Protective Effect of Whole and Fat-Free Fluoridated Milk, Applied before or after Acid Challenge, against Dental Erosion

Abstract

This study analysed in vitro the effect of milk against dental erosion, considering three factors: the type of milk (bovine whole/fat-free), the presence of different fluoride concentrations and the time of application (before/after erosive challenge). Bovine enamel (n = 15/group) and root dentine (n = 12/group) specimens were submitted to the following treatments: after the first erosive challenge - 0.9% NaCl solution (negative control), whole milk with 0, 2.5, 5.0 and 10.0 ppm F, fat-free milk with 0, 2.5, 5.0 and 10.0 ppm F, and 0.05% NaF solution (positive control); before the first erosive challenge - whole milk with 0, 2.5, 5.0 and 10.0 ppm F, fat-free milk with 0, 2.5, 5.0 and 10.0 ppm F, and 0.05% NaF solution (positive control). Specimens were submitted to demineralisation-remineralisation regimes 4 times/day for 5 days. The response variables were enamel and dentine loss (in micrometres). Data were analysed using Kruskal-Wallis/Dunn's test (p < 0.05). For enamel, whole milk containing 10 ppm F, applied before the erosive challenge, was the most protective treatment, but with no significant difference compared with the same treatment carried out after the erosive challenge. For dentine, whole fluoridated milk (all concentrations, after), fat-free 10 ppm F milk (after, before) and whole milk with or without F (except 2.5 ppm F, all before) significantly reduced dentine erosion. It seems that the presence of fluoride, especially at 10 ppm, is the most important factor in reducing dental erosion.

Utilização de pastas contendo fosfopeptídeo de caseína-fosfato de cálcio amorfo com e sem fluoreto na prevenção da erosão dentária: uma revisão da literatura

“…A erosão dentária tem sido relatada por várias décadas 9 , no entanto a mudança nos hábitos alimentares e no estilo de vida da sociedade moderna 14 , com um aumento substancial no consumo de alimentos e bebidas potencialmente erosivos 15 , tem mudado sua frequência e a distribuição ao longo dos anos 9 , levando ao aumento de sua prevalência e tornando-a uma condição mais comum 4 . Quando em contato com a superfície dentária os ácidos acarretam a dissolução do tecido duro inorgânico, ocasionando diminuição da resistência mecânica e redução da dureza da camada superficial 11 .…”

“…Assim sendo, o principal objetivo dos estudos que envolvem erosão é a busca de um mecanismo eficaz no aumento da deposição mineral no esmalte superficial amolecido e, principalmente na redução da desmineralização, promovendo uma camada resistente contra o efeito dos ácidos responsáveis pela erosão 32 . Nesse contexto, o uso de técnicas que minimizem a perda mineral do esmalte dentário através do fortalecimento da superfície dentária contra a desmineralização 4 , tem sido cada vez mais estudado dentre as quais o emprego de proteínas, a exemplo da caseína 14 , cuja ação como agente anti-erosivo tem ganhado destaque 33 .…”

Relationship between erosive tooth wear and beverage consumption among a group of schoolchildren in Mexico City

“…With respect to the association between ETW and milk consumption, our results are similar to those obtained in a meta-analysis published in 2015 [7] where the consumption of milk was associated with ETW. Milk has a high concentration of calcium, phosphate, and casein, which protect the dental surface against hydroxyapatite dissolution [9,10]; moreover, its lipid and protein content adheres to the dental surface, acting as a barrier against acids that are able to reach the oral cavity through extrinsic or intrinsic sources [11]. Also, Corrêa et al [43] found, in a group of 2-20-year-old Brazilians, that the odds of exhibiting ETW in anterior teeth were 60% lower (OR = 0.40) in those who frequently drank milk compared with those who had a lower consumption.…”

“…These minerals protect the dental surface against hydroxyapatite demineralization [9,10]. Additionally, their lipids and proteins can adhere to the tooth surface, working as a protective barrier against acids [11].…”

Status and progress of treatment methods for root caries in the last decade: a literature review

“…Moreover, other components in milk, such as protein, fat and other minerals may influence its protective effect, possibly because they serve as a physical barrier against the acids or buffer related caries initiation and progression. 50,51 A dose-dependent effect of fluoridated milk was reported. 52 Patients with hyposalivation or who have undergone radiotherapy in the head and neck region are at high risk for root caries because of the reduction in salivary flow rate.…”