Acidic diet and dental erosion among athletes

Evaluating the pH of Various Commercially Available Beverages in Pakistan: Impact of Highly Acidic Beverages on the Surface Hardness and Weight Loss of Human Teeth

The objectives of this study were to investigate the pH of common beverages and to evaluate the effects of common acidic beverages on the surface hardness and weight loss of human tooth specimens. A total of 106 beverages were conveniently purchased from supermarkets in Karachi, Pakistan. Prior to evaluation, beverages were refrigerated or stored at room temperature in accordance with the manufacturers’ recommendations. Beverages were categorized into six groups: ‘Sports and Energy drinks’, ‘Water’, ‘Fruit Juices and Drinks’, ‘Sodas’, ‘Milk and Flavored Milk’ and ‘Teas and Coffee’. Using a pH meter, the pH of each beverage was measured in triplicate at room temperature. In addition, the influence of five highly acidic beverages on the weight loss and surface hardness of human tooth specimens was evaluated using gravimetric analysis and the Vickers hardness tester, respectively. ‘Sports and Energy drinks’, ‘Fruits Juices and Drinks’ and ‘Sodas’ were the most acidic beverage categories, with a pH range of 3.00−5.00. A total of 33% of beverages tested in this study were highly acidic (pH less than 4.00), 29% of beverages were moderately acidic (pH 4.00−4.99) and 31% were mildly acidic (pH 5.00−6.99). Significant weight loss was observed in all immersed specimens compared to control counterparts (p < 0.05). Similarly, for surface hardness, five highly acidic beverages (Red Bull, Pepsi, Apple Cidra, Tang Mosambi and Tang Orange) significantly decreased the surface hardness of specimens (p < 0.05). The pH levels of commonly available beverages in Pakistan are highly acidic, which may encourage loss of minerals from teeth; hence, affecting their surface hardness.

The European Association for Sports Dentistry, Academy for Sports Dentistry, European College of Sports and Exercise Physicians consensus statement on sports dentistry integration in sports medicine

Sports medicine has a multidisciplinary character which allows different medical specialties to investigate the prevention, etiology, and treatment of athletes' diseases. This leads to a decreased risk of injury and a faster return to play as well as an improvement in the overall health and well-being of athletes of any level and in all sports around the world. The oral health of athletes is now the subject of great attention internationally because of the increased prevalence and incidence of health issues such as dental caries and erosion, periodontal disease, defective occlusion, temporomandibular joint disorders, and orofacial injuries. Scientific evidence and research on these issues have also intensified over recent years. The best way to maintain player's health and performance is to include oral health in sports medicine with physicians and dentists working closely together at the individual level as well as with the cooperation between local and international sports medicine and dentistry associations. The European Association for Sports Dentistry, the Academy for Sports Dentistry, and the European College of Sports and Exercise Physicians are leading the way and have worked together to develop a consensus statement describing the main pillars of oral health integration into sports medicine based on the most common oral diseases found in athletes and linked to exercise, sports, and performance.

The top five selling UK energy drinks: implications for dental and general health

Aim Energy drinks are widely consumed worldwide and are recognised for their adverse health effects, usually due to their high caffeine content. However, little is known about their impact on oral and general health. The aim of this investigation was to review the most popular energy drinks sold in the UK, for their possible effect on oral health and contribution to obesity. Materials and methods Five drinks representing 75% of the UK energy drinks market were purposively selected (Lucozade, Red Bull, Monster, Rockstar and Relentless). pH and sugar content were measured and their ingredients reviewed in the context of oral and general health, focusing on dental caries and erosion and obesity. Results All five energy drinks investigated had pH values below the critical value (5.5) associated with dental erosion; the lowest pH was 2.72 (Lucozade) and the highest was 3.37 (Monster). The drinks also contained excessive amounts of free sugars, ranging from 25.5 g (Red Bull) to 69.2 g (Rockstar). Differences in sugar content were mainly explained by portion size. Other ingredients contained within the energy drinks, caffeine and various acids, are also linked to oral and general health. Conclusion Regular consumption of energy drinks could contribute to dental erosion and the development of obesity. Lucozade and Rockstar were found to potentially have the greatest impact on oral health and obesity. Achieving a healthy product by reformulation is highly unlikely due to the very high initial free sugar content. Thus, health professionals need to acknowledge the popularity of these products and help their clients to reduce their use. This is the first study which compares in detail the potential oral and general health consequences of overuse of a selection of energy drinks popular in the UK.

