Randomized in situ trial on the effect of milk and CPP-ACP on dental erosion Short title: Effect of milk and CPP-ACP on erosion

OBJECTIVES This randomised in situ study aimed to analyse the effect of milk (with or without 5ppm F) and CPP-ACP pastes (with or without 900ppm F) on dental erosion. METHODS The study was a seven phase (5 days each) crossover design involving 15 participants wearing intraoral appliances with enamel and dentine specimens. Specimens were extraorally eroded (erosive soft drink, 6×90s/day) and brushed (2×30s/day, 2N) using a non-fluoridated toothpaste (negative control). The test products were milk, milk+5ppm F (twice daily, each 100ml/2min), CPP-ACP paste, CPP-ACP paste+900ppm F (3min/day) or a SnCl2/AmF/NaF mouthrinse (positive control, 30s/day), which were applied immediately after erosion with the appliances in the oral cavity. In an additional group, a fluoridated toothpaste was used without any additional test product. Tissue loss was determined profilometrically after 5 days and statistically analysed by linear mixed models methodologies (p<0.05). RESULTS Compared with the negative control (non-fluoridated toothpaste only, enamel: 2.2±1.3�m; dentine: 3.8±2.2�m), enamel and dentine loss was significantly reduced by the use of fluoridated toothpaste (enamel: 1.1±1.0�m; dentine: 2.4±1.7�m) and the SnCl2/AmF/NaF mouthrinse (1.5±1.5�m; dentine: 1.8±1.9�m). CONCLUSIONS Milk and CPP-ACP were not effective in reducing enamel and dentine loss significantly, independently of the presence of fluoride. CLINICAL SIGNIFICANCE Enamel and dentine erosion were significantly reduced by the use of a fluoridated toothpaste or a SnCl2/AmF/NaF mouthrinse, but not by milk or CPP-ACP under the conditions of the present study. CLINICAL TRIALS REGISTRATION NCT01566357. DOI: https://doi.org/10.1016/j.jdent.2014.07.009 Posted at the Zurich Open Repository and Archive, University of Zurich ZORA URL: https://doi.org/10.5167/uzh-99776 Accepted Version Originally published at: Wiegand, Annette; Attin, Thomas (2014). Randomised in situ trial on the effect of milk and CPP-ACP on dental erosion. Journal of Dentistry, 42(9):1210-1215. DOI: https://doi.org/10.1016/j.jdent.2014.07.009