Analysis of the erosive effect of different dietary substances and medications. Br J Nutr. 2012;107:252-262. [PMID: 21733310 DOI: 10.1017/s0007114511002820]

Corrosion-induced changes in surface properties and roughness of orthodontic wires

INTRODUCTION

This study aimed to investigate the surface free energy and surface roughness (SR) of metallic alloys under the influence of acid solutions.

METHODS

The experiment involved the use of 270 rectangular wire samples measuring 0.019 × 0.025-in. These samples were sourced from 3 different commercial brands: Dentsply GAC, American Orthodontics, and Orthoclassic. This in vitro study categorized the samples into 3 groups based on the solutions employed: deionized water, citric acid, and phosphoric acid. Each group consisted of 90 samples, with 30 samples representing each type of alloy-stainless steel, nickel-titanium, and titanium molybdenum alloy (TMA). The wire segments were immersed in their respective solutions for 72 hours at a controlled temperature of 37°C, with continuous orbital agitation at 130 rpm. After the immersion period, the study analyzed both surface free energy and SR. The mean values obtained were subjected to an analysis of variance at a significance level of 5%.

RESULTS

All alloys displayed hydrophobic behavior, as indicated by interaction free energy values <0. In acidic environments (phosphoric acid and citric acid), significant differences were observed among different brands and alloys, affecting surface energy and interaction free energy. Variations in SR among metallic alloys included steel with the lowest SR variations, followed by nickel-titanium and TMA. Notably, the TMA alloy stood out with significantly higher surface energy compared with that of the other alloys (P <0.001).

CONCLUSIONS

In this study, all examined alloys demonstrated a hydrophobic nature, suggesting a limited attraction to water. Notably, TMA exhibited the least hydrophobic behavior among the alloys studied. However, when exposed to citric acid, TMA displayed the most substantial alterations in its surface properties. These results underscored the significance of accounting for the distinctive properties of each alloy and their responses to diverse challenges, such as exposure to acidic solutions, during the selection of orthodontic wires for orthodontics treatment.

Effect of Low pH Dietary Supplements on Discoloration of Resin Composites

AIM

This study aimed to evaluate the impact of the consumption of low pH dietary supplements on the color stability of different resin composites.

MATERIALS AND METHODS

Three different restorative materials were used for this in vitro study: Filtek One Bulk-Fill (FOB), Filtek Z550 (Z550), and Fill-Up (FUP). Samples fabricated from each composite group were divided into four subgroups, and color measurements were performed at baseline. The control subgroup was stored in distilled water, and the other three subgroups were immersed in acidic dietary supplement solutions (Redoxon, Supradyn, and Voonka Collagen Shake) for 2 minutes daily for 28 days. Color measurements were obtained using a digital spectrophotometer. Color change values (ΔE1) were calculated after each color measurement. Next, all samples were immersed in a coffee solution for 7 days and repeat color measurements were taken to determine ΔE2 values. The study groups were compared using the Kruskal-Wallis test (α =0.05).

RESULTS

ΔE1 values were significantly different among the groups (P < 0.05). While Voonka Collagen Shake produced the greatest discoloration in FOB (1.67 ± 1.08) and Filtek Z550 (3.59 ± 1.90) materials, Fill-Up showed the highest discoloration (3.14 ± 0.37) with Supradyn. Analysis of ΔE2 values demonstrated a significant difference only for the Filtek Z550-Redoxon group versus the control group (P < 0.05).

CONCLUSION

Acidic dietary supplements not only produce color alterations in resin composites but also reduce the staining resistance of the composite further, depending on the type of composite and dietary supplement. Consumption of staining food after taking Redoxon effervescent tablets produces greater discoloration in Filtek Z550 restorations compared with other restorative materials.

Erosive Potential and Sugar Content of Popular Beverages: A Double Whammy for Dentition

Objectives

This study aims to identify the pH level and subsequently the erosive potential of beverages including their sugar content.

Materials and Methods

Beverages were purchased from a local convenience store, and some of the beverages were freshly prepared. The acidity of each beverage was identified using a calibrated pH meter. The pH was obtained in triplicate, and the results were expressed in average values with standard deviations. The pH values were then used to determine their erosive potential and the sugar content was obtained from the packaging and recorded.

Results

A total of 167 beverages were purchased and categorized. The beverages were categorized into 15 groups: milk tea, hawker drinks, instant drinks, fresh fruit juices, milk, energy drinks, designer coffee, soda, canned drinks, cultured milk, vegetable juices, cordials, bottled fruit drinks, tea, and mineral water. The pH value ranges from 2.65 to 7.85. Seven beverages (4.2%) were classified as extremely erosive, 53 beverages (31.1%) were classified as erosive, and 36 beverages (21.6%) were classified as minimally erosive. In total, 57.5% of the beverages were potentially erosive, and most of the soda and energy drinks were erosive. The highest sugar content per 100 g was BOH Teh Tarik Original (71.8 g), whereas the highest sugar content per serving was Carabao energy drink (10.8 g).

Conclusion

High sugar content and low acidic content of beverages could have a negative impact on the dentition. An intervention is required from a public health perspective to regulate the consumption of sweetened and flavored beverages.

Evaluation of the effect of soft drinks on the surface roughness of dental enamel in natural human teeth

Background: Exposing enamel to soft drinks and beverages causes changes in the microscopical morphology. Changes in the physical characteristics, like hardness and surface roughness, were studied with various parameters. Factors such as pH, exposed duration, and other content of the soft drinks have different effects on the enamel.

Methods: Thirty-six human premolar teeth were randomly divided into three groups (n=12). Group 1 consisted of teeth which were immersed in artificial saliva (control), group 2 consisted of teeth which were immersed in Pepsi, and group 3 consisted of teeth which were immersed in Mirinda. After the preparation of samples and necessary measures, surface roughness was measured using the profilometer. Baseline measurements were taken. Reading two and reading three were taken after exposing the specimens for three days and 15 days, respectively. All of the collected data were compared statistically using SPSS and presented in tables and graphs.

Results: At the baseline, the surface roughness value was the same for all three groups. On the 3 ^rd day, the Mirinda group showed more surface roughness compared to that of the test and Pepsi groups, which was statistically significant. On the 15 ^th day, both the Pepsi and Mirinda groups showed increased surface roughness compared to that of the control, which was statistically significant.

Conclusions: Within the limitation of this study, it can be concluded that surface roughness increased when teeth were exposed to both soft drinks

The Suitability of Questionnaires for Exploring Relations of Dietary Behavior and Tooth Wear

Tooth wear is a relevant oral health problem, especially at a young age. Although ongoing acid exposures may contribute to tooth wear, the role of acidic dietary components in this context remains unclear. To date, in tooth wear studies, dietary behavior has been assessed using traditional questionnaires, but the suitability of this approach has not been investigated so far. In our longitudinal study, we followed 91 participants (21.0 ± 2.2 years) over a period of 1 year (373 ± 19 days) and monitored tooth wear with an intraoral scanner. At baseline (T0) and at the end (T1), we assessed dietary behavior with questionnaires asking about the consumption frequencies of acidic dietary components and the acid taste preferences. Complete data were available from 80 subjects. The consumption frequencies of T0 and T1 correlated weakly to moderately. Taste preferences seem to be a more consistent measure, but there was predominantly no significant correlation with the corresponding consumption frequencies. None of the dietary parameters showed a significant relation with tooth wear. The suitability of dietary questionnaires to assess tooth-relevant dietary behavior seems to be limited.

