Erosive potential of ice tea beverages and kombuchas.

OBJECTIVES: Kombuchas and other tea-based beverages are often perceived as healthy products despite the lack of knowledge on their effects on oral health. This in vitro study determined the erosive potential of commercial kombuchas, and ice teas compared to cola drinks. MATERIALS AND METHODS: The pH and fluoride content of 7 kombuchas and 18 tea drinks were measured with ion-selective electrodes. Calcium dissolution from hydroxyapatite grains was quantified by atomic absorption spectroscopy after beverage exposure. The effect of beverages on the enamel surface was visualized by scanning electron microscopy (SEM). Distilled water, and cola drinks were used as negative and positive controls. RESULTS: The kombuchas exhibited lower pH values (2.82-3.66) than the ice teas (2.94-4.86), but still higher than the cola drinks (2.48-2.54). The fluoride concentration varied between 0.05 and 0.46 ppm and for 7 beverages the concentration was below the detection limit. The calcium release for kombuchas was 198-746 mg/l, for ice teas 16.1-507 mg/l, and for cola drinks 57.7-71.9 mg/l. Twenty-two beverages had a significantly greater calcium release than the cola drinks (p = .009-.014). The surface etching of the enamel was seen in the SEM analysis after beverage exposure. CONCLUSIONS: Tea-based beverages have even higher erosive potential than cola drinks. Kombuchas especially, displayed a considerable erosive potential.

Investigação do potencial erosivo de gomas de mascar não convencionais / Investigation the erosive potential of unconventional chewing gums

Objetivo: mensurar o potencial erosivo de gomas de mascar não convencionais disponíveis no mercado brasileiro. Material e método: estudo experimental (in vitro) de caráter quantitativo. Foram adquiridos oito sabores de gomas de mascar: Poosh® (pinta língua); Plutonita® (abraço congelante, dentada ardente, baba de bruxa e língua ácida); e TNT® (sangue, lava e tumba). Para análise da acidez, foram realizadas leituras em triplicata do pH e acidez titulável (AT), utilizando um potenciômetro e eletrodo combinado de vidro em soluções obtidas após a maceração das gomas de mascar em água duplamente deionizada. Nas soluções com valores de pH inferiores a 5,5, foi mensurada a AT adicionando-se alíquotas de 100 µLNaOH 0,1 M, até alcançar pH 5,5. Os resultados foram submetidos à Análise de Variância (ANOVA). As comparações das médias de pH e acidez titulável foram realizadas pelo teste de Tukey, com um nível de 5% de significância (p<0,05). Resultados: os valores de pH variaram entre 2,4 (abraço congelante) e 3,5 (baba de bruxa), diferin-do significantemente do controle (água mineral/pH=6,2). Os valores de acidez titulável variaram entre 628µL de NaOH 0,1 M (sangue) e 10700µL de NaOH 0,1 M (abraço congelante). A goma de mascar sabor abraço congelante apresentou o pH mais baixo e a mais elevada acidez titulável, diferindo significantemente dos demais sabores. Conclusões: as gomas de mascar avaliadas são ácidas, mas diferem quanto ao seu potencial erosivo. Seu consumo abusivo pode constituir um fator de risco para erosão dental.(AU)

Objective: to measure the erosive potential of non- -conventional chewing gums available in the Brazilian market. Material and methods: this is an in vitro study using the following flavors of chewing gums from the Brazilian market: Poosh® (tongue cleaner); Plutonita® (freezing hug, burning bite, witch slime and acid tongue); TNT® (blood, lava and tomb). For acidity analysis, pH and titratable acidity (TA) readings were performed in triplicate using a potentiometer and combined glass electrode in solutions obtained after maceration of the chewing gums in double deionized water. In solutions with pH values below 5.5, the TA was measured by adding aliquots of 100 µL 0.1 M NaOH, until pH 5.5 was reached. The results were submitted to Analysis of Variance (ANOVA). Comparisons of pH and titratable acidity means were performed by Tukey test at a 5% significance level (p<0.05). Results: the pH values that ranged from 2.4 (freezing hug) to 3.5 (witch's slime) differed significantly from the control (mineral water/ pH=6.2). Titratable acidity values ranged from 628µL of 0.1 M NaOH (blood) to 10700µL of 0.1 M NaOH (freezing hug). The freezing hug flavor chewing gum had the lowest pH and the highest titratable acidity differing significantly from the other flavors. Conclusions: the evaluated chewing gums are acidic, but differ in their erosive potential. Their abusive consumption may constitute a risk factor for dental erosion.(AU)