Interactive effect of rehydration with diluted sports drink and water gargling on salivary flow, pH, and buffering capacity during ergometer exercise in young adult volunteers

The present study was conducted to investigate the influence of rehydration with diluted sports drink and water gargling on salivary flow, pH and buffering capacity during exercise. Nineteen participants performed a 30-min bicycle ergometer exercise at 80% of maximal heart rate while consuming a sports drink, followed by gargling with water, or no gargling, immediately after the exercise (Exp. 1). The same experiment was then conducted on 9 participants who drank 1.5-fold diluted sports drink (Exp. 2-A) and 10 who drank 2-fold diluted sports drink (Exp. 2-B). Paraffin-stimulated whole saliva samples were collected for 3 min before, during and after exercise, and salivary parameters were examined using a hand-held pH meter. Statistical significance was assessed using multi-factor ANOVA and Turkey-Kramer test (P < 0.05). The decrease in salivary pH was significantly suppressed after water gargling in Exp. 1 (P < 0.01) and Exp. 2-A (P < 0.001). Dilution of the sports drink had an interactive effect with water gargling in Exp. 2-B (P < 0.01). These results suggest that gargling with water suppresses the decrease of salivary pH resulting from sports drink rehydration during ergometer exercise, but that this effect may be lost if athletes consume sports drink that has been diluted 2-fold with water.

A survey of sports drinks consumption among adolescents

Background Sports drinks intended to improve performance and hydrate athletes taking part in endurance sport are being marketed to children, for whom these products are not intended. Popularity among children has grown exponentially. Worryingly they consume them socially, as well as during physical activity. Sports drinks are high in sugar and are acidic. Product marketing ignores the potential harmful effects of dental caries and erosion.Objective To investigate the use of sports drinks by children.Method One hundred and eighty-three self-complete questionnaires were distributed to four schools in South Wales. Children in high school years 8 and 9 (aged 12-14) were recruited to take part. Questions focused on use of sports drinks, type consumed, frequency of and reason for consumption and where drinks were purchased.Results One hundred and sixty children responded (87% response rate): 89.4% (143) claimed to drink sports drinks, half drinking them at least twice a week. Lucozade Sport(™) was the most popular brand. The main reason for consuming the drinks was attributed to the 'nice taste' (90%, 129/143). Most respondents purchased the drinks from local shops (80.4%, 115) or supermarkets (54.5%, 78). More boys claimed to drink sports drinks during physical activity (77.9% versus 48.6% girls, P <0.001). Whereas more girls claimed to drink them socially (51.4% versus 48.5% boys, NS).Conclusion A high proportion of children consumed sports drinks regularly and outside of sporting activity. Dental health professionals should be aware of the popularity of sports drinks with children when giving health education advice or designing health promotion initiatives.

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.

Vibrational monitor of early demineralization in tooth enamel after in vitro exposure to phosphoridic liquid

The Raman spectroscopic method has been applied to quantitatively assess the in vitro degree of demineralization in healthy human teeth. Based on previous evaluations of Raman selection rules (empowered by an orientation distribution function (ODF) statistical algorithm) and on a newly proposed analysis of phonon density of states (PDOS) for selected vibrational modes of the hexagonal structure of hydroxyapatite, a molecular-scale evaluation of the demineralization process upon in vitro exposure to a highly acidic beverage (i.e., CocaCola™ Classic, pH=2.5) could be obtained. The Raman method proved quite sensitive and spectroscopic features could be directly related to an increase in off-stoichiometry of the enamel surface structure since the very early stage of the demineralization process (i.e., when yet invisible to other conventional analytical techniques). The proposed Raman spectroscopic algorithm might possess some generality for caries risk assessment, allowing a prompt non-contact diagnostic practice in dentistry.

Attitudes and barriers to providing dietary advice: perceptions of dental hygienists and oral health therapists

OBJECTIVES

Effective dietary counselling in a dental setting can significantly reduce the risk of oral disease. However, studies suggest that dental professionals are not instigating dietary advice on a regular basis, and there is a lack of current information of the barriers experienced that limit the delivery of dietary advice. The aim of this study was to investigate the current attitudes and practice behaviours of dental hygienists and oral health therapists in NSW, Australia, regarding dietary advice, and identify the barriers that limit its delivery.

METHODS

A convenience sample of dental hygienists and oral health therapists were surveyed using a mail-out questionnaire. The questionnaire investigated the demographic data of participants, the attitudes and practice behaviours of participants, the perceived barriers and current dietary resources accessed by participants.

