The effects of smoothies on enamel erosion: an in situ study.

OBJECTIVES To measure, in vitro, the pH and titratable acidity (TA) of various soft drinks and to assess the erosive effect of smoothies using an in situ model. METHOD The in vitro phase of this study included measuring the inherent pH of six different commercially available smoothies, diet coke, and citric acid 0.3% (positive control) using a pH meter. The TA was determined by titration with NaOH. In the second part of the study, an in situ model was used. An upper removable appliance capable of retaining two enamel slabs was constructed and worn by 14 volunteers. The drinks under test were Innocent(®) strawberries and banana smoothie and citric acid. Volunteers were instructed to dip the appliance in the test solutions extra-orally five times daily for 2 min each time for 21 days. Measurements of enamel loss were made by surface profilometry and microhardness. RESULTS Diet Coke was found to be the most acidic drink (pH 2.61), whereas Innocent(®) mangoes and passion fruit smoothie showed to be the least (pH 3.9). With regard to TA, Innocent(®) blackberries, strawberries, and blackcurrant smoothie had the highest TA requiring 10.8 mol of NaOH to reach pH 7.0, whereas citric acid required only 3.1 mol of NaOH to reach the same pH value. Surface profilometry and microhardness testing revealed that citric acid caused a statistically significantly greater tooth surface loss compared with smoothie after 21-day pH cycling protocol. CONCLUSION Smoothies are acidic and have high TA levels. Innocent(®) strawberries and banana smoothie had an erosive potential to the teeth. However, its erosive effect was significantly less compared with citric acid after 21-day pH cycling protocol using an in situ model.