Influence of cigarette smoke combined with different toothpastes on enamel erosion.

This in vitro study aimed to evaluate the effect of different toothpastes on dental enamel subjected to an erosive cycle with and without exposure to cigarette smoke. Bovine enamel specimens were randomly allocated into 12 groups (n = 12). For the in vitro simulation of smoking, half the groups underwent an exposure cycle of 20 cigarettes per day for 5 days. Subsequently, all groups were subjected to a 5-day erosion cycle intercalating demineralization (1 min; 1% citric acid; pH = 3.5) and treatment with toothpaste slurries (2 min) of NaF, SnF2, F/Sn/Chitosan, F/CaSiO3/Na3PO4, and F/bioactive glass. The control group was immersed in distilled water. Surface microhardness (SMH) was measured initially, after exposure to smoke, and after the erosive cycle, and %SMH was calculated. At the end of the experimental cycle, surface roughness, profilometry, and atomic force microscopy (AFM) were performed. SMH increased after exposure to cigarette smoke (p < 0.05). After the erosive cycle, there were no differences between the presence and absence of cigarette smoke exposure in SMH and roughness (p > 0.05). Besides increasing enamel SMH, cigarette smoke did not prevent enamel loss after the erosion cycle (p < 0.05). In profilometry, roughness and surface loss had the lowest values in the groups treated with SnF2 and F/Sn/Chitosan (p < 0.05). AFM showed lower mineral loss with F/CaSiO3/Na3PO4 and F/Sn/Chitosan. For all groups, except F/CaSiO3/Na3PO4, cigarette smoke resulted in higher enamel wear. F/Sn/Chitosan showed the best results against erosion.

Susceptibility of partially desalivated rats to erosive tooth wear by calcium-supplemented beverages.

OBJECTIVES: To investigate the susceptibility of partially desalivated rats to erosive tooth wear (ETW); the anti-erosive effect of a calcium-supplemented beverage; and the quantification of ETW by microcomputed tomography (micro-CT). METHODS: The study population consisted of thirty-eight rats, divided into partially desalivated (n = 19) and normal salivary flow (n = 19). They were randomly allocated into three subgroups (n = 6-7): A-diet soda, B-diet soda + calcium, C-water (control). Solutions were provided ad libitum for 28 days, and the rats were euthanized afterwards. Each left hemi-mandible was scanned using micro-CT for enamel volume (three molars) calculation. Visual analysis of photographs of the lingual surface of first molars was performed independently by three blinded examiners. Data were statistically analysed (α = .05). RESULTS: Micro-CT revealed no significant differences between partially desalivated or normal groups. Rats consuming A had more enamel loss than those consuming B or C, which did not differ from each other. For visual analysis, desalivation did not affect ETW. Rats consuming C showed the lowest ETW, followed by B and then A, for both partially desalivated and normal rats. Spearman correlation between the two ETW quantification methods was -.65. CONCLUSIONS: Partial desalivation did not increase ETW. Ca-containing beverage prevented ETW. Micro-CT quantified ETW, although it was not as sensitive as visual analysis.

Dental erosion in archaeological human remains: A critical review of literature and proposal of a differential diagnosis protocol.