Relationship between erosive tooth wear and possible etiological factors among dental students

OBJECTIVES

The aim of this study was to assess the relationship between erosive tooth wear (ETW) and possible etiological factors in a group of dental students.

MATERIALS AND METHODS

A total of 126 dental students from a public dental school were included in this study. A questionnaire was used to investigate the possible etiological factors related to ETW. The Basic Erosive Wear Examination (BEWE) criteria were used to examine the status of ETW. A univariable and multivariable logistic regression models were used to assess the relationship between the presence of ETW and explanatory variables.

RESULTS

Univariable analysis revealed that taking acidic foods and alcohol more than 4-5 times per week increases the odds of ETW by 6.043 and 2.532 times, respectively, and taking dairy products, fruit juice, and milk more than 4-5 times per week decreases the likelihood of ETW by 61%, 66%, and 80%, respectively. The results of multivariable regression analysis showed that the frequency of consumption of especially acidic foods significantly increased the risk of ETW (OR = 9.981, 95% CI 3.577-27.849, p < 0.001).

CONCLUSIONS

Although the ETW status of dental students, who are the future dentists, varies depending on different possible etiological factors, especially the consumption of acidic foods has increased the risk of ETW approximately 10 times.

CLINICAL RELEVANCE

The findings highlight the high relevance of ETW, especially with acidic food consumption, and the importance of controlling potential etiological factors in dental students.

In vitro comparison of the erosive potential of four different wines on human dental enamel

Background/Aim: This study aimed to investigate the erosive potential of wines derived from Anatolia on human teeth in vitro. Material and Methods: In this study two red (Öküzgözü, Boğazkere) and two white (Sultaniye, Narince) wines, citric acid and distilled water were used to investigate erosive effects. The pH, titratable acidity, iron and calcium ion levels of the groups were measured. Each group included 10 specimen and they were exposed to 25 ml of wine sample for 5 seconds, artificial saliva for 10 seconds for 10 times. The initial and the final phosphate concentrations were measured by the UV spectrophotometer and the difference between the measurements was calculated. One sample was examined under a scanning electron microscope and the data were analyzed statistically using One-way ANOVA and Pearson correlation test. Results: Mineral loss and erosive lesion depth values were ranged from highest to the lowest Sultaniye, Boğazkere, Öküzgözü and Narince, respectively. Correlation between mineral loss and pH was statistically significant (p<0.01). However, there was no correlation between the iron and calcium ion level and mineral loss. Conclusions: All the investigated wines have pH values below the critical value for enamel dissolution while Sultaniye was significantly more erosive than the others. There is a negative correlation between pH and erosive potential of the wine. Within the limits of this in vitro study, it can be expected that a regular consumption of wines might cause dental erosion.

Influence of energy drinks on enamel erosion: In vitro study using different assessment techniques

Background

Dental erosion has become a relevant public health problem in recent years and is related to the increase in the consumption of acidic beverages. Objective: The aim of the present study was to evaluate the erosive potential of energy drinks on dental enamel using an in vitro erosion model.

Material and Methods

Thirty-eight blocks of human enamel were divided into four groups: G1- TNT Energy Drink®(n=8), G2- Red Bull® (n=10), G3- Monster Energy® (n=10), and G4- Coca-Cola® (n=10) (positive control). For the chemical analysis, the pH values, titratable acidity, and buffering capacity of the beverages were measured in triplicate. For the erosive test, the specimens were immersed in the beverages (5ml/block) for 30 minutes at room temperature with gentle shaking. Initial and final surface microhardness values were measured and the percentage of the loss of surface microhardness was calculated. Profilometry (surface loss and lesion depth) and mineral loss analysis (quantitative light-induced fluorescence) were performed. The data were analysed statistically using ANOVA followed by the Bonferroni correction, Pearson’s correlation test, and multiple linear regression (p<0.05).

Results

The energy drinks had pH values ranging from 2.36 to 3.41. The lowest titratable acidity value was recorded for Monster Energy® and the highest was recorded for TNT Energy Drink®. All energy drinks had buffering capacity values higher than Coca-Cola®. Analysing the eroded enamel surface, the specimens submitted to TNT Energy Drink® had the greatest percentage loss of surface microhardness, surface loss, depth, and mineral loss, followed by those submitted to Red Bull® and Monster Energy®. Surface loss was the only predictor of mineral loss (p<0.001).

Conclusions

Based on the study model employed, all the energy drinks examined were erosive to tooth enamel and TNT Energy Drink® had the worst behaviour.

Key words:Energy drinks, tooth erosion, tooth demineralisation, hardness tests, quantitative light-induced fluorescence.

Effect of cranberry juice deacidification on its antibacterial activity against periodontal pathogens and its anti-inflammatory properties in an oral epithelial cell model

Cranberries are widely recognized as a functional food that can promote oral health. However, the high concentration of organic acids in cranberry juice can cause tooth enamel erosion. Electrodialysis with bipolar membrane (EDBM) is a process used for the deacidification of cranberry juice. The present study investigated whether the removal of organic acids (0%, 19%, 42%, 60%, and 79%) from cranberry juice by EDBM affects its antibacterial activity against major periodontopathogens as well as its anti-inflammatory properties in an oral epithelial cell model. A deacidification rate ≥60% attenuated the bactericidal effect against planktonic and biofilm-embedded Aggregatibacter actinomycetemcomitans but had no impact on Porphyromonas gingivalis and Fusobacterium nucleatum. Cranberry juice increased the adherence of A. actinomycetemcomitans and P. gingivalis to oral epithelial cells, but reduced the adherence of F. nucleatum by half regardless of the deacidification rate. F. nucleatum produced more hydrogen sulfide when it was exposed to deacidified cranberry juice with a deacidification rate ≥42% compared to the raw beverage. Interestingly, the removal of organic acids from cranberry juice lowered the cytotoxicity of the beverage for oral epithelial cells. Deacidification attenuated the anti-inflammatory effect of cranberry juice in an in vitro oral epithelial cell model. The secretion of IL-6 by lipopolysaccharide (LPS)-stimulated oral epithelial cells exposed to cranberry juice increased proportionally with the deacidification rate. No such effect was observed with respect to the production of IL-8. This study provided evidence that organic acids, just like phenolic compounds, might contribute to the health benefits of cranberry juice against periodontitis.

The association between erosive tooth wear and diet, hygiene habits and health awareness in adolescents aged 15 in Poland

Purpose

The aim of the study was to assess the prevalence of erosive tooth wear (ETW) and risk indicators in the population of adolescents aged 15 in Poland.

Methods

Erosive tooth wear in 2639 participants was determined by calibrated examiners according to the BEWE scoring system, and the prevalence of risk factors was assessed on the basis of a survey.

Results

Erosive tooth wear was reported in 24.3% of participants. Initial loss of surface (BEWE 1) was the predominant finding, observed in 21.3% of participants. Hard tissue loss (BEWE 2 and 3) occurred very rarely, only in 3% of participants. Acidic diet, masculine gender and lower socio-economic status were associated with higher prevalence and severity of erosive lesions in the examined population.