RESULTS

Of 987 dental hygienists and oral health therapists, 426 participants responded. The study results suggest that many dental hygienists and oral health therapists have positive beliefs regarding the importance of dietary counselling. However, there are a multitude of barriers preventing the delivery of dietary advice; these include time, patient compliance, patient knowledge of nutrition topics, personal counselling skills and practitioners' knowledge of nutrition.

CONCLUSION

Whilst dental hygienists and oral health therapists recognize the importance of diet and have positive attitudes towards providing dietary advice to patients, this study identified many barriers preventing implementation in practice. This information may be used to develop targeted strategies aimed at overcoming these barriers and improving behaviours.

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.

The tooth wear evaluation system: a modular clinical guideline for the diagnosis and management planning of worn dentitions

Tooth wear is a multifactorial condition, leading to the loss of dental hard tissues, viz. enamel and dentine. Tooth wear can be divided into the subtypes mechanical wear (attrition and abrasion) and chemical wear (erosion). Because of its multifactorial aetiology, tooth wear can manifest itself in many different representations, and therefore, it can be difficult to diagnose and manage the condition. A systematic approach is a sine qua non. In the below-described tooth wear evaluation system (TWES), all necessary tools for a clinical guideline are present in different modules. This allows the dental clinician, in a general practitioner setting as well as in a referral practice setting, to perform a state-of-the-art diagnostic process. To avoid the risk of a too cumbersome usage, the dental clinician can select only those modules that are appropriate for a given setting. The modules match with each other, which is indispensable and essential when different modules of the TWES are compared. With the TWES, it is possible to recognise the problem (qualifying), to grade its severity (quantifying), to diagnose the likely causes and to monitor (the progress of) the condition. In addition, a proposal for the classification of tooth wear is made. Further, it is possible to determine when to start a treatment, to make the decision which kind of treatment to apply and to estimate the level of difficulty of a restorative treatment.

The effect of a bioglass paste on enamel exposed to erosive challenge

OBJECTIVES

The current study is evaluating the effect of using a 45S5 bioglass paste and topical fluoride application on the cross sectional micro-hardness and the chemical surface changes of eroded enamel.

METHODS

Enamel discs were obtained from the buccal surface of one hundred extracted human non-carious third molars. The enamel surfaces were ground flat and each disc was coated with two layers of acid resistant nail varnish except for an exposed treatment window (3mm×2mm) on the buccal surface of the tooth. All specimens were challenged for 60 min by orange juice (Tropicana, Chicago, USA) pH 3.85+0.5. The specimens were divided into four groups: the 45S5 bioglass paste group, fluoride gel group (5 min application), fluoride gel group (24h application) while the rest of specimens served as control. The cross-sectional micro-hardness of 20 specimens from each group was measured. Five specimens from each group had their top eroded enamel surfaces examined by SEM-EDS. One-way ANOVA was used to compare the cross-sectional micro-hardness of the three groups p<0.05.

RESULTS

45S5 bioglass paste application significantly improved the sub-surface eroded enamel when compared to fluoride and control specimens (p<0.05).

CONCLUSION

45S5 bioglass paste can efficiently improve the micro-hardness of the sub-surface eroded enamel surface.

CLINICAL SIGNIFICANCE

The use of the 45S5 Bioglass paste can be used efficiently as a potent remineralizing agent for the sub-surface enamel lesions resulting from erosive challenges.

Oral health and impact on performance of athletes participating in the London 2012 Olympic Games: a cross-sectional study

BACKGROUND

Oral health is important both for well-being and successful elite sporting performance. Reports from Olympic Games have found significant treatment needs; however, few studies have examined oral health directly. The aim of this study was to evaluate oral health, the determinants of oral health and the effect of oral health on well-being, training and performance of athletes participating in the London 2012 Games.

METHODS

Cross-sectional study at the dental clinic within the Polyclinic in the athletes' village. Following informed consent, a standardised history, clinical examination and brief questionnaire were conducted.

RESULTS

302 athletes from 25 sports were recruited with data available for 278. The majority of athletes were from Africa, the Americas and Europe. Overall, the results demonstrated high levels of poor oral health including dental caries (55% athletes), dental erosion (45% athletes) and periodontal disease (gingivitis 76% athletes, periodontitis 15% athletes). More than 40% of athletes were 'bothered' by their oral health with 28% reporting an impact on quality of life and 18% on training and performance. Nearly half of the participants had not undergone a dental examination or hygiene care in the previous year.

