardness (DSH) of enamel specimens within the first 2 min (DSH 2 -0 ¼ SH 2 min 2 SH baseline ) and the second 2 min exposure (DSH 4 -2 ¼ SH 4 min 2 SH 2 min ). To characterise these agents, various chemical properties, e.g. pH, concentrations of Ca, P i and F, titratable acidity to pH 7·0 and buffering capacity at the original pH value (b), as well as degree of saturation (pK 2 pI) with respect to hydroxyapatite (HAP) and fluorapatite (FAP), were determined. Erosive challenge caused a statistically significant reduction in SH for all agents except for coffee, some medications and alcoholic drinks, and non-flavoured mineral waters, teas and yogurts (P,0·01). By multiple linear regression analysis, 52 % of the variation in DSH after 2 min and 61 % after 4 min immersion were explained by pH, b and concentrations of F and Ca (P,0·05). pH was the variable with the highest impact in multiple regression and bivariate correlation analyses. Furthermore, a high bivariate correlation was also obtained between (pK 2 pI) HAP , (pK 2 pI) FAP and DSH. There is increasing evidence, from in vitro and in situ studies, that the excessive consumption of acidic drinks and foods poses a risk to dental hard tissues (1 -8) . Tooth surface is softened in the early stage, and subsequently bulk material is dissolved, layer by layer, from the tooth surface. This type of tooth wear is defined as tooth erosion and is caused by acids (extrinsic and intrinsic) or chelating agents not involving bacterial action. There is a trend towards the increased consumption of acidic drinks and foods. In 2007, the worldwide annual consumption of soft drinks reached 552 billion litres, the equivalent of just under 83 litres/person per year, and this is projected to increase to 95 litres/person per year by 2012. However, the figure had already reached an average of 212 litres/person per year in the USA in 2009 (9) . To decrease extrinsic erosive tooth wear, the emphasis should be on preventive strategies that mainly aim at reducing the exposure of teeth to potentially erosive agents.As a prerequisite, it is essential for medical personnel and patients to have a thorough knowledge of the erosive potential of popular dietary substances. In the past several decades, studies investigating the erosive potential of different dietary substances and medications have been performed in different countries (3 -8,10) . A wide range of drinks, foods and medications, such as soft drinks, sports drinks, juices, salad dr...

Effect of foods and drinks on primary tooth enamel after erosive challenge with hydrochloric acid

“…However, there are studies in which yogurt reduced enamel microhardness. 12,25 Lussi et al 26 described that plain yogurt did not cause dental erosion, but the presence of acidic additives in flavoured yogurt resulted in a clinically negligible reduction in after 2 min of exposure. In this experimental model, strawberry yogurt (pH 4.19) did not reduce the enamel microhardness of primary teeth.…”

Dentin hypersensitivity: pain mechanisms and aetiology of exposed cervical dentin

“…Further, these acids can dramatically reduce the dentin surfaces’ ability to resist abrasive forces due to surface softening [10, 105, 139, 140] resulting in further dentin removal and wider open dentin tubules. Contrary to popular belief, yoghurts were not found to cause erosion of enamel and remove the smear layer [141]. Some mouthrinses with low pH will readily dissolve the smear layer to expose open tubules [142] as do some toothpastes detergents, such as sodium lauryl sulphate [143, 144].…”

In vitro evaluation of the erosive potential of viscosity-modified soft acidic drinks on enamel

“…The beverages tested in this study set-up were chosen due to their acidic nature, well-documented erosive potential [22,23] and worldwide consumption. The original viscosities of the tested beverages were regulated by adding hydroxypropyl cellulose (HPC), which is a derivative of polysaccharide cellulose and widely used in food, drug and cosmetics areas to obtain targeted viscosity of products [24].…”