Dental Erosion in the Human Tooth - Research Paper Example

? Dental Erosion in human tooth when exposed to coffee and tea Introduction The effective treatment of a health problem requires the identification of its causes; in this way, measures can be developed for preventing the problem to appear in the future – or at least to reduce its effects. Current paper focuses on dental erosion as related to the consumption of drinks like coffee and tea. Dental erosion can cause severe damages to the teeth, especially if it is not treated on time. The empirical research developed in this field proved that the risks for dental erosion caused by food and drinks are not similar; for instance, soft drinks are more likely to cause dental erosion compared to tea, the erosive effect of which is quite limited – compared to soft drinks, as proved through the research developed for this paper. In order to check the role of drinks – especially of coffee and tea – in the development of dental erosion it would be necessary to refer primarily to the characteristics of dental erosion, as a common dental problem for children and adults. Also, the reference to the structure of tea and coffee it would be necessary – to identify those ingredients that are mainly responsible, if such case exists, for the dental erosion, either in the short or the long term. Finally, the factors that affect teeth enamel need to be presented, emphasizing on coffee and tea. It is proved that coffee and tea are safe alternatives instead of soft drinks or other beverages in order to prevent dental erosion. 2. Dental erosion as related to the consumption of coffee and tea 2.1 Dental erosion, definition and history In accordance with Slootweg (2007) the dental erosion can be described as ‘the loss of dental hard tissues due to chemical injuries other than those occurring in tooth caries’ (Slootweg 2007, 29. Erosion is differentiated from caries at the following point: the specific damage of teeth can result from bad dietary habits, especially the consumption of soft drinks (Briony and Bishop 2007); as for caries, this is caused from bacteria, i.e. it is not related to the diet (Briony and Bishop 2007). This means that different measures need to be taken in order to prevent erosion compared to those required for caries. The above findings also lead to the following assumption: because erosion is related to diet it would be more difficult to be confronted, being caused by food and drinks which are part of the everyday diet of most people – for instance, coffee or soft drinks. Soft drinks have been related to erosion because of the acids they contain; indeed, it has been proved that the following acids can increase the risk of erosion, depending the level at which drinks including such acids are consumed: ‘phosphoric acid, carbonic acid, citric acid, ascorbic acid, malic acid and tartaric acid’ (Briony and Bishop 2007, 412). On the other hand, it seems that the effects of these acids on dental enamel can be differentiated across people, in accordance with the structure of the teeth and the ability of the saliva to control the effects of the acids (Briony and Bishop 2007). The causes of dental erosion should be thoroughly checked since it is a problem widely expanded across people of all ages, especially children and teenagers – who are most likely to consume soft drinks. It should be noted that dental erosion has to be treated early because after destroying the enamel it can cause damages to the dentin, setting the tooth or teeth involved in risk, meaning that the extraction of the tooth might be required for preventing the damage to be expanded further (Slootweg 2007). 2.2 Tea and coffee structure The reference to the coffee structure is necessary in order to understand the reasons for which these two drinks can cause dental erosion; in fact, it seems that the erosive activity of these drinks is related to their ingredients, as explained below. On the other hand, the consumption of these drinks several times during the day, would be considered as another factor increasing their erosive activity – under the terms that it would be quite difficult to brush the teeth each time that coffee or tea is consumed during the day. The coffee beans, used for producing coffee as a drink, include ‘asparagine, sugars and acrylamide’ (Whitehurst and Oort 2009, 80); apart, of course, of caffeine which is the main ingredient of coffee beans. They are probably the above ingredients that make coffee a drink causing dental erosion. In any case, the quality of coffee beans can be strongly differentiated – depending on the species of the coffee trees involved; in this way, the effects of coffee, as part of the diet, can also vary. As for the tea leaves, three are their key ingredients: caffeine, tannins and cellulose (Pavia, Lampman, Kriz and Engel 2010, 77). Before tea leaves enter the market, caffeine is isolated – aiming to make the product less strong, and more appropriate for frequent consumption. The effects of coffee and tea on teeth, especially regarding the cause of dental erosion are analytically presented below by referring to the findings of the empirical research developed in this field. 