Enamel Erosion from Comparable United Kingdom and United States Beverages

Enamel erosion is an oral health concern in the United Kingdom (UK), yet is not considered problematic in the United States (US).

Objective: Our objective was to compare physiochemical properties and erosion potentials between comparable UK and US beverages.

Methods: Selected beverages from the US and UK included Coke®, Diet Coke®, orange soda, diet orange soda, orange juice and apple juice. The pHs and buffering capacities (1M KOH/50 ml) were measured using an automated titrator, while fluoride concentrations were read directly with an ion-specific electrode. Erosion potential was determined using extracted human molars and premolars. Teeth with exposed 1x5mm windows were immersed in randomly assigned beverages (n=5 teeth/beverage) for 25 hours; beverages were refreshed every 5 hours. Following exposure, teeth were sectioned and photographed using a polarized light microscope. Lesion depths were measured using Image Pro Plus software.

Results: The pH was lower in UK than in US apple juice (3.30vs3.43; p=0.039) and orange juice (3.67vs3.83; p=0.002), while the pH was higher in UK orange soda (3.03vs2.57; p=0.001) and diet orange soda (2.90vs2.73; p=0.039). The buffering capacity was higher in UK than in US apple juice (5.32vs2.93ml; p<0.001), orange juice (7.16vs5.81; p<0.001), orange soda (4.70vs3.86; p=0.007) and diet orange soda (5.50vs4.12; p<0.002). Fluoride was lower in UK than in US apple juice (0.15vs0.51ppm; p<0.001), orange juice (0.10vs0.34ppm; p<0.001), Coke® (0.11vs0.52ppm; p<0.001) and Diet Coke® (0.10vs0.72ppm; p<0.001), while fluoride was higher in UK orange soda (1.07vs0.21ppm; p<0.001) and diet orange soda (1.14vs0.69ppm; p<0.001). Lesion depths were higher in UK than in US apple juice (138.6±11.0vs105.3±19.1µm, p=0.010), orange juice (102.0±22.2vs69.4±13.5µm, p=0.023) and Diet Coke® (151.5±20.9vs91.4±11.9µm, p<0.001). Lesion depths did not differ between UK and US Coke®, orange soda and diet orange soda.

Conclusion: Differences were observed in physiochemical properties and erosion potentials between beverages from the UK and US. Support: T32 DEO14678-05.