The effects of beverage erosion on enamel: evaluating surface characteristics and loss of calcium and phosphate ions

Abstract

BackgroundThe erosive impacts of various beverages on dental enamel have been identified as a potential erosive threat to dental hard tissues. This in vitro study aimed to address this by utilizing a systematic approach and advanced analytical methods to study enamel erosion due to selected beverages in a simulated oral environment.MethodsForty-nine extracted sound second premolar teeth were collected, disinfected, and prepared. These teeth were randomly allocated into seven groups, each exposed to a different beverage: distilled water, mineral water, instant coffee, black tea, Pepsi-Cola, orange juice, and synthetic vinegar. The modified Nordini Artificial Model (mNAM) was used to simulate the oral cavity. The enamel surfaces were scanned using a Scanning Electron Microscope (SEM) and analyzed using Energy-Dispersive X-ray Spectroscopy (EDS). Surface hardness was measured using the Knoop Hardness Scale. Statistical analysis was conducted using the Wilcoxon signed-rank test, with a significance level set at p < 0.05.ResultsDistilled water and mineral water exhibited no significant changes in enamel surface or hardness. Coffee caused an 8–9% loss of calcium and phosphate, indicating potential erosion. Black tea showed signs of remineralization rather than demineralization. Pepsi-Cola and orange juice caused substantial erosion, with Pepsi-Cola resulting in a nearly 24% loss of calcium. Vinegar had a marked erosive effect, with a 17% loss of both calcium and phosphate. SEM images corroborated these findings, showing pronounced enamel prisms and increased visibility of minor cracks in post-treatment teeth. EDS analysis revealed significant changes in the elemental composition of the enamel.ConclusionsThis study categorised beverages based on their pH and fluoride content, revealing that drinks like Pepsi-Cola and orange juice are acidic but low in fluoride, whereas black tea, mineral water, and vinegar are acidic yet contain fluoride. The study suggests that the decrease in pH of acidic beverages may contribute to dental erosion, with fluoride as a mitigating factor. Among the various metrics assessed for evaluating dental erosion, hardness emerged as the most reliable quantitative parameter.