OBJECTIVE: Although studies of dental wear on archaeological human remains have largely focused on mechanical wear (attrition and abrasion) in the past, chemical wear (erosion) is being increasingly identified as a separate form of wear. This paper aims to review the current state of research and to develop a protocol that may be universally used by biorchaeologists to specifically identify dental erosion. DESIGN AND RESULTS: A critical review of literature has been done in order to highlight the issues related to diagnosis of dental erosion in archaeological human remains. The bodies of work based on the analysis of both modern and archaeological dentitions raise their separate problems. In addition to a need to re-evaluate symptoms of dental erosion, notably dentin 'cupping', it is apparent that no specific protocol is adapted from medical to archaeological sciences. Authors rather rely on tooth wear indices and photographs of modern clinical cases for diagnosis. Furthermore, the diagenetic chemical alternation has rarely been considered as a bias. CONCLUSIONS: Here we suggest a three-step protocol: the primary method is the microscopic identification of dental erosion by SEM, followed by the exclusion of taphonomic aetiology on surrounding bone and soil pH analysis. Archaeologists should also explore possible causative agents of wear using archaeological and historic knowledge about the population being analyzed.

Consensus Report of the European Federation of Conservative Dentistry: Erosive tooth wear – diagnosis and management.

OBJECTIVE: Due to an increased focus on erosive tooth wear (ETW), the European Federation of Conservative Dentistry (EFCD) considered ETW as a relevant topic for generating this consensus report. MATERIALS AND METHODS: This report is based on a compilation of the scientific literature, an expert conference, and the approval by the General Assembly of EFCD. RESULTS: ETW is a chemical-mechanical process resulting in a cumulative loss of hard dental tissue not caused by bacteria, and it is characterized by loss of the natural surface morphology and contour of the teeth. A suitable index for classification of ETW is the basic erosive wear examination (BEWE). Regarding the etiology, patient-related factors include the predisposition to erosion, reflux, vomiting, drinking and eating habits, as well as medications and dietary supplements. Nutritional factors relate to the composition of foods and beverages, e.g., with low pH and high buffer capacity (major risk factors), and calcium concentration (major protective factor). Occupational factors are exposition of workers to acidic liquids or vapors. Preventive management of ETWaims at reducing or stopping the progression of the lesions. Restorative management aims at reducing symptoms of pain and dentine hypersensitivity, or to restore esthetic and function, but it should only be used in conjunction with preventive strategies. CONCLUSIONS: Effective management of ETW includes screening for early signs of ETW and evaluating all etiological factors. CLINICAL RELEVANCE: ETW is a clinical condition, which calls for the increased attention of the dental community and is a challenge for the cooperation with other medical specialities.

The pH of beverages in the United States.

BACKGROUND: Dental erosion is the chemical dissolution of tooth structure in the absence of bacteria when the environment is acidic (pH < 4.0). Research indicates that low pH is the primary determinant of a beverage's erosive potential. In addition, citrate chelation of calcium ions may contribute to erosion at higher pH. The authors of this study determined the erosive potential measured by the pH of commercially available beverages in the United States. METHODS: The authors purchased 379 beverages from stores in Birmingham, Alabama, and categorized them (for example, juices, sodas, flavored waters, teas, and energy drinks) and assessed their pH. They used a pH meter to measure the pH of each beverage in triplicate immediately after it was opened at a temperature of 25°C. The authors recorded the pH data as mean (standard deviation). RESULTS: Most (93%, 354 of 379) beverages had a pH of less than 4.0, and 7% (25 of 379) had a pH of 4.0 or more. Relative beverage erosivity zones based on studies of apatite solubility in acid indicated that 39% (149 of 379) of the beverages tested in this study were considered extremely erosive (pH < 3.0), 54% (205 of 379) were considered erosive (pH 3.0 to 3.99), and 7% (25 of 379) were considered minimally erosive (pH ≥ 4.0). CONCLUSIONS: This comprehensive pH assessment of commercially available beverages in the United States found that most are potentially erosive to the dentition. PRACTICAL IMPLICATIONS: This study's findings provide dental clinicians and auxiliaries with information regarding the erosive potential of commercially available beverages. Specific dietary recommendations for the prevention of dental erosion may now be developed based on the patient's history of beverage consumption.