Conclusion

Two modifiable factors—acidic diet and low health awareness—were found to be highly unsatisfactory in the adolescents aged 15 in Poland. Accordingly, to prevent the deterioration of the functionality and aesthetics of the teeth in young people, certain measures, such as routine clinical examination, education, dietary consulting and prophylaxis, should be implemented as early as possible, focusing predominantly on families with lower socio-economic status.

Influence of Low-pH Beverages on the Two-Body Wear of CAD/CAM Monolithic Materials

The aim of this in vitro study is to evaluate the effect of different acidic media on volumetric wear and surface roughness of CAD/CAM monolithic materials. Forty-eight rectangular specimens were prepared using different CAD/CAM monolithic materials: nanohybrid composite (Grandio Blocks, Voco), resin-based composite (Cerasmart, GC), lithium disilicate (E-Max, Ivoclar), and high-translucency zirconia (Katana STML, Kuraray Noritake). After storage in distilled water at 37 °C for two days, the specimens were tested using a chewing machine with a stainless-steel ball as an antagonist (49N loads, 250,000 cycles). Testing was performed using distilled water, Coca-Cola, and Red Bull as abrasive media. Wear and surface roughness analyses of the CAD/CAM materials were performed using a 3D profilometer and analyzed with two-way analysis of variance and post hoc pairwise comparison procedures. Worn surfaces were examined using scanning electron microscopy. Resin-based materials suffered higher volumetric wear than ceramics (p = 0.00001). Water induced significantly less volumetric wear than the other tested solutions (p = 0.0014), independent of the material tested. High-translucency zirconia showed less surface roughness than all the other materials tested. The selection of monolithic CAD/CAM materials to restore worn dentition due to erosive processes could impact restorative therapy stability over time. Resin-based materials seem to be more influenced by the acidic environment when subjected to a two-body wear test.

Deacidification of Cranberry Juice Reduces Its Antibacterial Properties against Oral Streptococci but Preserves Barrier Function and Attenuates the Inflammatory Response of Oral Epithelial Cells

Cranberry (Vaccinium macrocarpon) may be a potent natural adjuvant for the prevention of oral diseases due to its anti-adherence, anti-cariogenic, and anti-inflammatory properties. However, the high titrable acidity of cranberry juice (CJ) has been reported to cause gastrointestinal discomfort, leading consumers to restrict their intake of this beverage. Electrodialysis with a bipolar membrane (EDBM) can reduce the organic acid content of CJ while retaining the flavonoids associated with potential health benefits. This study aimed to assess how the deacidification of CJ by EDBM impacts the antibacterial properties of the beverage against cariogenic (Streptococcus mutans, Streptococcus sobrinus) and commensal (Streptococcus gordonii, Streptococcus oralis, Streptococcus salivarius) streptococci, and how it affects oral epithelial barrier function and inflammatory response in an in vitro model. The removal of organic acids from CJ (deacidification rate ≥42%) reduced the bactericidal activity of the beverage against planktonic S. mutans and S. gordonii after a 15-min exposure, whereas only the viability of S. gordonii was significantly impacted by CJ deacidification rate when the bacteria were embedded in a biofilm. Moreover, conditioning saliva-coated hydroxyapatite with undiluted CJ samples significantly lowered the adherence of S. mutans, S. sobrinus, and S. oralis. With respect to epithelial barrier function, exposure to CJ deacidified at a rate of ≥19% maintained the integrity of a keratinocyte monolayer over the course of 24 h compared to raw CJ, as assessed by the determination of transepithelial electrical resistance (TER) and fluorescein isothiocyanate-conjugated dextran paracellular transport. These results can be in part attributed to the inability of the deacidified CJ to disrupt two tight junction proteins, zonula occludens-1 and occludin, following exposure, unlike raw CJ. Deacidification of CJ impacted the secretion of IL-6, but not of IL-8, by oral epithelial cells. In conclusion, deacidification of CJ appears to provide benefits with respect to the maintenance of oral health.

Differences in Oral Health Status in Elite Athletes According to Sport Modalities

Oral health status may affect physical and sports performance. The purpose of this study was to assess the oral health status and oral health habits of elite athletes according to the performed sports type. A sample of 186 elite athletes divided into individual sports (n = 74; 53 men and 21 women; 24.9 ± 9.3 years) and team sports (n = 112; 97 men and 15 women; 24.5 ± 4.8 years) participated in the study. The decayed, missing, and filled teeth index (DMFT), the oral health impact profile (OHIP), and the diet assessment of caries risk (DACR) were evaluated to assess their oral health status. Athletes in individual modalities had a lower number in total teeth, healthy teeth, and restoration index (p < 0.05). Furthermore, this group showed a greater number of missing (p < 0.001) and decayed teeth (p < 0.05) and a greater DMFT index (p < 0.001). A relationship between sports modality and prevalence of malocclusions (p < 0.01), periodontal plaque (p < 0.05), and the habit of consuming energy drinks (p < 0.05) was also highlighted. Elite athletes who compete in individual sports presented a worse oral situation.

Methodology to Quantify and Screen the Demineralization of Teeth by Immersing Them in Acidic Drinks (Orange Juice, Coca-Cola™, and Grape Juice): Evaluation by ICP OES

Oral health problems may occur as a result of the ingestion of acid drinks. The objective of this in vitro study was to quantify and screen the concentration of potassium (K), phosphorus (P), calcium (Ca), magnesium (Mg), manganese (Mn), zinc (Zn), iron (Fe), copper (Cu), barium (Ba), lead (Pb), arsenic (As), cadmium (Cd), aluminum (Al), cobalt (Co), chromium (Cr), molybdenum (Mo), sodium (Na), nickel (Ni), selenium (Se), and vanadium (V) released from bovine incisors during an erosive challenge at different times of exposure when immersed in Coca-Cola™, orange juice, and grape juice. A total of 240 samples of bovine incisor teeth were used for the erosive challenge and allocated in groups. Digestion of drinks was performed using microwave-assisted digestion. The content in acidic drinks was monitored before and after the erosive challenge at exposure times of 1, 5, and 60 min using inductively coupled plasma optical emission spectrometry (ICP OES). The drinks’ pH varied slightly during the erosive challenge but remained below the critical value of pH 5 to cause tooth demineralization. The concentrations of elements released from the bovine incisors during the in vitro erosive challenge depend on exposure times when immersed in acidic beverages. For some elements such as Ca, Mn, Zn, Fe, Cu, Ba, Pb, As, and Cd, quantified in acidic drinks, grape juice had greater erosive potential than Coca-Cola™ and orange juice. Quantification and monitoring of chemical elements in bovine teeth can be performed considering a longer erosive time and other types of acidic drinks. Further analysis using human teeth is still not available and must be conducted. The demineralization of teeth not only occurs in acidic beverages; physical and chemical factors play other roles and should be investigated.

