Clinical Evaluation of pH Challenges in Subjects With/Without Erosion

Objectives: Frequent sipping of acidic beverages plays an important role in dental erosion development and progression. This study replicated “in-vivo” the oral environment of a person that frequently sips acidic beverages. The purpose was to investigate the differences in pH response between subjects with and without dental erosion. Neutralization response to an antacid was also evaluated.

Methods: Twenty subjects with tooth erosion were matched in age and gender with twenty healthy controls according to specific inclusion/exclusion criteria. Baseline measures were taken of salivary pH, buffering capacity and flow rate using Saliva Check System (GC America). Subjects swished with diet cola (Diet Pepsi) three times at 10 minute intervals. Changes in pH were monitored at 5 and 10 minute intervals using a digital pH meter (Minilab IQ120 ISFET). Swishing regimen was repeated on a second visit, followed by swishing with sugar-free liquid antacid (Mylanta). Recovery times were also recorded. Data was analyzed using Independent T-tests (alpha<0.05).

Results: No significant differences in pH were found between erosion and non-erosion groups in response to multiple acid challenges (p=0.695) or antacid neutralization (p=0.861). Salivary flow rate and buffering capacity were also similar between groups (p=0.279; p=0.288). No significant difference was found when comparing pH change from immediate response to 10 minutes after the third swish, with antacid (p=0.118) or without antacid (p=0.225). However, there was a significant difference between use and non use of antacid within groups (p>0.001 for both). When pH recovery times were compared between groups, no significant difference was found after multiple acid challenges (p=0.114) but a significant difference was found after the antacid swish (p>0.001).

Conclusion: Erosion and non-erosion subjects responded similarly to multiple acid/antacid challenges. However, recovery time to baseline pH was significantly longer for subjects with erosion after antacid use. Funds provided by the Delta Dental Foundation.