Consensus report of the European Federation of Conservative Dentistry: erosive tooth wear--diagnosis and management.

OBJECTIVE: Due to an increased focus on erosive tooth wear (ETW), the European Federation of Conservative Dentistry (EFCD) considered ETW as a relevant topic for generating this consensus report. MATERIALS AND METHODS: This report is based on a compilation of the scientific literature, an expert conference, and the approval by the General Assembly of EFCD. RESULTS: ETW is a chemical-mechanical process resulting in a cumulative loss of hard dental tissue not caused by bacteria, and it is characterized by loss of the natural surface morphology and contour of the teeth. A suitable index for classification of ETW is the basic erosive wear examination (BEWE). Regarding the etiology, patient-related factors include the pre-disposition to erosion, reflux, vomiting, drinking and eating habits, as well as medications and dietary supplements. Nutritional factors relate to the composition of foods and beverages, e.g., with low pH and high buffer capacity (major risk factors), and calcium concentration (major protective factor). Occupational factors are exposition of workers to acidic liquids or vapors. Preventive management of ETW aims at reducing or stopping the progression of the lesions. Restorative management aims at reducing symptoms of pain and dentine hypersensitivity, or to restore esthetic and function, but it should only be used in conjunction with preventive strategies. CONCLUSIONS: Effective management of ETW includes screening for early signs of ETW and evaluating all etiological factors. CLINICAL RELEVANCE: ETW is a clinical condition, which calls for the increased attention of the dental community and is a challenge for the cooperation with other medical specialities.

Dental caries and erosion status of 12-year-old Hong Kong children.

BACKGROUND: This study aimed to assess the dental caries and erosion status of 12-year-old Hong Kong children and study the determinants of dental caries and dental erosion of these children. METHODS: The survey was performed from 2011 to 2012 with ethics approval. Stratified random sampling was adopted to select 12-year-old children in 7 primary schools in Hong Kong. The participating parents were asked to complete a self-administered questionnaire concerning their children's diet and oral health habits. The children were examined for caries status with WHO criteria by 3 calibrated examiners. Detection of dental erosion followed Basic Erosive Wear Examination (BEWE) criteria. RESULTS: A total of 704 children were recruited and 600 (316 boys, 53%) participated in the survey. There were 124 children (21%) with caries experience (DMFT > 0) and their DMFT was 0.34 ± 0.76. About half of their decay was unfilled (DT = 0.16 ± 0.52) The DMFT of girls and boys were 0.45 ± 0.89 and 0.23 ± 0.61, respectively (p = 0.001). Girls also had a higher DT (0.21 ± 0.62 compared with 0.11 ± 0.41, p = 0.013) and FT than boys (0.23 ± 0.63 compared with 0.12 ± 0.44, p = 0.016). Most children (75%) had at least some sign of erosion (BEWE > 0), but no severe erosion (BEWE = 3). Logistic regression showed girls who consumed soft drinks and took vitamin C supplements had higher caries risk. Dental erosion was more severe among the children who had caries experience and consumed fruit juice. CONCLUSIONS: The 12-year-old Hong Kong children had low caries experience, and almost half of the decay was left untreated. Although severe erosion was not found, many children had early signs of erosion.

Novel in-situ longitudinal model for the study of dentifrices on dental erosion-abrasion.

