Abstract
Introduction: Status of oral health depends on diet that we consume on daily basis. Diet does not predispose tissues of oral cavity at risk but it’s the change in pH that leads to acidic oral environment causing dry mouth, tooth decay, erosion and bad breath. Potential role of various foods in enamel demineralization has been evaluated. The decreased pH for longer durations ultimately leads to enamel dissolution and lesion formation. the current study is aimed to evaluate the change in pH in oral cavity after consumption of Milk, Milk with added sugar, carbonated drink and fresh lemon juice.
 Methodology: It was a cross sectional study conducted at tertiary care hospital of Karachi from November 2020 to January 2021. An elementary school was contacted for permission access to recruit the teen ager students (13-16year) of either gender. The total calculated sample size at 50% proportion of school strength was 140 students that were further divided into 4 groups i.e., 35 students / group. Recruited participants were educated regarding the study protocols and aims moreover they were divided into groups (Group A, B, C and D) randomly and milk, milk with added sugar, carbonated drink and fresh lemon juice was given to participants to drink in respective order of grouping. After consumption of specific drink pH readings were recorded after 15 minutes, 30 minutes, 1 hour and 2 hours. Saliva was obtained in sterile container for 5 times from one participant. The salivary pH was directly estimated using the digital pH meter (SIGMA pH meter: model number 131) calibrated with buffers of pH 4 and 7.
 Results: The mean age of participants was 13.9 ± 2.3 years. There were 89 (63.5%) females and 51 (36.4%) males. Most of the participants were from 8th and 9th class. The decrease in pH of saliva after consumption of either drink was observed in all groups when compared to controls. The paired t test analysis revealed a significant (p-value=0.002) decrease in pH after 15 minutes and that acidic level of pH was maintained for 30 minutes (p-value=0.037). ANOVA analysis showed insignificant relation among all groups after having beverages. As after two hours salivary pH returned to normal range when compared to control.
 Conclusion: There was no any difference in salivary pH after consuming milk, milk with added sugar, carbonated drink and fresh lemon juice after 15 minutes. After 2 hours pH of saliva reverts to its normal value.
Highlights
Status of oral health depends on diet that we consume on daily basis
Pre and post analysis of salivary pH showed decrease in pH of saliva after consumption of either drink in all groups when compared to controls
As after two hours salivary pH returned to normal range when compared to control
Summary
Status of oral health depends on diet that we consume on daily basis. Diet does not predispose tissues of oral cavity at risk but it’s the change in pH that leads to acidic oral environment causing dry mouth, tooth decay, erosion and bad breath. Potential role of various foods in enamel demineralization has been evaluated, among all the most common source of dietary sugars in children include cold drinks, confectionaries, biscuits, and breakfast cereals that contain sucrose but due their sticky nature consumption of these foods decreases the pH for longer durations that leads to enamel dissolution and lesion formation [5,6]. According to Barbour, M.E., et al citrus fruits, tomatoes, chilies, fruit flavoring chemicals have equal erosive potential as that of cola beverage [7] It was observed in a case control study that consumption of four dietary acids i.e. Citrus fruit juices, Carbonated beverages sweets and chocolates in between or after the meal can lead to formation of erosive lesion [8]
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