Influence of Er,Cr:YSGG laser on root dentin submitted to erosive and/or abrasive challenges

This study evaluated how Er,Cr:YSGG laser, associated or not with 5% fluoride varnish, influences the surface roughness and volume loss of bovine root dentin submitted to erosive and/or abrasive wear. One hundred and twenty dentin specimens were divided into the groups: without preventive treatment (WPT), 5% fluoride varnish (FV); Er,Cr:YSGG laser irradiation (L), and varnish combined with laser (FV + L). The specimens (n = 10) were subdivided into: 1 = erosion (E); 2 = abrasion (A); and 3 = erosion followed by abrasion (E + A). The erosive solution used was a soft-drink (pH = 2.42 at 4ºC) applied in 5-min cycles twice a day for 10d. Abrasive wear involved brushing for 60s with an electric brush (1,600-oscillations/s) at a load of 2.0N. Surface roughness and volume loss were evaluated using a laser scanning confocal microscope. Roughness data were submitted to one-way ANOVA and Tukey post-hoc test. For volume loss, the Kruskal-Wallis and Dunn's post-hoc tests were used (α = 5%). The lowest values of roughness were found in the control areas of all subgroups (p > 0.05). In the experimental area, the [(WPT) + (E+A)] subgroup had a significantly higher roughness (5.712 ± 0.163 μm 2 ) than the other subgroups (p < 0.05). The L and (FV + L) groups had statistically similar roughness, regardless of the type of wear. The (FV + L) group had the lowest volume loss, regardless of the type of wear performed: [(FV + L) + (E)] = 7.5%, [(FV + L) + (A) = 7.3%, and [(FV + L) + (E + A)] = 8.1%. The subgroup [(WPT) + (E + A)] had the highest volume loss (52.3%). The proposed treatments were effective in controlling dentin roughness. Laser irradiation can be an effective method to increase root dentin resistance after challenges and limit problems related to non-carious lesions.

Factors Associated with Noncarious Cervical Lesions in Different Age Ranges: A Cross-sectional Study

OBJECTIVES

 Understanding the possible risk factors of noncarious cervical lesion (NCCL) is important for prevention and clinical management of the condition. The aim of this study was to investigate the factors associated with the prevalence of NCCL among adolescents, adults, and elderly people.

MATERIALS AND METHODS

 A cross-sectional study involving 501 participants aged 15 years or older was conducted. Participants were examined to assess the number of natural teeth and the prevalence and severity of NCCL by calibrated examiners. Data on age, gender, harmful toothbrushing habits, and acidogenic diet were collected through individual interviews. Multivariate Poisson's regression models were used to evaluate the association between the independent variables and the prevalence of NCCL according to the three age groups: 15 to 39, 40 to 64, and 65 years or older. RESULTS : The prevalence of NCCL among participants was 62.5% (95% confidence interval: 58.2-66.7). Among 15- to 39-year-old participants, the mean of NCCL was higher in males, those with lower number of teeth and acidogenic diet intake. Males aged 40 to 64 years and those with harmful brushing habits were more likely to present higher mean of NCCL. Elderly people with harmful toothbrushing habits had a greater mean of NCCL.

CONCLUSION

 Demographic (age and gender), clinical (number of teeth), and behavioral characteristics (harmful brushing habits and acidogenic diet) were meaningful factors associated with NCCL severity. The above-mentioned relationships varied between age groups.

Erosive effect of industrialized fruit juices exposure in enamel and dentine substrates: An in vitro study

Background

Erosive tooth wear has been a highly prevalent and emerging phenomenon related to eating habits of the population. Aim: This study sought to investigate industrialized fruit juices exposure in enamel and dentine substrates in terms of erosive effect.

Material and Methods

Human enamel and dentine specimens were randomized into 8 groups (n=8): Grape juice – Ades®, Grape juice – Del Valle Kapo®, Grape juice – Aurora®, Orange juice – Del Valle Kapo®, Orange juice – Ades®, Strawberry juice – Mais Vita®, Strawberry juice – Ades®, Citrus fruit juice – Tampico®. Specimens were submitted to an in vitro erosive challenge and to a microhardness test to evaluate the percentage of surface microhardness loss. The pH, titratable acidity, buffering capacity, degree of saturation and critical pH concerning hydroxyapatite and fluorapatite of the juices were measured as well as their composition of calcium, phosphate, fluoride, and total protein. Data were submitted to the analysis of variance and multivariate linear regression (α=0.05).

Results

All test agents were undersaturated concerning hydroxyapatite and fluorapatite. A significant interaction between the type of juice and substrate was found (α=0.000, β=0.99). However, Orange juice – Del Valle Kapo®, Orange juice – Ades®, and Strawberry juice – Mais Vitta® demonstrated no difference between substrates. Grape juice – Ades® promoted less mineral than other juices in enamel and dentine. The calcium concentration in juices was a protective variable for microhardness loss in both substrates.

Conclusions

The erosive effect of industrialized fruit juices affects enamel differently from dentine, and this effect differed between some, but not all, tested juices.

Key words:Tooth erosion, dental enamel, dentine. beverages, food habits.

The effect of red wine in modifying the salivary pellicle and modulating dental erosion kinetics

This study investigated the potential of red wine in modulating dental erosion kinetics in the presence or absence of salivary pellicle. Polished human enamel specimens were used in two conditions; presence or absence of acquired enamel pellicle; and subdivided according to exposure: red wine, orange juice, apple juice, or citric acid. The specimens were incubated in clarified whole human saliva (presence of acquired enamel pellicle) or in a humid chamber (absence of acquired enamel pellicle) for 2 h at 37°C, then in the test substances for 1 min, at 25°C, under shaking. This was repeated four times. Surface hardness was measured initially and after each cycle and surface reflection intensity was measured initially and after all cycles. In the presence of acquired enamel pellicle, red wine caused the least surface hardness loss, followed by orange juice, apple juice, and citric acid. Statistically significantly less surface reflection intensity loss was observed for red wine and orange juice than for apple juice and citric acid. In the absence of acquired enamel pellicle, red wine and orange juice caused less surface hardness loss than apple juice and citric acid. Orange juice showed the least surface reflection intensity loss, followed by red wine, citric acid, and apple juice. The polyphenol composition of these drinks can notably modulate the erosion kinetics.

Spectroscopic and microscopic examination of teeth exposed to green tea at different temperatures

Tea is a popular beverage consumed at different temperatures. The effect of tea on teeth at different temperatures has not been studied previously. The present study used an in vitro green tea immersed tooth model at different tea temperatures (hot and cold) compared to an in vivo tea administration model allowing rats to drink tea over the course of a week. The elements present in tea leaves were identified by Inductively Coupled Plasma Mass Spectrometry (ICP-MS) and compared to the elements in teeth (enamel surface) using Laser-Induced Breakdown Spectroscopy (LIBS). Here, LIBS demonstrated in vivo and in vitro green tea treatments resulted in a significant increase in the mineral elements found in enamel. For the in vitro assessment, elements in enamel varied based on cold-tea and hot-tea treatment; however, hot water reduced the elements in enamel. Atomic force microscopy found the in vivo tea group had a higher roughness average (RA) compared with the in vivo water group. Cold tea and hot tea in vitro groups demonstrated lower RA than in vitro water controls. Scanning electron microscopy found hot water induced cracks more than 1.3μm in enamel while cold tea and hot tea promoted the adhering of extrinsic matter to teeth. Overall, teeth treated to high temperature lost the mineral phase leading to demineralization. Our results indicate that green tea protects enamel, but its protective action in dental structures is enhanced at cold temperature.