A novel longitudinal erosion-abrasion in-situ model was proposed. In an exploratory test (phase 1) toothbrushing effect was investigated using a parallel design, whereas in the main study (phases 1 + 2), a crossover design tested the effect of fluoride dentifrice. In phase 1, 16 subjects (n = 5-6 subjects per group) wore partial dentures with enamel specimens for 28 d and adhered to one of the following treatment regimens: regimen A, erosion only; regimen B, erosion + toothbrushing with fluoride-containing dentifrice [1,100 ppm of fluoride as sodium fluoride (NaF)]; and regimen C, erosion + toothbrushing with placebo dentifrice (0 ppm fluoride). Erosion consisted of the exposure of specimens to grapefruit juice. In regimens B and C, toothbrushing was performed with the test dentifrices 5 min after erosion. For the main study a second phase was carried out in which subjects initially treated with regimen B were treated with regimen C, and vice versa (crossover, n = 11), repeating the same experimental protocol. Enamel wear was measured by optical profilometry at baseline and every 7 d thereafter. In the exploratory test (phase 1), no significant differences were observed among regimens at any of the study time-points. In the main study (phases 1 + 2), higher enamel wear was observed for regimen C than for regimen B. A significant trend was observed for the increase of enamel wear over time. Fluoridated dentifrice reduced the development of erosive-abrasive lesions. The proposed longitudinal model provided adequate responses for erosion-abrasion frequency and fluoride effects.

Toothpaste and erosion.

Dental erosion develops from the chronic exposure to non-bacterial acids resulting in bulk mineral loss with a partly demineralised surface of reduced micro-hardness. Clinical features are loss of surface structures with shallow lesions on smooth surfaces and cupping and flattening of cusps; already in early stages, coronal dentine often is exposed. Not only enamel, but also dentine is therefore an important target tissue for anti-erosion strategies. The main goal of active ingredients against erosion is to increase the acid resistance of tooth surfaces or pellicles. The challenge with toothpastes is that abrasives, otherwise beneficial in terms of cleaning properties, may counteract the effects of active ingredients. Fluoride toothpastes offer a degree of protection, but in order to design more effective formulations, active ingredients in addition to, or other than, fluorides have been suggested. Polyvalent metal cations, Ca/P salts in nano-form, phosphates, proteins, and various biopolymers, e.g. chitosan, are substances under study. The complex combined action of active ingredients and abrasives on the dental hard tissues, and the role of excipients of complex toothpaste formulations are not yet fully understood. Current evidence is flawed by the diversity of experimental designs, and there is no knowledge from clinical studies with patients so far. However, research results indicate that there is potential to develop effective toothpastes in this field. As the prevalence of initial erosive lesions particularly in younger age groups is high in some countries, such strategies would be of great importance for maintaining oral health.

Erosive potentials of brewed teas.

PURPOSE: To measure the pH, titratable acidity, fluoride concentration and erosive potential of brewed teas. METHODS: Bag teas were purchased to represent black, green, citrus, fruity, and floral tea flavors from Tulsi, Bigelow, HyVee, Tazo, and Yogi brands and brewed (1 bag/240 ml) in boiling water for 3 minutes. The pH, titratable acidity, and fluoride concentrations were measured. Following these measurements, a representative tea from each flavor was selected for investigation of erosion potential. Six extracted human molars were randomly assigned to each tea. Teeth were painted with fingernail polish to expose a 1 x 4 mm window and then soaked in tea for a total of 25 hours with teas refreshed every 5 hours. Teeth were then sectioned using a microtome and photographed using a polarized light microscope. Lesion depths (i.e., eroded surfaces) were measured using Image Pro Plus software. Differences in physiochemical properties and lesion depths between beverages were investigated using one-way ANOVA with post-hoc Tukey's HSD test. Relationships among lesion depths and physiochemical properties were evaluated using the Pearson correlation test. RESULTS: pH, titratable acidity and fluoride concentrations differed between tea flavors (P < 0.05) and between brands (P < 0.05). Lesion depths produced by the citrus tea (83.1 +/- 10.3 microm) were greater than those produced by the fruity tea (56.5 +/- 6.1 microm); both teas produced greater depths than black (30.1 +/- 7.4 microm), floral (25.0 +/- 3.2 microm) or green (22.3 +/- 6.3 microm) teas (P < 0.05). pH (r = -0.96; P = 0.009) was inversely and titratable acidity (r = 0.97; P = 0.006) was positively associated with lesion depths.