2.3 Factors that affect teeth enamel 2.3.1 Soft drinks Soft drinks have been considered as the primary causes of dental erosion. In fact, in the research developed on the specific subject it has been proved that the acid included in the soft drinks is a key factor for the development of dental erosion; of particular interest are the following characteristics of soft drinks: ‘the pH, the type of acid and the buffering capacity’ (Jeukendrup and Gleeson 2010, 122). The effects of soft drinks in terms of dental erosion are discussed in the study of Low and Alhuthali (2008); the above researchers tried to check the erosive effect of soft drinks, i.e. the potential role of these drinks in the development of dental erosion; the research was based on a simple-weighing method – using ‘clean and caries free adult human molars and premolars’ (Low and Alhuthali 2008, 1323). A series of soft drinks has been used in the research, aiming to highlight the following issues: a) soft drinks can cause dental erosion and b) the level of dental erosion caused by soft drinks is different – probably because of the differences in their ingredients (see Graph 1 below). Graph 1 – Weight loss in adult tooth when exposed to soft drinks – as tested by Low and Alhuthali (2008, 1324) 2.3.2 Fruit juice Apart from soft drinks, fruit juices can also cause the loss of dental enamel. The erosive effect of fruit juices has been tested in practice through the above method: ‘enamel windows have been exposed to beverages for 25hrs’ (Murrell et al. 2010). The research has been based on a series of beverages available in UK and USA. It has been proved that pure apple juice and orange juice available in UK has lower pH compared to the similar products of USA (Murrell et al. 2010). At the same time, the orange soda of USA has a lower pH compared to the same product of UK. The aim of the study was to prove that the erosive effects of soft drinks can be differentiated in accordance with their place of origin – meaning that different methods used in the preparation of similar drinks worldwide can lead to the differentiation of these drinks in terms of dental erosion. Another important finding of the above study has been the fact that fruit juices can also cause loss of dental enamel – even if they would not be expected to have such effect. 2.3.3 Tea The use of tea as an alternative drink in order to control dental erosion has been a common issue for researchers studying the specific subject. Simpson, Shaw and Smith (2001) tried to check the effects of black tea on teeth, in terms of dental erosion aiming to test the potential effectiveness of tea as a daily drink for preventing dental erosion. At a first level, they analyzed the pH of black tea – aiming ‘to identify its acid content’ (Simpson, Shaw and Smith 2001, 374). Then they tested the effects of black tea on dental erosion by using a group of participants; ten adults aged from 21-23 years participated in the above experiment (Simpson, Shaw and Smith 2001). It was proved that because of its low pH black tea can be a quite safe alternative instead of soft drinks when trying to prevent dental erosion (Simpson, Shaw and Smith 2001). Of course, the erosive effect of tea cannot be ignored; it is just noted that this erosive effect is lower compared to the soft drinks and other similar beverages, so that, when trying to prevent dental erosion it would be preferable to consume tea. The specific fact is proved through the empirical research conducted by Brunton and Hussain (2001). The above researchers tried to identify the erosive effect of herbal tea and of black tea; the level of enamel of three groups of approximately 20 persons was measured before and after the consumption of black tea and herbal tea (Brunton and Hussain 2001); it was proved that both herbal tea and black tea have erosive effects but the level of erosion caused by herbal tea can be up to 5 times higher compared to black tea (Brunton and Hussain). From another point of view, the empirical research developed by Magalhaes et al. (2009) proved that green tea extract can be an effective substance for reducing dentin erosion; it is noted however that the above role of green tea should be further checked through relevant empirical research. 