Effect of pH Cycling Frequency on Glass-Ceramic Corrosion

The effect of pH changes on the chemical durability of dental glass–ceramic materials was evaluated using weight loss and ion release levels. The hypothesis that increased pH changes will exhibit greater corrosion was investigated. The ion concentration was analyzed using inductively coupled plasma atomic emission spectrometer (ICP). The surface compositions were investigated using X-ray photoelectron spectroscopy (XPS). The surface morphologies were examined using scanning electron microscopy (SEM). Dental glass–ceramics were tested in constant immersion, 3-day cycling, and 1-day cycling with pH 10, pH 2, and pH 7 for 3, 15, and 30 days. The 1-d cycling group demonstrated the highest levels of weight loss compared with 3-d cycling and constant immersion. For the ion release, Si⁴⁺ and Ca²⁺ had the highest rates of release in 1-d cycling, whereas the Al³⁺ release rate with constant pH 2 was highest. The alteration/passivation layer that was formed on the surface of disks possibly prevented further dissolution of pH 10 corroded disks. XPS analysis demonstrated different surface compositions of corroded disks in pH 10 and pH 2. Si⁴⁺, K⁺, Na⁺, Al³⁺, and Ca²⁺ were detected on the surface of corroded pH 10 disks, whereas a Si⁴⁺ and P⁵⁺-rich surface formed on corroded pH 2 disks. SEM results demonstrated rougher surfaces for corroded disks in cycling conditions and pH 2 constant immersion. In conclusion, increased pH changes significantly promote the corrosion of dental glass–ceramic materials.

Effect of pediatric multivitamin syrups and effervescent tablets on the surface microhardness and roughness of restorative materials: An in vitro study

Background/purpose

Multivitamin syrups and effervescent tablets are commonly used for dietary support in children; however, these preparations may have detrimental effects on the surface of restorative materials. The aim of this study was to evaluate the effect of two multivitamin syrups and two effervescent tablets taken daily on the surface microhardness and roughness of two different restorative materials.

Materials and methods

The study groups were comprised of a conventional glass ionomer cement, Ketac Molar, and a giomer, Beautifil II. A total of 140 disc-shaped specimens were prepared and randomly assigned to 5 subgroups. The samples were immersed in 4 multivitamins (Supradyne syrup, Supradyne effervescent, Sambucol syrup, Sambucol effervescent) and deionized water (control group) for 2 min once a day for 28 days. Surface microhardness and roughness measurements were recorded at baseline and on the 7th, 14th, 21st and 28th days. Surface microhardness was measured using a Vickers hardness tester and surface roughness was determined using a profilometer.

Results

For all subgroups; the surface microhardness values of the Ketac Molar and Beautifil II demonstrated a statistically significant decrease from the baseline to the 28th day measurements (p < 0.05), while the surface roughness displayed increased values that were found to be statistically significant (p < 0.05). The Ketac Molar surface roughness values were significantly higher than Beautifil II in all subgroups for all measurement days (p = 0.0001).

Conclusion

The prolonged use of multivitamin syrups and effervescent tablets may have negative effects on the physical properties of restorative materials.

Novel Coating to Minimize Corrosion of Glass-Ceramics for Dental Applications

The effect of a novel silicon carbide (SiC) coating on the chemical durability of a fluorapatite glass-ceramic veneer was investigated by examining weight loss and ion release levels. The hypothesis that this novel coating will exhibit significant corrosion resistance was tested. Inductively coupled plasma atomic emission spectrometer (ICP) was used for ion concentration determination and scanning electron microscopy (SEM) for surface morphology analyses. Samples were immersed in pH 10 and pH 2 buffer solutions to represent extreme conditions in the oral cavity. Analyses were done at 15 and 30 days. The SiC coated group demonstrated significant reduction in weight loss across all solutions and time points (p < 0.0001). Ion release analyses demonstrated either a marginally lower or a significantly lower release of ions for the SiC-coated disks. SEM analysis reveals planarization of surfaces by the SiC-coated group. The surfaces of coated samples were not as corroded as the non-coated samples, which is indicative of the protective nature of these coatings. In conclusion, SiC is a novel coating that holds promise for improving the performance of ceramic materials used for dental applications.

Prevention of Enamel Softening by Rinsing with a Calcium Solution before Dental Erosion

OBJECTIVES

This in situ study aimed to evaluate whether rinsing with a calcium-containing solution prior to an erosive attack reduces the softening of enamel.

MATERIALS AND METHODS

A total of 240 bovine enamel samples with determined baseline surface microhardness (KHN) were allocated to 5 runs in which each of the 12 volunteers performed the following experiment: 4 enamel samples were inserted in a custom-made intraoral appliance and carried in the mouth (upper jaw) for 30 min before each volunteer either rinsed his mouth for 60 s with a fluoride- and stannous ion-containing dental erosion protection mouth rinse as positive control (run 1), milk (run 2), a solution prepared from a 500-mg calcium effervescent tablet dissolved in 100 mL (run 3) or 200 mL (run 4) water, or did not perform any rinsing with a test solution before the erosive attack (run 5, negative control). To simulate the erosive attack, volunteers rinsed their mouth with a commercial soft drink (Sprite Zero) for 60 s and afterwards with water to stop the erosive process. Finally, surface microhardness was measured again and hardness loss (ΔKHN) calculated. A mixed effect model was fitted to the data set to investigate whether the different runs showed differences with respect to ΔKHN.

RESULTS

No significant difference in softening of enamel (mean of ΔKHN; lower confidence level/upper confidence level) was observed between the negative control run 5 (50.7; 60.8/40.6), run 2 (50.7; 60.8/40.6), run 3 (38.7; 48.8/28.6) and run 4 (40.7; 50.8/30.6) (p > 0.05, respectively). Enamel softening in the positive control run 1 (25.4; 35.6/15.3) was significantly lower compared to the softening in run 5 (p < 0.001). No significant difference was observed between run 1 and run 3 (p = 0.09).

CONCLUSION

Other than the fluoride- and stannous ion-containing dental erosion protection mouth rinse, none of the investigated calcium-containing solutions is able to significantly reduce erosion-induced softening of enamel.

Ultrastructural changes in the cemento-enamel junction caused by acidic beverages: An in vitro study

The present in vitro study was aimed at evaluating the morphological changes in the cemento-enamel junction (CEJ) after exposure to acidic beverages using the scanning electron microscopy (SEM). The initial pH and titratable acidity (TA) was analyzed from follow groups: (I) Coca cola, (II) orange juice, (III) Cedevita, (IV) Red Bull, (V) Somersby cider, and (VI) white wine. The CEJ samples (n = 64), obtained from unerupted third molars, were allocated to one control (artificial saliva, n = 16) and six experimental groups (n = 8). The experimental samples were immersed in beverages (50 ml) for 15 min, three times daily, 10 days, and in artificial saliva between immersions. SEM analysis was performed in a blind manner, according to scoring scale. One-way ANOVA and Tukey's post hoc tests, as well as Kruskal-Wallis and Mann-Whitney U test used for statistical analysis. The pH values of the acidic beverages ranged from 2.65 (Coca cola) to 3.73 (orange juice), and TA ranged from 1.90 ml (Coca cola) to 5.70 ml (orange juice) of NaOH to reach pH 7.0. The SEM analysis indicated statistically significant differences between the control samples and those immersed in acidic beverages. The Groups IV, I, and II, showed the highest CEJ damage grade while those of the Group VI were the lowest. All the tested acidic beverages caused morphological changes in the CEJ with a smaller or larger exposure of dentine surface, and were not always related to the pH or TA of acidic beverages.

