The Erosive Potential of Alcoholic and Non-alcoholic Beverages in Iceland

Objectives: Dental erosion associated with consumption of acidic beverages is a potential oral health concern. In Iceland, over 30% of adolescents show signs of dental erosion. Erosive damage increases risk of carious lesions/sensitivity and destabilizes tooth structure, limiting restorative options. Our objective was to determine erosive potential of popular Icelandic beverages based upon weight, expressed as percentage tooth loss.
Methods: 25 commonly consumed Icelandic alcoholic/nonalcoholic beverages were used. After baseline measure, one section of a healthy permanent premolar/molar was immersed in a beverage for 13 days. Beverages were renewed daily, with containers placed on a gyrator to maintain continuous movement. Bottled water was used as a control. Tooth sections were removed every third day, dried, and weighed via gravitational analysis. Photographs were obtained prior to weighing. Initial pH and titratable acidity were measured with a pH probe and meter.
Results: Of the 25 beverages tested, 5 were nonalcoholic, 20 contained alcohol. Alcohol content ranged from 0-12.5%, pH’s from 0-5.6. The percentage tooth loss ranged from 0.0 to 24%, mean 8.4 ± 6.68%. There was a significant negative correlation between pH and percentage tooth loss (R = -0.662; p<0.001). An independent-samples t-test was conducted to compare percentage tooth loss between alcoholic and non-alcoholic beverages. There was no significant difference in the measures for percentage tooth loss from alcoholic beverages (M=0.07, SD=0.054) and non-alcoholic beverages (M=0.12, SD=0.105); t(23) = -1.667, p = 0.109.
Conclusions: Overall, tooth loss was associated with increasing acidity. However, there were several beers for which tooth loss was very negligible compared to others of the same pH/alcohol content. This requires further investigation. In addition to pH, beverage compositions vary which may influence their erosive potential. Knowledge of the erosive potential of beverages is important for creating clinical guidelines regarding beverage consumption practices and development of potentially “safer” beverages.