Evaluation of bleaching efficacy and erosion potential of four different over-the-counter bleaching products.

PURPOSE: To evaluate the bleaching efficacy and erosion potential of various over-the-counter bleaching products following a test method specified in ISO 28399. METHODS: Specimens were prepared from bovine molars, stained in tea solution, embedded and randomly assigned to six groups of 10 enamel and dentin specimens each. Color was assessed at baseline, 1 day and 1 month post-bleaching with the Vita Bleachedguide 3D Master shade guide. Surface roughness changes (deltaRa), determined by baseline and post-treatment values were measured with a profilometer. The negative (NC) and positive control (PC) was treated with grade 3 water and 1.0% citric acid, respectively. Over-the-counter products were used according to manufacturer's instructions. Brite Teeth Pro (BT), Natural White 5-Minute Whitening (NW), Luster Premium White (LP), and Crest 3D Whitestrips (WS) represented a brush-on-paint system, tray system, light-activated system and adhesive-strip system, respectively. Kruskal-Wallis procedure was used to compare surface roughness changes among groups. Color change was assessed with Friedman-test and stratified by hard tissue type with alpha= 0.05. RESULTS: WS was the only group demonstrating color changes in enamel and dentin (P< 0.05). There were no differences in deltaRa for enamel and dentin among NC, BT, LP, and WS. NW showed increase in deltaRa in dentin (P< 0.05), while PC demonstrated an increase in deltaRa regardless of hard tissue type (P< 0.05).

Effect of sweetening agents in acidic beverages on associated erosion lesions.

Accurate diagnosis of erosion defects caused by acidic beverages is essential when designing a comprehensive management strategy that includes combating possible recurrence. The manifestations of erosion lesions associated with acidic beverages are diverse, as seen in the differences and similarities of lesions associated with various regular and diet varieties of beverages. Erosion lesions caused by regular sugar-sweetened beverages display signs similar to dental caries, while lesions resulting from diet, non-sugar-sweetened soft drinks have defects similar to mechanical wear of the dentition. Aggravating factors such as toothbrushing or compromised oral home care could influence the features of erosion lesions. These diverse characteristics of erosion lesions could make identification difficult. This article describes pertinent signs of erosion defects associated with the regular and diet varieties of acidic beverages and discusses their causative factors. This information is designed to avert an improper diagnosis that would derail any restorative intervention and alter a proper preventive management course.

Estudo "in situ" da superfície de dentes bovinos após exposição por medicamento fitoterápico / In situ study of bovine tooth surface after exposure to herbal medicine

Objetivo: Avaliação do desgaste da superfície do esmalte dentário de incisivos bovinos submetidos à ação de um medicamento fitoterápico (Melkatess). Metodologia: Participaram deste estudo "in situ", seis voluntários (alunos do curso de Odontologia do Centro Universitário do Pará - CESUPA) que utilizaram, durante sete dias, um dispositivo intraoral contendo oito blocos de dentes bovinos medindo 4 mm x 4 mm, os quais foram submetidos à ação do medicamento fitoterápico - Melkatess a cada 8h, durante 5 min. Em cada bloco bovino foram confeccionadas duas áreas, uma área-controle e uma área submetida à erosão, sendo que para obtenção destas áreas no mesmo bloco, foram aplicadas duas camadas de esmalte cosmético de unha (Risqué, Niasi, Taboão da Serra, São Paulo, Brasil), deixando-se uma janela central com cerca de 1,5 mm de largura. Após o período de teste, as amostras foram avaliadas pelo método de Perfilometria. Os dados foram analisados pelo Anova e teste de Tukey (p menor que 0,05). Resultados: Observou-se que as médias de desgaste do grupo controle (2,02±0,18 µm) diferiram estatisticamente (p menor que 0,05) das médias encontradas no grupo exposto ao medicamento Melkatess (4,44±0,27 µm). Houve maior desgaste nas áreas expostas ao medicamento em relação às áreas não-expostas ao medicamento (área-controle). Conclusão: O medicamento fitoterápico (Melkatess) possui potencial erosivo sobre as superfícies do esmalte de incisivos bovinos.