Beware Energy Drinks: A Case of a Toxic Triad Syndrome in a Diabetic Patient With Nonalcoholic Fatty Liver Disease

Energy drinks are widely used and very popular. They are touted as "harmless" energy boosters for use in professional, recreational and domestic settings. They are typically high in monosaccharides, and caffeine with other assorted products like ginseng. Careful study of the potential risks of their use is nonexistent while rigorous documentation of their touted energy boosting capacity is also meagre. We present the cautionary case of a 46-year-old Caucasian man with well-controlled type 2 diabetes and nonalcoholic fatty liver disease who developed a toxic triad syndrome of gastritis, hepatitis and pancreatitis within 4 months of commencing daily consumption of 2-3 160z cans of the energy drink Monster Energy. His clinical symptoms and biochemical derangements promptly resolved with stopping the beverage. We discuss the potential risks inherent in unsupervised liberal consumption of energy drinks and the need for both caution and vigilance among clinicians and patients.

Erosive potential of soy-based beverages on dental enamel

BACKGROUND

This study aimed to investigate the erosive potential of soy-based beverages in comparison to fruit juices of the same flavor.

METHODS

Human enamel blocks were randomly divided into 9 groups (n = 8), according to the beverage category (soy or non-soy juices). The initial pH, TA and β at the original pH value were measured in triplicate. The composition of calcium, phosphate and total protein was analyzed using the specific colorimetric method. The fluoride analysis was performed using a selective electrode. The degree of saturation (DS) and the critical pH (CpH) of each beverage with respect to hydroxyapatite (HAp) and fluorapatite (FAp) were calculated using the computational software. Enamel samples were immersed into 67.5 mL of each drink for 120 minutes. Enamel surface loss (ESL) and differences in surface roughness (ΔRa_E-S) were analyzed by a 3D non-contact profilometer.

RESULTS

Non-soy beverages exhibited the lowest pH values (2.93 to 3.40). The highest values of calcium concentration were founded in soy-based formulations. Juices with soy in their composition tend to have high DS when compared with non-soy based beverages (p = .0571). Soy beverages produced less ESL than non-soy beverages (p < .05). ΔRa_E-S was not significantly different between the categories. The ESL and ΔRa_E-S were positively correlated with initial pH and buffering capacity in soy-based beverages. On the other hand, in non-soy beverages, the ESL was negatively correlated with the TA to 7.0 and the fluoride composition whereas the ΔRa_E-S was negatively correlated with the TA to 5.5.

CONCLUSIONS

The erosive potential of soy beverages was lower than non-soy based beverages.

Calcium Pre-Rinse: Effect on permeability of dentin tubules by fluoride rinse

Background

The aim of this study was to evaluate whether calcium (CaL) solution would enhance the capacity of sodium fluoride (NaF) solution in reducing the permeability of hypersensitive dentin.

Material and Methods

Thirty-two Wistar rats ingested for 45 days acidic isotonic drink (Gatorade, pH 2.7) ad libitum to induce dental erosion. Then, molar teeth received a cold stimulus to confirm the presence and score the intensity of dentin hypersensitivity based on body contraction and noise. Animals were allocated to four groups (n=8), according to the solution(s) applied in the oral cavity: NaF (12 mmol/L, 1 min); CaL (150 mmol/L, 1 min); CaL followed by NaF (CaF+NaF, 1 min each); distilled water (DW, 1 min, as negative control). The animals were euthanized and the mandibles dissected into hemimandibles, which were sealed with sticky wax, except for the occlusal surface of the molar teeth. The samples were immersed in 10% copper sulphate solution and in 1% dithioxamide alcoholic solution (25 min each). The samples were sectioned longitudinally and imaged under optical microscope. Then, dentin permeability was measured as the area of copper ion penetration, using ImageJ software. Photomicrographs were obtained by scanning electron microscopy.

Results

68.7% of animals had body contraction associated or not with noise. One-way ANOVA followed by Tukey´s test indicated that groups treated with NaF solution, whether or not preceded by CaL solution, presented lower permeability than the remaining groups [CaL+NaF: 3405.7 μm2 (±1796.4); NaF: 4111.7 μm2 (±2450.6); CaL: 42254.6 μm2 (±30399.2); DW: 37064.6 μm2 (±21994.4)]. Photomicrographs showed that CaL+NaF group presented an increased proportion of occluded dentin tubules in comparison to the NaF-only group.

Conclusions

Although qualitatively there seems to be a benefit in using CaL pre-rinse, this solution did not quantitatively enhance the capacity of NaF in reducing permeability of hypersensitive dentin.

Key words:Dentin hypersensitivity, Fluoride, Calcium lactate, Animal model.

Clinical management and prevention of dental caries in athletes: A four-year randomized controlled clinical trial

The aims of this four-year randomized controlled clinical trial were to gain insights into management and prevention of dental caries and the effect of stannous fluoride products in athletes. Fifty-four participants were randomized into test and control groups. The test group used special stannous fluoride products. The primary endpoint dental caries was assessed by the ICDAS-II-System and analyzed both by a linear mixed model for repeated measures and a generalized linear mixed model. During the observation period an increase in caries-free surfaces from 64.91 ± 6.42 at baseline to 73.22 ± 4.43 was observed. In surfaces with caries superficialis and caries media, a decrease from 13.94 ± 5.70 and 2.96 ± 2.55 surfaces at baseline to 7.89 ± 3.18 and 0.46 ± 0.78 after 2.5 years was noted, respectively. The analysis showed no effect of stannous fluoride products, but a significant difference for the time of examination (p < 0.0001). In addition, it could be shown that at any time of examination, the odds of developing caries media on a new surface was significantly lower than at baseline (up to 25-times). Due to biannual dental examinations, professional tooth cleaning and restorative treatment the number of caries-free surfaces increased and the odds of a new surface to be afflicted with caries media decreased 25-fold.

