Effects of Titratable Acidity and Organic Acids on Enamel Erosion In Vitro

Background: Erosion is a gradual process that occurs fairly quickly, and the full extent of the erosive effects of acidic beverages is not yet clear. The present study aimed to determine the differences in the erosive potentials among four naturally acidic fruit nectars within the same range of titratable acidity and to determine the influence of the components of organic acids on tooth erosion. Methods: Diluted fruit nectars (mandarin 1:1.1, orange 1:1.7, lemon 1:15, grapefruit 1:20) with the same range of titratable acidity (7.9 ml) and their corresponding organic acids (0.05%, 0.1%, 0.3%, and 0.5% citric acid, malic acid, and a citric and malic acid mixture [pH 2.8], respectively) were used. Specimens were placed in conical tubes with 50 ml of each of the test solutions for 1 hour. A microhardness test and scanning electron microscopy were used to measure enamel erosion. Acid separation was carried out using high-performance liquid chromatography to analyze the composition of each test solution. Results: Similar decreases in the Vickers hardness number (VHN) were observed among the groups treated with the following diluted fruit nectars: diluted mandarin nectar ($75.9{\Delta}VHN$), diluted lemon nectar ($89.1{\Delta}VHN$), diluted grapefruit nectar ($91.7{\Delta}VHN$), and diluted orange nectar ($92.5{\Delta}VHN$). No statistically significant differences were found in the enamel surface hardness after erosion (p>0.05). Citric and malic acids were the major organic acids in the test fruits. The lemon and orange groups had the highest malic acid concentrations, and the mandarin group had the lowest malic acid concentration. Conclusion: The titratable acidity and the citric and malic acid contents of the fruits could be crucial factors responsible for enamel erosion. Therefore, fruit-based drinks should be regarded as potentially erosive.