Objective: To evaluate the erosion of the enamel surface of bovine incisors subjected to the action of a herbal medicine (Melkatess). Methods: Six volunteers (dental students from the University Center of Para - CESUPA, PA, Brazil) were enrolled in this in situ study by using for 7 days an intraoral appliance containing 8 bovine tooth enamel blocks measuring 4mm x 4mm, which were subjected to the action of an herbal medicine (Melkatess) for 5 minutes every 8 hours. Each block had a control area and an area subjected to erosion. To obtain these areas, the blocks were coated with two layers of nail polish (Risqué), leaving a 1.5 mm wide central window. After the test period, the samples were examined by profilometry. Data were analyzed statistically by ANOVA and Tukey's test (p less than 0.05). Results: The averages of erosion in the control group (4.44±0.27 µm) differed significantly (p less than 0.05) from those of the group exposed to Melkatess (2.02±0.18 µm). There was greater erosion of the areas exposed to the medicine compared with those that were not exposed (control areas). Conclusion: The herbal medicine (Melkatess) showed erosive potential on the enamel surface of bovine incisors.

Development of an orange juice surrogate for the study of dental erosion.

The aim of this study was to create a synthetic juice (SJ) to be used as a surrogate for natural orange juices in erosion studies, verifying its erosive potential. The SJ was formulated based on the chemical composition of orange juices from different locations. Forty enamel and 40 root dentin specimens were randomly assigned into 4 experimental groups (n = 10): SJ; 1% Citric Acid (CA); Minute Maid Original® (MM) and Florida Natural Original® (FN). The specimens were immersed in their respective solutions for 5 min, 6x/day for 5 days, in an erosion-remineralization cycling model. Enamel specimens were analyzed by surface Knoop microhardness and optical profilometry and dentin specimens only by optical profilometry. Outcomes were analyzed statistically by ANOVA followed by Tukey's test considering a significance level of 5%. For enamel, the surface loss and microhardness changes found for MM and SJ groups were similar (p>0.05) and significantly lower (p<0.01) than those found in the CA group. For dentin, CA promoted significantly greater (p<0.01) surface loss compared with all the other groups. No significant difference (p>0.05) was observed in dentin surface loss between MM and SJ. In conclusion, CA was the most erosive solution, and SJ had a similar erosive potential to that of MM natural orange juice.

A comparative study of pH modulation and trace elements of various fruit juices on enamel erosion: an in vitro study.

Fruit juices are popular worldwide with children of all ages as they are sweet and perceived to be healthful. This in vitro study was sought to measure pH of 10 different fruit juices, to find out possible erosive effects on human dental enamel of 40 extracted sound premolars and also to measure fluoride and trace elements of these juices. The estimation of pH of fruit juices was done by using Systronic upH 362 pH meter. The erosive effects of fruit juices were tested by using polarized light microscope. Orion electrode was used to measure fluoride. The trace elements were estimated by using Atomic Absorption Spectrophotometer No. 6501F. The pH values in different juices were observed at different levels, and pH values of these juices were more acidic than baseline after 24 hours. As the time increased, the erosion effect became more in pineapple; grape and sugarcane juices, and they had more cariogenic trace elements like selenium, iron and manganese. So, these juices were found to be cariogenic. To conclude, orange, mousambi, mango, pomegranate, apple, chikku and watermelon juices had no erosive effect on the human enamel, with the presence of highest amount of trace elements like fluoride and phosphorous which are considered as strongly cariostatic.

Effect of salivary factors on the susceptibility of hydroxyapatite to early erosion.

