The Early Stages of Native Enamel Dissolution Studied with Atomic Force Microscopy

Abstract

Food-induced demineralization (erosion) is one of the key factors in surface structural changes of tooth enamel, with soft drinks being a significant etiological agent. The objective of this study was to measure early stages of enamel loss with high accuracy on native enamel surfaces combined with qualitative observations of changes in the surface morphology using the atomic force microscope (AFM). Native unerupted third molar surfaces were partly covered with a gold reference layer. Samples were imaged with the AFM before dissolution (at baseline) and after exposure to three different drinks (mineral water, a “toothkind” blackcurrant drink, and a lemon and lime juice drink) at five different exposure times (15 min, 30 min, 1 h, 2 h, and 3 h). The changes in the surface morphology were investigated qualitatively as well as quantitatively. This study showed that the maximum material loss occurred at the aprismatic parts of the enamel close to the perikymata. The maximum enamel loss was greatest for the lemon and lime juice drink and lowest for water. A two-way ANOVA of the transformed data, employing the natural logarithm, showed a statistically significant difference between both the drinks and the exposure time at a 95% confidence level (P=0.000). This demonstrates that the AFM is a suitable tool for measuring early stages of enamel demineralization.