Influence of Er,Cr:YSGG laser, associated or not to desensitizing agents, in the prevention of acid erosion in bovine root dentin

This in vitro study evaluated the influence of the Er,Cr:YSGG laser, associated or not to desensitizing agents, in the prevention of acid erosion in bovine root dentin. Eighty dentin specimens were selected and divided into eight groups (n = 10): G1: negative control; G2: positive control (5% fluoride varnish-FV); G3: Er,Cr:YSGG laser; G4: FV + laser; G5: 3% potassium oxalate; G6: 3% potassium oxalate + laser; G7: biphasic calcium silicate/phosphate gel (gel); G8: gel + laser. Laser parameters: 0.5 W, 6.25 J/cm² at 1-mm distance. The erosive drink used was a cola soft-drink (pH = 2.42 at 4 °C), lasting 5 min, twice a day, with 6-h intervals between the challenges, during 14 days. Kolmogorov-Smirnov and Levene's tests were satisfied. The surface roughness data were submitted to ANOVA and Tukey post hoc tests. For the wear profile, Kruskal-Wallis and Dunn post hoc tests were used. Afterwards, the Spearman correlation test was performed. All statistical tests assumed a significance level of 5% (α = 0.05). G1 presented the highest surface roughness value after the erosive challenge (3.586 μm² ± 0.205 μm²) and the G7 presented the lowest surface roughness value after the erosive challenge (1.071 μm² ± 0.180 μm²). For the lost volume, G4 presented the lowest percentage (9.7% ± 0.9%), while G1 had the highest percentage (41.8% ± 2.5%), both with p < 0.05. There was a weak correlation between the response variables (ρ = 0.33). All groups presented lower values of surface roughness and loss of volume when compared to the negative control group. For the surface roughness, the biphasic calcium silicate/phosphate gel presented the best result. For volume loss, the 5% fluoride varnish + Er,Cr:YSGG laser showed the best results compared to the other groups.

Impact of honey on dental erosion and adhesion of early bacterial colonizers

The aim was to investigate if honey causes erosion and if salivary pellicle modified with honey, or its components, or the by-product propolis has a protective effect against dental erosion and adhesion of early bacterial colonizers. The tested substances were: 3 types of honey, methylglyoxal (MGO), hydrogen peroxide, propolis. First in the erosion experiment, 120 human enamel specimens were covered with salivary pellicle and modified with the substances. Then they were eroded with 1% citric acid, pH 3.6 for 2 min, before surface hardness was measured. In the microbiological assay, the enamel specimens (n = 126) covered with modified salivary pellicle were contaminated with bacterial suspensions. The antimicrobial activity of each substance and their effect on early bacterial colonizer adhesion and biofilm formation were determined. Despite a low pH, honey did not cause erosion. On the other hand, pellicle modification with the tested solutions did not protect the enamel from erosion. Microbiologically, the 3 honeys inhibited species-specific growth of oral bacteria. Propolis decreased initial attachment of Streptococcus gordonii, while one honey inhibited demineralization of enamel by biofilm. In conclusion, pellicle modification with honey, or its components, or propolis did neither protect against erosion nor promote it. Propolis presented some bacterial adhesion inhibition.

Mimicking and Measuring Occlusal Erosive Tooth Wear with the "Rub&Roll" and Non-contact Profilometry

Chewing, drinking, and occasional tooth grinding will result in physiological tooth wear during a lifetime. Extreme challenges, such as bruxism or habitual chewing on foreign objects, may lead to excessive wear. Recently, the role of erosion in accelerating mechanical tooth wear has been recognized, but the interplay between chemical and mechanical wear processes has not been extensively studied. Our laboratory recently introduced a novel oral wear simulation device, the Rub&Roll, that enables the user to perform wear and loading studies separately or simultaneously in an erosive and/or abrasive environment. This manuscript describes an application of the device: the combined mechanical and erosive loading of extracted human (pre)molars in a simulated chewing movement, with a controlled application of force, velocity, fluid, and time, and the application of non-contact profilometry in visualizing and measuring the resulting wear pattern. The occlusal morphology that was created in the experiment with the highest loading level is very similar to the clinical presentation of erosive wear.

Sports drink consumption and dental erosion among amateur runners

This cross-sectional study assessed the prevalence and potential risk factors for dental erosion in amateur athletes at running events. After a sample calculation, 108 runners from the state of Rio de Janeiro, Brazil, were selected and examined for dental wear by a single trained and calibrated evaluator (kappa = 1.00). To identify risk factors, the runners were interviewed by using a standardized, semi-structured questionnaire. The average (SD) age of the runners was 34.2 (11.45), and the prevalence of dental erosion was 19.4%. Gastroesophageal reflux, running frequency per week, and time expended during competition were associated with dental erosion (P < 0.05). The association between use of isotonic drinks and dental erosion was not significant (P > 0.05). In conclusion, dental erosion was not associated with use of isotonic drinks. However, frequency of exercise per week and gastroesophageal reflux were risk factors for dental erosion.

Are grape juices more erosive than orange juices?

AIMS

To evaluate the chemical characteristics of grape and orange juices, and their erosive potential in the decrease of microhardness and the loss of enamel structure.

METHODS

Five grape and orange juices were evaluated for pH, titratable acidity, calcium, phosphate, and fluoride concentration. De-ionised water and Cola soft drink were used as a negative and positive control, respectively. Twelve specimens of bovine enamel were immersed in beverages for 10 min at 37 °C, 3 times/day for 7 days. Erosive potential was quantified using microhardness and loss of enamel structure. Anova One Way, Student's t test, Multiple Regression and Spearman Correlation (p < 0.05) were used to analyse the results.

RESULTS

Powdered grape juice showed the lowest pH (3.18 ± 0.03) and pure grape juice presented the highest titratable acidity (5.48 ± 0.06 mL NaOH/100 mL). Fresh orange juice and soya-based grape juice revealed the lowest calcium (0.77 ± 0.12 mmol/L) and phosphate concentrations (0.35 ± 0.06 mmol/L), respectively. Among juices, powdered orange juice caused the greatest decrease in surface microhardness (SMH) (127.99 ± 40.47 ΔSMH) and grape juice from concentrate caused the greatest loss of enamel structure (13.30 ± 3.56 μm).

CONCLUSIONS

All of the evaluated juices contributed to dental erosion. Grape juices presented greater erosive potential than orange juices. Pure, powdered and concentrated grape juices showed similar loss of enamel structure to the Cola soft drink. The erosive potential of beverages was statistically correlated to pH, titratable acidity, calcium, phosphate and fluoride concentrations.

Demineralization-remineralization dynamics in teeth and bone

Biomineralization is a dynamic, complex, lifelong process by which living organisms control precipitations of inorganic nanocrystals within organic matrices to form unique hybrid biological tissues, for example, enamel, dentin, cementum, and bone. Understanding the process of mineral deposition is important for the development of treatments for mineralization-related diseases and also for the innovation and development of scaffolds. This review provides a thorough overview of the up-to-date information on the theories describing the possible mechanisms and the factors implicated as agonists and antagonists of mineralization. Then, the role of calcium and phosphate ions in the maintenance of teeth and bone health is described. Throughout the life, teeth and bone are at risk of demineralization, with particular emphasis on teeth, due to their anatomical arrangement and location. Teeth are exposed to food, drink, and the microbiota of the mouth; therefore, they have developed a high resistance to localized demineralization that is unmatched by bone. The mechanisms by which demineralization-remineralization process occurs in both teeth and bone and the new therapies/technologies that reverse demineralization or boost remineralization are also scrupulously discussed. Technologies discussed include composites with nano- and micron-sized inorganic minerals that can mimic mechanical properties of the tooth and bone in addition to promoting more natural repair of surrounding tissues. Turning these new technologies to products and practices would improve health care worldwide.

