Laboratory studies on the dental effects of soft drinks and other beverages Sarah Story Tennessee Technology University, Cookeville, TN IntroductionResults Conclusion A high percentage of people consume soft drinks that contain sugar or artificial sweeteners, flavorings, and various additives. The popularity of sports (energy) drinks is growing and this study compares enamel dissolution in these and a variety of other beverages. Enamel from extracted specimens were selected, weighed and immersed in the selected beverages for a total of 7 days. The specimens were weighed at specific intervals throughout the immersion period with the solutions being changed daily (von Fraunhofer & Rogers 2004). Enamel dissolution occurred in all of the tested beverages, with far greater attack occurring in flavored and energy (sports) drinks than previously noted for water and cola drinks. Non-cola drinks, commercial lemonades, and energy sports drinks showed the most aggressive dissolution effect on the dental enamel. Reduced residence times of beverages in the mouth by salivary clearance or rinsing would appear to be beneficial. (von Fraunhofer, 2004) Methods Discussion References The teeth are sound (caries free) human molars and premolars that had been extracted for orthodontic or periodontal reasons. After sterilization in the autoclave each specimen was dried and weighed to 0.01 mg. All studies will be preformed at room temperature. The test beverages and test specimens will be placed in plastic containers with 5 mL of the test beverage. The specimens will be allowed to soak in the test beverage for 60 minutes each and then allowed to dry until for 24 hours and then weighed. This process will be preformed over 24 hour intervals for a 7 day (168 hour) period. The beverages for each specimen will be replaced daily with fresh solution after each weighing. The average weight of mass lost will be calculated and recorded on the data sheet. The amounts of enamel dissolution that occurred in the 20 specimens over the 7 day period are summarized in the table and figure 1. The control, tap water, showed no enamel dissolution. All other media exhibited a progressive attack on the dental enamel, with a linear or straight line relationship between the enamel dissolution and exposure time over the test period. Typical dissolution curves are shown in Figure 1. The beverage Red Bull showed the greatest affect on the dental enamel followed my Minute Maid Lemonade. Results from Fruit Punch Gatorade were within.002 grams of Minute Maid Lemonade, and showed the third greatest enamel dissolution from the tested beverages. The results from Mountain Dew were within grams of the Red Bull and Minute Maid Lemonade, and resulted in being the beverage with the least enamel dissolution before the control. The Figures 2 and 3 shows an example of enamel dissolution in a teenage boy who managed to do decade’s worth of damage to his enamel in just a few years. Effects such as those in figures 2 and 3 could be expected with continued exposure. here ♦Davani R, Walker J, Qian F, Wefer JS. Measurement of viscosity, pH and titratable acidity of sports drinks. J Dent Res 2003;82 (Special Issue A): Abstract No. 326 ♦Grenby, T.H., A. Phillips, T. Desai, and M. Mistry Laboratory studies of the dental properties of soft drinks. British Journal of Nutrition 62: ♦Rugg-Gunn AJ, Nunn JH. Diet and dental erosion. Nutrition, diet and oral health. Hong Kong: Oxford University Press; ♦Von Fraunhofer, Anthony J., Matthew M. Rogers Dissolution of dental enamel in soft drinks. General Dentistry July/August: ♦Von Fraunhofer, Anthony J., Matthew M. Rogers Effects of sports drinks and other beverages on dental enamel. General Dentistry January/February: BeverageContainerpHSugar per 12 oz. 7 Day Average Weight Lost Mountain DewBottle grams.023 g Red BullCan grams.043 g Minute Maid Lemonade Bottle grams.033 g Fruit Punch Gatorade Bottle grams.035 g Control (tap water) Bottle7.00 grams0 g Table. Beverages utilized in this study. Fig. 2 & Fig. 3 Left- Molar with acid erosion. This teen-ager has the enamel of a 65-year old. Right-Normal molar Fig. 1. Enamel dissolution in various beverages. This study exposed caries- free dental enamel to a variety of popular beverages continuously over a period of 7 days (168 hours). Some criticisms that can be made about this experiment are: the small sample size of beverages used and the short exposure time (von Fraunhofer & Rogers 2004). The beverages that were selected were selected because of there potential to have an erosive effect on the dental enamel based on the results from other researched studies. A larger sample size is usually preferable when conducting an experiment (von Fraunhofer & Rogers 2004).. However, this study was intended to identify which beverages held the most erosive effect on the enamel. Regarding the length of the test period, it has to be recognized by von Fraunhofer and Rogers (2004) that realistic testing of enamel dissolution in soft drinks and other beverages is demanding because it is difficult to determine the extent of oral exposure for any given individual. Many different factors affect any individual person which can make them more or less susceptible to enamel dissolution. However, it is possible to make certain projections through careful experiments. Based on an average daily consumption pf 25 ounces of soft drink and a residence time in the couth of five seconds, the total exposure time to beverages would equal 22, 750 seconds (380 minutes or 6.3 hours) per year. However, it is more likely that the exposure time for a beverage on the dentition is closer to 20 seconds before salivary clearance occurs which would make the annual exposure time of dental enamel to beverages approximately 90,000 seconds (1,500 minutes or 25 hours). Despite limitations, certain conclusions can be drawn from this study. First, exposure to beverages with the presence of simple carbohydrates (sugars found in these beverages) or artificial sweeteners show noticeable amounts of enamel dissolution. A more interesting observation was the decreased amount of enamel dissolution in the cola-based drink when compared to the non-cola drinks. These differences could not be credited to the beverages pH since there has been no known correlation between pH and enamel dissolution (Grenby & others 1989). The pH range for most beverages is , which is well below the marked pH for dental caries (5.5). The range suggests that enhanced enamel dissolution results from effects other than beverage pH, most likely the additives within non-cola beverages that are added for desired results. As indicated earlier, acids found in these beverages can alter the effects of dental erosion because of their ability to lower the pH needed to maintain caries free teeth (Rugg-Gunn and Nunn 1999). As a result, they can be very aggressive towards dental enamel (Davani & others 2003). The data reported here indicates that certain beverages may cause significant enamel dissolution with repeated exposure. The non-cola drinks showed the greatest dissolution of the dental enamel. The data suggests that enamel aggressively is determined by beverage composition (such as additives) rather than beverage pH. Mountain Dew was found to be the safest drinks tested followed by Minute Maid Lemonade, Fruit Punch Gatorade, and lastly Red Bull. It would seem that reducing beverage intake and residence time in the mouth by salivary clearance or rinsing would be beneficial.