CONCLUSIONS

The oral health of athletes attending the dental clinic of the London 2012 Games was poor with a resulting substantial negative impact on well-being, training and performance. As oral health is an important element of overall health and well-being, health promotion and disease prevention interventions are urgently required to optimise athletic performance.

Effects of rehydration and food consumption on salivary flow, pH and buffering capacity in young adult volunteers during ergometer exercise

Background

The aim of this study was to investigate the influences of rehydration and food consumption on salivary flow, pH, and buffering capacity during bicycle ergometer exercise in participants.

Methods

Ten healthy volunteers exercised on a bicycle ergometer at 80% of their maximal heart rate. These sessions lasted for two periods of 20 min separated by 5-min rest intervals. Volunteers were subjected to one of the following conditions: (1) no water (mineral water) or food consumption, (2) only water for rehydration, (3) water and food consumption, (4) a sports drink only for rehydration, and (5) rehydration with a sports drink and food. Statistical significance was assessed using one-way analysis of variance and Dunnett’s test (p < 0.05).

Results

The salivary pH decreased significantly during and after exercise in conditions 4 and 5. The salivary buffering capacity decreased significantly during exercise and/or after the exercise in conditions 1, 3, 4, and 5.

Conclusions

The results showed that salivary pH and buffering capacity decreased greatly depending on the combination of a sports drink and food.

Carbohydrate supplementation and prolonged intermittent high-intensity exercise in adolescents: research findings, ethical issues and suggestions for the future

In the last decade, research has begun to investigate the efficacy of carbohydrate supplementation for improving aspects of physical capacity and skill performance during sport-specific exercise in adolescent team games players. This research remains in its infancy, and further study would be beneficial considering the large youth population actively involved in team games. Literature on the influence of carbohydrate supplementation on skill performance is scarce, limited to shooting accuracy in adolescent basketball players and conflicting in its findings. Between-study differences in the exercise protocol, volume of fluid and carbohydrate consumed, use of prior fatiguing exercise and timing of skill tests may contribute to the different findings. Conversely, initial data supports carbohydrate supplementation in solution and gel form for improving intermittent endurance running capacity following soccer-specific shuttle running. These studies produced reliable data, but were subject to limitations including lack of quantification of the metabolic response of participants, limited generalization of data due to narrow participant age and maturation ranges, use of males and females within the same sample and non-standardized pre-exercise nutritional status between participants. There is a lack of consensus regarding the influence of frequently consuming carbohydrate-containing products on tooth enamel erosion and the development of obesity or being overweight in adolescent athletes and non-athletes. These discrepancies mean that the initiation or exacerbation of health issues due to frequent consumption of carbohydrate-containing products by adolescents cannot be conclusively refuted. Coupled with the knowledge that consuming a natural, high-carbohydrate diet -3-8 hours before exercise can significantly alter substrate use and improve exercise performance in adults, a moral and ethical concern is raised regarding the direction of future research in order to further knowledge while safeguarding the health and well-being of young participants. It could be deemed unethical to continue study into carbohydrate supplementation while ignoring the potential health concerns and the possibility of generating similar performance enhancements using natural dietary interventions. Therefore, future work should investigate the influence of pre-exercise dietary intake on the prolonged intermittent, high-intensity exercise performance of adolescents. This would enable quantification of whether pre-exercise nutrition can modulate exercise performance and, if so, the optimum dietary composition to achieve this. Research could then combine this knowledge with ingestion of carbohydrate-containing products during exercise to facilitate ethical and healthy nutritional guidelines for enhancing the exercise performance of adolescents. This article addresses the available evidence regarding carbohydrate supplementation and prolonged intermittent, high-intensity exercise in adolescent team games players. It discusses the potential health concerns associated with the frequent use of carbohydrate-containing products by adolescents and how this affects the research ethics of the field, and considers directions for future work.

Dental erosive wear and salivary flow rate in physically active young adults

BACKGROUND

Little attention has been directed towards identifying the relationship between physical exercise, dental erosive wear and salivary secretion. The study aimed i) to describe the prevalence and severity of dental erosive wear among a group of physically active young adults, ii) to describe the patterns of dietary consumption and lifestyle among these individuals and iii) to study possible effect of exercise on salivary flow rate.

