Effects of pH, titratable acidity and calcium concentration of non alcoholic carbonated beverages on enamel erosion: an in vitro study.

Objective: Beverage acidity has been measured routinely using the pH value. However, titratable acidity is thought to be a true indicator of beverage erosive potential. It has also been reported that experimental addition of calcium in beverages can reduce the progression of erosion. This study was carried out to investigate effects the of pH, titratable acidity and calcium concentration of non alcoholic carbonated beverages on enamel erosion of extracted human premolar teeth.Method: The erosive potential of 13 carbonated beverages and control was characterized based on analysis of pH, titratable acidity, and calcium concentrations. This was followed by ename demineralization tests. Baseline and post-immersion measurements of enamel microhardness were carried out using Vickers microhardness tester. Mean and standard deviation for each parameter was calculated. One way analysis of variance (ANOVA), paired t test, pearson's correlation, and multiple linear stepwise regression analysis were employed for statistical analysis. P values <0.05 were considered statistically significant.Result: Among the beverages, Pepsi had the lowest pH while Sip-on-appy had the highest pH. Titratable acidity was lowest for Limca and highest for Red Bull. Calcium concentration was lowest in Limca and Sprite and highest in Appy fizz. Statistically significant negative correlation between pH and percentage reduction of enamel microhardness, and between calcium concentration and percentage reduction of enamel microhardness was found. Multiple linear stepwise regression analysis revealed pH as the best predictor for erosive potential.Conclusion: All beverages have potential for enamel erosion. Beverages with lower pH and less calcium are more erosive.Key words: Tooth wear, enamel erosion, beverages, enamel microhardness