OBJECTIVE: Salivary pellicle is known to reduce the erosion of enamel and differences in the level of protection exist between individual saliva sources, but which parameters or components are important is not known. The focus of this study was to investigate the relationship between saliva parameters and early erosion of hydroxyapatite (HAp) with an in situ grown saliva film. METHODS: Twenty-eight volunteers carried two HAp and one porcelain discs in their buccal sulcus for 1.5 h. Next, the discs covered with pellicle and the attached saliva film were exposed extraorally to 50 mM (pH = 3) citric acid for 2 min and unstimulated and stimulated saliva was collected. Calcium loss from HAp after erosive challenge was measured, corrected for calcium loss from pellicle on porcelain discs and averaged. Several salivary parameters were analysed. Pearson's linear correlation and multiple regression analysis were used to study the relation between saliva parameters and HAp erosion. RESULTS: Significant correlations were found between HAp erosion and the concentration of phosphorus in unstimulated saliva (r = 0.40, p = 0.03) and between HAp erosion and the concentration of sodium (r = -0.40, p = 0.03), chloride (r = -0.47, p = 0.01), phosphorus (r = 0.45, p = 0.01) and flow (r = -0.39, p = 0.04) of stimulated saliva. Multivariate analysis revealed a significant role in the HAp erosion for sodium, urea, total protein, albumin, pH and flow of unstimulated saliva and for sodium, potassium, urea, and phosphorus of stimulated saliva. CONCLUSIONS: Several salivary parameters are associated with the susceptibility of HAp to erosion.

Preventive effects of dentifrice containing 5000ppm fluoride against dental erosion in situ.

OBJECTIVE: To evaluate the effectiveness of a dentifrice with 5000ppm fluoride in preventing dental erosion by orange juice in situ in comparison to a control dentifrice with 1450ppm fluoride. METHODS: This was a double-blind and randomized clinical study with a cross-over design. Sixteen subjects wore an intra-oral appliance containing two enamel disks with an exposed surface of approximately 2mm×5mm. Enamel disks in the study group were treated with a dentifrice with 5000ppm fluoride and in the control group with 1450ppm fluoride. The subjects rinsed with slurries of study dentifrices for one minute before immersing the enamel disks in 250ml orange Juice four times in an 8-h period daily. The treatment procedure was repeated for three 5-day phases for each dentifrice. Enamel erosion was measured after each 5-day treatment phase using a focus-variation 3D scanning microscopy. Medians and inter-quartile ranges (IQR) of mean erosion depth were compared between the groups. RESULTS: The mean erosion depths of enamel varied greatly amongst the subjects. Enamel treated with 5000ppm fluoride had less erosion (median 5.7µm, IQR 4.5µm) as compared to the control (median 12.6µm, IQR 12.3µm) after 15 days of fluoride treatment and erosive challenge cycles (p<0.05). CONCLUSIONS: Enamel treated with 5000ppm fluoride had significantly improved resistance to erosion by orange juice. Periodic application of 5000ppm fluoride may be beneficial in individuals at risk of acidic erosion associated with soft drink consumptions.

Roughness and pH changes of enamel surface induced by soft drinks in vitro-applications of stylus profilometry, focus variation 3D scanning microscopy and micro pH sensor.

This study aimed to evaluate enamel surface roughness (Ra) and pH before and after erosion by soft drinks. Enamel was exposed to a soft drink (cola, orange juice or green tea) for 1, 5 or 60 min; Ra was measured using contact-stylus surface profilometry (SSP) and non-contact focus variation 3D microscope (FVM). Surface pH was measured using a micro pH sensor. Data were analyzed at significance level of alpha=0.05. There was a significant correlation in Ra between SSP and FVM. FVM images showed no changes in the surface morphology after various periods of exposure to green tea. Unlike cola and orange juice, exposure to green tea did not significantly affect Ra or pH. A significant correlation was observed between surface pH and Ra change after exposure to the drinks. Optical surface analysis and micro pH sensor may be useful tools for non-damaging, quantitative assessment of soft drinks erosion on enamel.