Dietary intakes and anthropometric measures of Indigenous Australian women and their infants in the Gomeroi gaaynggal cohort

Indigenous Australians continue to experience disparities in chronic diseases, many of which have nutrition-related trajectories. Optimal nutrition throughout the lifespan is protective for a number of adverse health outcomes, however little is known about current dietary intakes and related anthropometric outcomes of Indigenous women and their infants. Research is required to identify nutrition issues to target for health promotion activities. The Gomeroi gaaynggal programme is an ongoing, prospective cohort of pregnant Indigenous Australian women and their children. A cross-sectional examination of postnatal dietary intakes and anthropometric outcomes of mothers and children are reported. To date, 73 mother–child dyads have participatedpostpartum. Breastfeeding initiation was 85.9% and median (interquartile range) duration of any breastfeeding was 1.4 (0.5–4.0) months. Infants were introduced to solid foods at 5.0 months (4.0–6.0) and cow’s milk at 12.0 (10.0–13.0) months. At 12 monthspostpartum, 66.7% of women were overweight or obese, 63.7% at 2 years. Compared with recommendations, reported median maternal nutrient intakes from 24-h recall were low in fibre, folate, iodine, calcium, potassium and vitamin D and high in proportions of energy from total and saturated fat. Limitations of this study include a small sample size and incomplete data for the cohort at each time point. Preliminary data from this ongoing cohort of Indigenous Australian women and children suggest that women may need support to optimize nutrient intakes and to attain a healthy body weight for themselves and their children.

Erosive characteristics and fluoride content of cola-type drinks

AIM

Excessive consumption of carbonated soft drinks is detrimental to general and oral health. This study determined endogenous pH, titratable acidity (TA) and fluoride (F) ion concentration of cola-type drinks available in the UK. Subsidiary aims were to compare: (i) endogenous pH and TA of drinks upon opening (T0) and after 20 minutes (T20); (ii) endogenous pH, TA and F ion concentration of diet vs regular and plastic bottle vs canned drinks.

METHODS

Endogenous pH, TA (mls 0.1M NaOH) and F ion (mg/L) of 71 products were measured using a pH meter and F-ISE. A Wilcoxon Signed Ranks Test compared pH and TAs at T0 and T20; a Mann-Whitney U test compared pH, TAs and F ion concentration for; a) regular vs diet drinks; and b) plastic bottle vs canned drinks.

RESULTS

Mean (±SD) pH for regular and diet drinks was 2.44 ± 0.12 and 2.83 ± 0.33 respectively (p = 0.001). Mean NaOH (ml) to raise pH to 5.5 and 5.7 was 5.49 ± 0.76 and 6.40 ± 0.78 (regular drinks); 5.17 ± 1.03 and 6.03 ± 1.07 (diet drinks). Diet (p = 0.040) and regular (p = 0.041) drinks had higher TA to pH 5.7 at T0 compared with T20; at T20 regular drinks had higher TA to pH 5.5 (p = 0.026) and pH 5.7 (p = 0.030) than diet drinks. There was no difference in F ion concentration between regular vs diet drinks (p = 0.754) and no significant container effect.

CONCLUSION

Erosive characteristics were similar between manufacturers, but higher erosive potentials were evident at T0 compared with 20 minutes later and for regular compared with diet drinks. F ion concentration of drinks was low.

Effects of energy and sports drinks on tooth structures and restorative materials

Sports and energy drinks are consumed by more people than ever. Sports and energy drinks may enhance physical resistance, stimulate metabolism, prevent rehydration and replace electrolytes during high activity efforts. However, these drinks often have a low pH and are acidic, which can erode enamel and dentin, and increase dentine hypersensitivity. In addition to the adverse effects of sports and energy drinks on tooth structures, they often have the potential to damage restorative materials. These drinks often contain artificial colors which have potential to discolor resin composite materials and glass ionomers. The acidic nature of these drinks could also lead to a degradation, increase in wear, and roughening of the surface of the restorative materials. Many of the negative consequences of sport and energy drinks can be related to their over-consumption among children and teenagers. Patients should be advised to have a healthy diet, and consume soft and energy drinks in moderation, to avoid any negative dental or health consequences. The over-consumption of sports and energy drinks which are high in sugar and have the lowest pH are most likely to cause avoidable dental problems.

Analyses of the Erosive Effect of Dietary Substances and Medications on Deciduous Teeth

This study aimed at analysing the erosive potential of 30 substances (drinks, candies, and medicaments) on deciduous enamel, and analyse the associated chemical factors with enamel dissolution. We analysed the initial pH, titratable acidity (TA) to pH 5.5, calcium (Ca), inorganic phosphate (P_i), and fluoride (F) concentration, and degree of saturation ((pK -pI)_HAP, (pK -pI)_FAP, and (pK−pI)_CaF2) of all substances. Then, we randomly distributed 300 specimens of human deciduous enamel into 30 groups (n = 10 for each of the substances tested. We also prepared 20 specimens of permanent enamel for the sake of comparison between the two types of teeth, and we tested them in mineral water and Coca-Cola^®. In all specimens, we measured surface hardness (VHN: Vickers hardness numbers) and surface reflection intensity (SRI) at baseline (SH_baseline and SRI_baseline), after a total of 2 min (SH_2min) and after 4 min (SH_4min and SRI_4min) erosive challenges (60 ml of substance for 6 enamel samples; 30°C, under constant agitation at 95 rpm). There was no significant difference in SH_baseline between deciduous and permanent enamel. Comparing both teeth, we observed that after the first erosive challenge with Coca-Cola^®, a significantly greater hardness loss was seen in deciduous (−90.2±11.3 VHN) than in permanent enamel (−44.3±12.2 VHN; p = 0.007), but no differences between the two types of teeth were observed after two challenges (SH_4min). After both erosive challenges, all substances except for mineral water caused a significant loss in relative surface reflectivity intensity, and most substances caused a significant loss in surface hardness. Multiple regression analyses showed that pH, TA and Ca concentration play a significant role in initial erosion of deciduous enamel. We conclude that drinks, foodstuffs and medications commonly consumed by children can cause erosion of deciduous teeth and erosion is mainly associated with pH, titratable acidity and calcium concentration in the solution.

Impact of Acquired Pellicle Modification on Adhesion of Early Colonizers

New preventive approaches against dental erosion caused by acidic drinks and beverages include fortification of beverages with natural polymers. We have shown that the mixture of casein and mucin significantly improved the erosion-inhibiting properties of the human pellicle layer. This study aimed to investigate the effect of pellicle modification by casein, mucin and a casein-mucin mixture on the adhesion of early bacterial colonizers. Test specimens of human tooth enamel were prepared, covered with saliva and coated with 0.5% aqueous (aq.) casein, 0.27% aq. mucin or with 0.5% aq. casein-0.27% aq. mucin, after which the adhesion of Streptococcus gordonii, Streptococcus oralis, and Actinomyces odontolyticus was measured after incubation for 30 min and 2 h. log10 colony-forming units were compared by nonparametric tests. All three bacterial strains adhered in higher number to pellicle-coated enamel than to native enamel. The protein modifications of pellicle all decreased the counts of adhering bacteria up to 0.34 log10/mm2, the most efficient being the casein-mucin mixture. In addition to the recently shown erosion-reducing effect by casein-mucin, modification of the pellicle may inhibit bacterial adherence compared to untreated human pellicle.