METHODS

Young members (age range 18-32 years) of a fitness-centre were invited to participate in the study. Inclusion criteria were healthy young adults training hard at least twice a week. A non-exercising comparison group was selected from an ongoing study among 18-year-olds. Two hundred and twenty participants accepted an intraoral examination and completed a questionnaire. Seventy of the exercising participants provided saliva samples. The examination was performed at the fitness-centre or at a dental clinic (comparison group), using tested erosive wear system (VEDE). Saliva sampling (unstimulated and stimulated) was performed before and after exercise. Occlusal surfaces of the first molars in both jaws and the labial and palatal surfaces of the upper incisors and canines were selected as index teeth.

RESULTS

Dental erosive wear was registered in 64% of the exercising participants, more often in the older age group, and in 20% of the comparison group. Enamel lesions were most observed in the upper central incisors (33%); dentine lesions in lower first molar (27%). One fourth of the participants had erosive wear into dentine, significantly more in males than in females (p = 0.047). More participants with erosive wear had decreased salivary flow during exercise compared with the non-erosion group (p < 0.01). The stimulated salivary flow rate was in the lower rage (≤ 1 ml/min) among more than one third of the participants, and more erosive lesions were registered than in subjects with higher flow rates (p < 0.01).

CONCLUSION

The study showed that a high proportion of physically active young adults have erosive lesions and indicate that hard exercise and decreased stimulated salivary flow rate may be associated with such wear.

Patterns in consumption of potentially erosive beverages among adolescent school children in the Netherlands

AIM

To determine the frequency of intake and patterns in consumption of potentially erosive beverages in school children in the Netherlands.

METHODS

A cross-sectional, single centre study was performed among 502 school children in Rotterdam, in age varying between 12 and 19 years. Data on consumption of soft drinks, energy drinks, sports drinks and alcopops were obtained through a self-reported questionnaire. Gender- and age-related differences in consumption were analysed with Chi-square, Kruskal-Wallis and Mann-Whitney tests. Associations between variables were investigated with Chi-square tests and Spearman's rank order correlation analysis.

RESULTS

Boys consumed soft drinks, energy drinks and sports drinks more frequently than girls, and on average also consumed higher amounts of these drinks. No gender-related differences were observed in alcopop consumption. Consumption of all drinks was most frequent at 14- or 15-year of age, with the exception of alcopops which was most frequent by 16-year-old school children. Significant positive associations were observed between the consumption of soft drinks, energy drinks and/or sports drinks. Alcopop consumption was only associated with consumption of energy drinks.

CONCLUSION

Consumption of soft drinks, energy drinks, sports drinks and alcopops by school children is related to age and gender. The significant positive associations between the consumption of these drinks suggest that a subgroup of school children exists with a high cumulative intake of these potentially erosive drinks.

Effect of casein phosphopeptide-amorphous calcium phosphate added to acidic beverages on enamel erosion in vitro

BACKGROUND

To investigate, in vitro, the effect on enamel erosion of the addition of 0.2% w/v casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) to four commercially-available soft drinks, two of which were carbonated.

METHODS

Enamel specimens (n=27) were sectioned from sound extracted human third molar teeth and polished to a mirror finish. Exposed enamel windows of 1 mm2 were created by painting the surface with acid-resistant nail varnish. Four citric flavoured soft drinks (pH range 2.2 to 2.4) and distilled deionized water (DDW) were tested. Each drink was tested with and without 0.2% CPP-ACP w/v. The specimens were placed into 50 mL of solution at 37 °C for 30 minutes, rinsed and varnish removed. The samples were profiled with a white light profilometer and erosive depths recorded.

RESULTS

All soft drinks tested caused enamel erosion but adding 0.2% w/v CPP-ACP significantly reduced (p<.05) erosive depth in all test solutions in comparison with the solutions without CPP-ACP. The erosive depths for all solutions with 0.2% CPP-ACP did not differ significantly from those of DDW.

CONCLUSIONS

Adding CPP-ACP at 0.2% w/v significantly decreased the erosivity of all four soft drinks. The erosivity of the soft drinks with 0.2% CPP-ACP added did not differ significantly from that of distilled water.

