title: An in vitro investigation of the erosive potential of smoothies.
abstract: BACKGROUND
  Recent health promotion campaigns have encouraged the public to consume at least five portions of fruit and vegetables per day. Many see consuming fruit smoothies as a way of achieving this.
  
  
  OBJECTIVE
  To ascertain the potential or otherwise for fruit smoothies to bring about dental erosion.
  
  
  METHODS
  Laboratory study.Method This was an in vitro investigation in which five varieties of shop bought fruit smoothies, including a 'thickie' were investigated, with respect to their initial pH, titratable acidity and effect upon exposure to the surface microhardness and profile of extracted human teeth. In addition their performance was compared to negative (Volvic(™) water) and positive (orange juice) control drinks as well as a homemade smoothie, based upon the recipe of one of the commercially bought drinks, from which ingredient omissions were made.
  
  
  RESULTS
  The majority of the drinks investigated had a baseline pH below the critical pH of enamel (5.5) and required comparable volumes of 0.1M NaOH to raise their pH to neutrality as the positive control. Only two drinks (Volvic(™) still mineral water, the negative control, and the yoghurt, vanilla bean and honey 'thickie') displayed a higher pH, though to neutralise the thickie, a lesser quantity of alkali addition was required. The immersion of the tooth samples in the drinks brought about reductions in their surface hardness (expressed as a percentage change of median hardness) but these were only significant (p <0.001) for the cranberry, blueberry and cherry fruit smoothie and homemade strawberry and banana fruit smoothie. There was no reduction in surface hardness in the case of the teeth immersed in the thickie. Omission of certain ingredients from the homemade smoothie affected the magnitude of surface hardness reductions seen. With regard to the loss of surface contour of the tooth samples following immersion in the drinks, as assessed by depth loss, there were significant differences between the drinks (p = 0.0064) with the thickie and negative control not causing depth loss and the kiwi, apple and lime smoothie producing most depth loss (28.26 (5.45) μm).
  
  
  CONCLUSIONS
  Within the limitations of this study some fruit smoothies have the potential to bring about dental erosion if consumed irresponsibly. This can be influenced by ingredient variations. In order to minimise the risk of developing dental erosion, without removing the claimed nutritional benefits of their consumption, their consumption should be confined to mealtimes.
authors: The Dental School and Hospital, Park Place, Dundee, DD1 4HN.
authors: S M
authors: SM
authors: Blacker
authors: R G
authors: RG
authors: Chadwick
mesh_terms: D000704:Analysis of Variance; D001628:Beverages / Q000009:adverse effects*; D003747:Dental Enamel Solubility / Q000502:physiology*; D005638:Fruit / Q000009:adverse effects*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D066298:In Vitro Techniques; D013499:Surface Properties; D014077:Tooth Erosion / Q000209:etiology*