PDF
ePub
Citation
Print
Abstract
Objectives
The aims of this in vitro study were (1) to assess the erosive potential of several children’s beverages in comparison to cola and orange juice, by using an in vitro pH-cycling model, and (2) to investigate the factors related to dental erosion caused by the beverages.
Methods
Eight different children’s beverages (Chorongi, Capri-sun, Grateful nature wisdom, I-kicker, Koal-koal koala, My friend pororo, Qoo, and Strong zzanggu), Cola, and an orange juice, which are available in the Korean market, were used. To characterize each test beverage, the pH, titratable acidity to pH 7.0, concentration of calcium and phosphorus, and degree of saturation with respect to hydroxyapatite (DSHAP) were analyzed. Erosive potential of the test beverages was assessed by the depth of enamel loss observed in specimens subjected to pH cycling for 8 days. This cycle consisted of exposure to each beverage for 20 min, thrice daily, and to a remineralizing solution every day. The correlation between the depth of the enamel loss and the chemical properties of the beverages was assessed by Spearman’s rank correlation coefficients and multiple linear regression tests (P<0.05).
Results
The depth of enamel loss caused by the beverages was found to vary from 0.11 to 105.47 μm. Enamel loss with all the children’s beverages tested was lesser compared to that with Cola (P<0.05) but was similar or greater than that with orange juice, except in one beverage. The pH, concentration of calcium, and DSHAP were significantly correlated with the depth of enamel loss (r=―0.842, r=―0.796, and r=―0.867, respectively; P<0.01). Multiple regression analysis showed that pH and concentration of calcium were impact variables for the erosive potential of test beverages (P<0.05).
Conclusions
The children’s beverages tested had lower erosive potential than Coca Cola, but five (I-kiker, Grateful nature wisdom, Qoo, Capri-sun, and Chorongi) of them had higher erosive potential than orange juice. Moreover, among the chemical properties of beverages, significant factors affecting enamel loss were pH value and concentration of calcium.
References
1. Wiegand A, Müller J, Werner C, Attin T. Prevalence of erosive tooth wear and associated risk factors in 2-7-year-old German kindergarten children. Oral Dis. 2006; 12:117–124.
2. Arnadottir IB, Holbrook WP, Eggertsson H, Gudmundsdottir H, Jonsson SH, Gudlaugsson JO, et al. Prevalence of dental erosion in children: a national survey. Community Dent Oral Epidemiol. 2010; 38:521–526.
3. Ehlen LA, Marshall TA, Qian F, Wefel JS, Warren JJ. Acidic beverages increase the risk of in vitro tooth erosion. Nutr Res. 2008; 28:299–303.
4. Hunter ML, West NX, Hughes JA, Newcombe RG, Addy M. Erosion of deciduous and permanent dental hard tissue in the oral environment. J Dent. 2000; 28:257–263.
5. West NX, Maxwell A, Hughes JA, Parker DM, Newcombe RG, Addy M. A method to measure clinical erosion: the effect of orange juice consumption on erosion of enamel. J Dent. 1998; 26:329–335.
6. Dugmore CR, Rock WP. A multifactorial analysis of factors associated with dental erosion. Br Dent J. 2004; 196:283–286. discussion 273.
7. Jensdottir T, Arnadottir IB, Thorsdottir I, Bardow A, Gudmunds-son K, Theodors A, et al. Relationship between dental erosion, soft drink consumption, and gastroesophageal reflux among Icelanders. Clin Oral Investig. 2004; 8:91–96.
8. Lussi A, Jaeggi T, Zero D. The role of diet in the aetiology of dental erosion. Caries Res. 2004; 38(Suppl 1):S34–44.
9. McClure FJ, Ruzicka SJ. The destructive effect of citrate vs. lactate ions on rats’ molar tooth surfaces, in vivo. J Dent Res. 1946; 25:1–12.
10. West NX, Hughes JA, Addy M. Erosion of dentine and enamel in vitro by dietary acids: the effect of temperature, acid character, concentration and exposure time. J Oral Rehabil. 2000; 27:875–880.
11. Lussi A, Jaggi T, Scharer S. The influence of different factors on in vitro enamel erosion. Caries Res. 1993; 27:387–393.
12. Hara AT, Zero DT. Analysis of the erosive potential of calcium-containing acidic beverages. Eur J Oral Sci. 2008; 116:60–65.
