title: A laboratory investigation of consumer addition of UHT milk to lessen the erosive potential of fizzy drinks.
abstract: BACKGROUND
  Much recent attention has been given to the erosive potential of carbonated beverages. Some have shown that the risks of developing erosion, if such drinks are consumed once daily and four times daily, are respectively 2.2 and 5.13 times greater than if they are not consumed at all. The addition of ultra-heat treated (UHT) milk to such beverages has been identified by a survey as common practice in Pakistan. It is known that the addition of calcium to orange juice and acidic candies reduces the capacity of these dietary items to produce dental erosion by the law of mass action. While potentially helpful, such a practice at manufacture may affect adversely product stability and flavour, thus compromising market share. As a result an alternative approach is for the consumer to carry out such modification. The addition of milk is one such potential means.Objective To assess the capacity of six brands of carbonated drinks to bring about dental erosion and determine if consumer modification by the addition of milk affected this.
  
  
  METHODS
  In vitro study.
  
  
  METHODS
  For each drink in both manufactured and consumer modified (25 ml of drink with 6.25 ml UHT milk) states, the pH and titratable acidity were measured. These assessments were also made for distilled water dilution of the manufactured drinks in the ratio of 1 part drink to 0.25 parts water. In addition, the effects of a 60 min exposure to the drinks in manufactured and consumer modified states, upon the surface microhardness and profile of human molar buccal tooth substance were determined.
  
  
  RESULTS
  The addition of milk significantly increased the mean pH (p <0.001) and decreased the mean titratable acidity (p <0.001). Its addition had significantly more (p <0.001) than a simple dilution effect upon these values. Milk addition significantly lessened (p <0.001) the reductions in surface microhardness of tooth substance when exposed to the drinks except in the case of one beverage. There was, however, no significant effect (p = 0.0732) of its inclusion upon the depth loss of tooth substance.
  
  
  CONCLUSIONS
  Within the limitations of this study, the addition of milk to carbonated beverages reduced overall their capacity to bring about dental erosion.
authors.affiliation: Department of Oral Biology, DOW University of Health Sciences, Pakistan
authors.forename: J
authors.initials: J
authors.lastname: Syed
authors.forename: R G
authors.initials: RG
authors.lastname: Chadwick
mesh_terms: D000143:Acids / Q000009:adverse effects / Q000032:analysis; D000818:Animals; D002021:Buffers; D002253:Carbonated Beverages / Q000009:adverse effects* / Q000032:analysis; D003256:Community Participation; D003747:Dental Enamel Solubility; D005247:Feeding Behavior; D005519:Food Preservation / Q000379:methods; D006358:Hot Temperature; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008892:Milk / Q000737:chemistry*; D017186:Titrimetry; D014077:Tooth Erosion / Q000139:chemically induced / Q000517:prevention & control*
chemical_list: D000143:Acids; D002021:Buffers