Elsevier

Journal of Dentistry

Volume 38, Issue 4, April 2010, Pages 284-289
Journal of Dentistry

Comparison of in vitro erosion potentials between beverages available in the United Kingdom and the United States

https://doi.org/10.1016/j.jdent.2009.11.008Get rights and content

Abstract

Objective

Our objective was to compare the physiochemical properties and erosion potentials between beverages available in the UK and the US.

Methods

The physiochemical properties (pH, titratable acidity and fluoride concentration) and erosion potential on enamel surfaces of beverages available in the UK were compared to similar beverages from the US. Enamel windows were exposed to beverages for 25 h. Teeth were sectioned through the windows, and lesion depths were defined as the average distance between the original tooth structure and the base of demineralization.

Results

The pH was lower in UK apple juice, orange juice, Diet Pepsi® and Sprite Zero® (p < 0.05), and higher in UK orange soda and diet orange soda than in similar US beverages (p < 0.05). Titratable acidities were higher in UK apple juice, orange juice, orange soda, diet orange soda and Sprite® (p < 0.01), and lower in UK Sunny D® than in the US counterpart (p < 0.001). Fluoride concentrations were lower in UK apple juice, orange juice, Coke®, and Diet Coke®, Sprite® and Sprite Zero® (p < 0.001), and higher in UK orange soda, diet orange soda, Pepsi® and Diet Pepsi® than in their US counterparts (p < 0.001). Lesion depths were higher in UK apple juice, orange juice, Diet Coke®, Sprite® and Sprite Zero® than in their US counterparts (p < 0.05). Lesion depths were associated with pH (p = 0.010) and country of origin (p = 0.002).

Conclusions

Under similar laboratory conditions, the physiochemical properties and erosion potentials on enamel surfaces differed between some, but not all, beverages available in the UK and the US.

Introduction

Dental erosion is defined as the pathologic, chronic loss of enamel and/or dentine resulting from chemical removal of the tooth surface, excluding tooth loss associated with bacterial produced acid.1, 2

The literature suggests that different prevalence rates of erosion exist between Europe and the United States (US). Bartlett et al. reported that studies conducted in Europe have cited erosion as being the most common and destructive form of tooth wear.3 The authors noted that studies conducted in North America have focused on attrition, rather than tooth wear and erosion.3 Dental erosion is an oral health concern in the United Kingdom (UK), yet erosion is not reported as frequently in the US.

Studies conducted in European countries suggest that the incidence of dental erosion ranges from 5 to 60%.4, 5, 6, 7, 8, 9 Dugmore and Rock reported a tooth erosion prevalence of 59.7% in a random sample of 12-year-old British children from Leicestershire and Rutland counties participating in a National Dental Health Survey.5 El Aidi et al. reported a baseline erosion prevalence of 32.2%, which increased to 42.8% during 1.5 years, in a convenience sample of 12-year-olds from the central Netherlands.6 Similar results were reported for 5-year-old Irish school children with 47% exhibiting some erosion.7 Deery et al. reported similar rates of erosion in adolescents from the UK and the US in a convenience sample, and acknowledged that limited data are available on the prevalence of erosion in the US, particularly in young children.10 Mathew et al. reported 36.5% of university athletes from the Midwest (US) had erosion.11 More recently, McGuire et al. reported that 45.9% of US adolescents participating in the 2003–2004 National Health and Nutrition Examination Survey had evidence of erosion on at least 1 tooth.12 The limited literature combined with limited interest by the US dental community supports the hypothesis that erosion is less problematic in the US than in the UK.

Numerous studies have investigated the role of diet in the etiology of erosion.1, 2 Acidic compounds such as citric, malic and phosphoric acids added to or found naturally in beverages and foods increase the erosion potential of that particular food.2 The presence of phosphate, calcium and fluoride can reduce the erosion potential of a beverage in vitro.13, 14, 15, 16, 17, 18 The quantity of fluoride typically found in soft drinks offers little protection, but higher concentrations of fluoride in such beverages could reduce the erosion potential.13

The pH, titratable acidities and in vitro erosion potentials of beverages available in Europe have been studied extensively,13, 14, 15, 16, 18, 19, 20, 21 while investigation of beverages available in the US is more limited.17, 22, 23 Most investigators have reported that 100% juices, carbonated beverages (i.e., pop, soda), sports drinks and energy drinks from both Europe and the US are potentially erosive, and that calcium addition or fortification minimizes the erosion potential. However, the erosive potential of beverages available in Europe cannot be directly compared to the erosion potential of those available in the US because the research was conducted by different investigators using different techniques in different laboratories at different time points.

Thus, differences in erosion observed between Europe and US could be due to different beverage erosion potentials and/or different drinking habits. We hypothesize that beverages commonly consumed in the UK have higher erosion potentials than those in the US. The objective of this study was to compare the physiochemical properties and erosion potentials on enamel surfaces between beverages available in the UK and the US.

Section snippets

Experimental design

An in vitro design was used to compare physiochemical properties (pH, titratable acidity and fluoride concentration) and erosion potentials on enamel surfaces of beverages available in the UK to those available in the US.

Beverage selection

Commonly consumed, potentially erosive, ready-to-drink beverages were identified in the UK and US. Examples of commonly consumed UK beverages were matched to similar US beverages, while examples of commonly consumed US beverages were matched to similar UK beverages for a total

Results

Physiochemical properties were compared between similar beverages from the UK and US. The pH was statistically lower in UK apple juice, orange juice, Diet Pepsi® and Sprite Zero®, and higher in UK orange soda and diet orange soda than in similar US beverages (Table 1). Titratable acidities were statistically higher in UK apple juice, orange juice, orange soda, diet orange soda and Sprite®, and lower in UK Sunny D® than in their US counterparts (Table 2). Fluoride concentrations were

Discussion

The results reported herein suggest that under similar laboratory conditions some, but not all, beverages available in the UK have higher erosion potentials than those available in the US. Neither titratable acidities nor fluoride concentrations were associated with the erosion potentials; however, initial pHs were associated with erosion potentials. Results reported herein are unique in that the UK and US beverages were compared under identical conditions within the same time frame.

The erosion

Conclusions

Differences were noted for pH, titratable acidity and erosion potentials between beverages available in the UK and the US. Although pH was negatively associated with erosion potential, pH did not explain the differences between countries. Additional investigation is necessary to identify if product formulations contribute to different clinical erosion patterns observed between Europe and the US.

Acknowledgements

The authors thank Maggie Hogan, Jeffrey Harless and Judy Heilman for their technical assistance in the laboratory. Portions of this study were presented and published in abstract form at the General Sessions of the International Association for Dental Research in Dallas, TX (2008).

This study was supported by NIDCR Grant T32 DEO14678-05. The contents are the responsibility of the authors and do not necessarily reflect the views of the granting organizations.

References (29)

  • C.R. Dugmore et al.

    The prevalence of tooth erosion in 12-year-old children

    British Dental Journal

    (2004)
  • H. El Aidi et al.

    A longitudinal study of tooth erosion in adolescents

    Journal of Dental Research

    (2008)
  • M.A. Harding et al.

    Dental erosion in 5-year-old Irish school children and associated factors: a pilot study

    Community Dental Health

    (2003)
  • B.L. Chadwick et al.

    Non-carious tooth conditions in children in the UK, 2003

    British Dental Journal

    (2006)
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