2.3.4 Coffee The consumption of coffee can benefit the teeth; however, such benefit would be achieved only if no sugar or milk or other similar substance would be added. The role of coffee in protecting the teeth is examined in the study of Antonio et al. (2011); the above researchers developed an empirical research testing the effectiveness of Coffea canephora extract when fighting the bacteria (Antonio et al 2011). It was proved that the specific extract can have a significant antibacterial ability, helping towards the limitation of caries (Antonio et al 2007). However, there was no direct reference to coffee as a substance for preventing dental erosion. In the study developed by Kitchens and Owens (2007) it was proved that the dental erosion caused by carbonated and non-carbonated beverages can be significantly higher compared to that caused by the StarBucks coffee or water (Kitchens and Owens 2007). In other words, coffee, as an erosive factor, seems to be of quite low importance compared to beverages of various ingredients. At this point the following issue should be taken into consideration: coffee beans are likely to have different ingredients, being of different quality and, thus, having different erosive activity. The coffee tested in the above study (this of Kitchens and Owens 2007) has been probably chosen because of its ingredients, containing sugar and milk, which are factors increasing the coffee’s erosive activity – instead of being for instance, a filter coffee with no sugar or milk added. In other words, coffee, even if sugar and milk is added, can be characterized as a drink of low erosive risk, compared to other drinks, as the cases presented above. 3. Conclusion The erosive effects of coffee and tea seem to be lower compared to other drinks, such as the soft drinks or fruit juices. The testing of all the above drinks regarding their involvement in dental erosion has verified their involvement in dental erosion. In any case it has been proved that each drink has a different erosive activity – referring to the level of this activity. Indeed, tea has been found to be less damaging for teeth compared to the soft drinks. On the other hand, the frequency of consumption of these drinks seems also to be a factor influencing their potentials to cause dental erosion: for instance, in children the soft drinks have been proved to be a major factor for dental erosion while in adults, coffee and tea would be considered as mostly related to dental erosion: this difference in findings, regarding the primary causes of dental erosion has been resulted because of the consumption trends of each part of the population. In any case, it has been made clear that the erosive activity of coffee and tea is lower compared to soft drinks and juices, if comparing these drinks based on a similar level of consumption. Having in mind the findings of the empirical research developed in the specific field it could be noted that coffee and tea are safer compared to other drinks regarding the risk for loss of enamel. For this reason, they should be preferred instead of soft drinks and other beverages. References A.G. Antonio, N.L.P. Iorio, V.S.S. Pierro, M.S. Candreva, A. Farah, K.R.N. dos Santos, and L.C. Maia. 2011.” Inhibitory properties of Coffea canephora extract against oral bacteria and its effect on demineralisation of deciduous teeth.” Archives of Oral Biology 56: 556-564. doi:10.1016/j.archoralbio.2010.12.001 Briony, Thomas, and Bishop, Jacki. 2007. Manual of dietetic practice. Oxford: Wiley-Blackwell. Brunton, P., and A. Hussain. 2001. “The erosive effect of herbal tea on dental enamel.” Journal of Dentistry 29: 517-520. Jeukendrup, Asker, and Gleeson, Michael. 2010. Sport Nutrition eBook-2nd Edition. Champaign, IL: Human Kinetics. Kitchens M, Owens BM. 2007. “Effect of carbonated beverages, coffee, sports and high energy drinks, and bottled water on the in vitro erosion characteristics of dental enamel.” Journal of Clinical Pediatric Dentistry 31(3): 153-159. PMID: 17550037 [PubMed - indexed for MEDLINE] Low, I., and A. Alhuthali. 2008. “In-situ monitoring of dental erosion in tooth enamel when exposed to soft drinks” Materials Science and Engineering 28: 1322–1325. doi:10.1016/j.msec.2008.02.005 Magalhaes, A., Wiegand, Annette, Rios, Daniela, Hannas, Angelica, Attin, Thomas, Afonso, Marilia, and Rabelo Buzalafa. 2009. «Chlorhexidine and green tea extract reduce dentin erosion and abrasion in situ” Journal of Dentistry 37: 994-998. doi:10.1016/j.jdent.2009.08.007 Murrell S, Marshall TA, Moynihan PJ, Qian F, and Wefel JS. 2010. “Comparison of in vitro erosion potentials between beverages available in the United Kingdom and the United States.” Journal of Dentistry 38(4): 284-289. PMID: 19962418 [PubMed - indexed for MEDLINE] Pavia, Donald, Lampman, Gary, Kriz, George and Engel, Randall. 2010. A Small Scale Approach to Organic Laboratory Techniques: A Small-Scale Approach. Belmont: Cengage Learning. Simpson, A., Shaw, L., and A. J. Smith. 2001. “Tooth surface pH during drinking of black tea.” British Dental Journal 190(7): 374-376. Slootweg, Pieter. 2007. Dental pathology: a practical introduction. New York: Springer. Whitehurst, Robert, and Oort, Maarten. 2009. Enzymes in Food Technology. Hoboken: John Wiley and Sons. Read More