13. Final drink and concentrate, formulae comparisons in situ and overview of the concept. J Dent. 1999; 27:345–350.
14. Hooper S, West NX, Sharif N, Smith S, North M, De’Ath J, et al. A comparison of enamel erosion by a new sports drink compared to two proprietary products: a controlled, crossover study in situ. J Dent. 2004; 32:541–545.
15. Touyz LZ. The acidity (pH) and buffering capacity of Canadian fruit juice and dental implications. J Can Dent Assoc. 1994; 60:454–458.
16. Shin YH, Kim YJ. Study on the primary tooth enamel erosion caused by children beverage. J Korean Acad Pediatr Dent. 2009; 36:227–236.
17. Min JH, Kwon HK, Kim BI. The addition of nano-sized hydroxyapatite to a sports drink to inhibit dental erosion: in vitro study using bovine enamel. J Dent. 2011; 39:629–635.
18. Davis RE, Marshall TA, Qian F, Warren JJ, Wefel JS. In vitro protection against dental erosion afforded by commercially available, calcium-fortified 100 percent juices. J Am Dent Assoc. 2007; 138:1593–1598. quiz 1615.
19. Larsen MJ, Nyvad B. Enamel erosion by some soft drinks and orange juices relative to their pH, buffering effect and contents of calcium phosphate. Caries Res. 1999; 33:81–87.
20. Grenby TH. Lessening dental erosive potential by product modification. Eur J Oral Sci. 1996; 104:221–228.
21. Lussi A, Megert B, Shellis RP, Wang X. Analysis of the erosive effect of different dietary substances and medications. Br J Nutr. 2012; 107:252–262.
22. Barbour ME, Parker DM, Allen GC, Jandt KD. Enamel dissolution in citric acid as a function of calcium and phosphate concentrations and degree of saturation with respect to hydroxyapatite. Eur J Oral Sci. 2003; 111:428–433.
23. Wongkhantee S, Patanapiradej V, Maneenut C, Tantbirojn D. Effect of acidic food and drinks on surface hardness of enamel, dentine, and tooth-coloured filling materials. J Dent. 2006; 34:214–220.
24. Jensdottir T, Bardow A, Holbrook P. Properties and modification of soft drinks in relation to their erosive potential in vitro. J Dent. 2005; 33:569–575.
25. Kim EJ, Lee HJ, Lee EJ, Bae KH, Jin BH, Paik DI. Effects of pH and titratable acidity on the erosive potential of acidic drinks. J Korean Acad Oral Health. 2012; 36:13–19.
26. Gray JA. Kinetics of enamel dissolution during formation of incipient caries-like lesions. Arch Oral Biol. 1966; 11:397–422.
27. Featherstone JD, Duncan JF, Cutress TW. A mechanism for dental caries based on chemical processes and diffusion phenomena during in-vitro caries simulation on human tooth enamel. Arch Oral Biol. 1979; 24:101–112.
28. Rugg-Gunn AJ, Maguire A, Gordon PH, McCabe JF, Stephenson G. Comparison of erosion of dental enamel by four drinks using an intra-oral applicance. Caries Res. 1998; 32:337–343.
29. Jensdottir T, Holbrook P, Nauntofte B, Buchwald C, Bardow A. Immediate erosive potential of cola drinks and orange juices. J Dent Res. 2006; 85:226–230.
Table 1
Control beverages and experimental children’s beverages sed in this study
Table 2.
Baseline pH, titratable acidity to pH 7.0, concentration of Ca and P, and degree of saturation with respect to hydroxyapatite measured for test beverages
Table 3.
The mean values of depths of enamel loss determined by non-contact interferometer after pH-cycling for 8 days
| Beverages | Depth of enamel loss Mean (SD) |
|---|---|
| Strong zzanggu | 0.11 (0.07)a |
| Koal-koal koala | 12.44 (3.56)b |
| My friend pororo | 14.06 (4.38)b |
| Tropicana orange juice | 17.79 (3.91)b |
| I-kicker | 31.87 (3.98)c |
| Grateful nature wisdom | 33.40 (4.10)c,d |
| Qoo | 40.67 (6.63)d |
| Capri-sun | 62.03 (9.23)e |
| Chorongi | 74.60 (12.86)e |
| Coca-cola | 105.47 (14.98)f |
| P-value | <0.0001 |
XML Download