More than one quarter of adults in the United States have untreated tooth decay, making it one of the most common health conditions in the country. While soda and other sugar-filled beverages are known to be associated with the degradation of tooth enamel, many newer and increasingly popular beverages and food fads have not been evaluated for their dental health associated risks. These include beverages such as hard seltzer and kombucha, which have both experienced a dramatic rise in popularity. In this study, we utilize atomic force microscopy (AFM) to detect changes in enamel surface morphology with sub-nanometer resolution and demonstrate the early erosive effects of these acidic solutions. Since 95% of enamel is composed of hydroxyapatite (HA), a repeating monomer with the chemical formula Ca10(PO4)6(OH)2, manufactured HA discs serve as a proxy for real enamel to avoid the variability inherent in actual teeth due to age, diet, and oral hygiene habits. The major cause of enamel degradation by hard seltzer and kombucha are assessed through a combinatorial study of hydroxyapatite being exposed to 1) fresh beverage, 2) degassed beverage, 3) solutions containing only individual acids present in the beverage, and 4) mixtures of the beverage and saliva. The HA discs were soaked for various time points and imaged using AFM in order to quantify surface roughness. To further aide in the interpretation of the enamel decay profiles determined by AFM, pH and titratable acidity of each beverage are also measured. This data allows for an evaluation of how beverage composition impacts enamel erosion. We find that, in comparison to Coca-Cola serving as an enamel erosion standard, kombucha is equally erosive despite its marketed health benefits. Results from this study demonstrate the substantial impact newly popularized beverages have on the health of the oral cavity.

Assessment of early enamel erosion by popular beverages using atomic force microscopy

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