Pop-cola acids and tooth erosion: an in vitro, in vivo, electron-microscopic, and clinical report

Introduction. Manufactured Colas are consumed universally as soft drinks. Evidence about the acid contents of Cola-beverages and its effects on teeth is rare. Aim. To assess (i) cola acidity and buffering capacity in vitro, (ii) tooth erosion after swishing with colas in vivo (iii) scanning electron microscopic effects on teeth of colas, and tooth-brush abrasion, and (iv) report a clinical case of erosion from cola consumption. Materials and Methods. (i) We measured six commercially available pop "Cola beverages", pH, and buffering capacities using a pH-Mettler Automatic Titrator, with weak solution of Sodium Hydroxide (ii) two cohorts, one with teeth, the second without teeth rinsed with aliquots of Cola for 60 seconds. Swished cola samples tested for calcium and phosphorus contents using standardized chemical analytical methods (iii) enamel, dentine, and the enamel-cemental junction from unerupted extracted wisdom teeth were examined with a scanning electron microscope after exposure to colas, and tested for tooth-brush abrasion; (iv) a clinical case of pop cola erosion presentation, are all described. Results. Comparisons among pop colas tested in vitro reveal high acidity with very low pH. Buffering capacities in millilitres of 0.5 M NaOH needed to increase one pH unit, to pH 5.5 and pH 7 are reported. Rinsing in vivo with pop cola causes leeching of calcium from teeth; SEM shows dental erosion, and pop-cola consumption induces advanced dental erosion and facilitates abrasion. Conclusions. (i) Pop-Cola acid activity is below the critical pH 5.5 for tooth dissolution, with high buffering capacities countering neutralization effects of saliva; (ii) calcium is leeched out of teeth after rinsing with pop colas; (iii) SEM evidence explains why chronic exposure to acid pop colas causes dental frangibles; (iv) a clinical case of pop-cola erosion confirms this.

Erosive effects of common beverages on extracted premolar teeth

BACKGROUND

Dental erosion is highly prevalent today, and acidic drinks are thought to be an important cause. The aim of the present investigation was to determine the erosive potential of a range of common beverages on extracted human teeth.

METHODS

The beverages were tested for their individual pHs using a pH meter. The clinical effects of the most erosive beverages were determined by the degree of etching and Vickers microhardness of enamel.

RESULTS

The results showed that many common beverages have pHs sufficiently low to cause enamel erosion. Lime juice concentrate (pH 2.1) had the lowest pH, followed by Coca-cola and Pepsi (both with pH 2.3) and Lucozade (pH 2.5). The erosive potential of these beverages was demonstrated by the deep etching of the enamel after five minutes. The Vickers Hardness of enamel was reduced by about 50 per cent in the case of lime juice (p < 0.001) and 24 per cent in the case of Coca-cola (p < 0.004). Addition of saliva to 50 per cent (v/v) of Coca-cola completely reversed the erosive effects on the enamel.

CONCLUSIONS

Although only a few of the beverages with the lowest pHs were tested, the present study showed that the most acidic drinks had the greatest erosive effects on enamel. While saliva was protective against erosion, relatively large volumes were required to neutralize the acidity.

Erosive Effect of a New Sports Drink on Dental Enamel during Exercise

PURPOSE

To compare the potential erosive effect of a prototype carbohydrate-electrolyte drink (PCE) with a neutral control (water) and a commercially available carbohydrate-electrolyte drink (CCE) during exercise.

METHODS

: Nineteen healthy adults (male, N = 16; female, N = 3) took part in this single blind, three-way crossover study. Subjects were given each of the three drinks according to a randomization schedule, approximately balanced for first-order carryover effects. At the beginning of each of the three study periods, the volunteers were fitted with an intraoral appliance containing two human enamel blocks. During each study period, volunteers exercised for 75 min.d(-1) (5 repetitions of 15 min of exercise, with 5-min rests between exercise repetitions), 5 d.wk(-1) for 3 wk. Each day, drink aliquots of 200 mL were consumed during a 5-min period before exercise and after every 15-min bout of exercise, followed by a final 400-mL aliquot ingested over a 10-min period: a total of 1400 mL per study day. Dental erosion was measured as tissue loss from the enamel blocks by profilometry at the end of each study period.

RESULTS

Water, PCE, and CCE produced 0.138 microm (SD 0.090 microm), 0.138 microm (SD 0.038 microm), and 4.238 microm (SD 3.872 microm) of enamel loss, respectively. A Wilcoxon t statistic showed a significant statistical difference between the PCE and CCE drinks (P < 0.001), whereas no significant difference could be detected between the PCE drink and water (P = 0.740).

CONCLUSION

The PCE solution showed minimal erosion compared with the commercially available drink, and was statistically indistinguishable from water under the conditions of this study. Use of CE solutions formulated to minimize erosion during exercise may provide significant dental benefits.