A randomised clinical trial to determine the abrasive effect of the tongue on human enamel loss with and without a prior erosive challenge.
OBJECTIVE
To investigate the abrasive effect of the tongue on human enamel loss with and without a prior dietary acid challenge in an in situ model.


METHODS
A single centre, single blind, randomly allocated, split mouth, four treatment regimen, in situ study in healthy adult volunteers was undertaken. Twenty four subjects wore two lower intra-oral appliances each fitted with 4 human enamel samples 6h/day for 15 days. The samples were treated with either 50ml orange juice or water for 5min ex vivo 4x/day; prior to being licked or not licked with the subject's tongue for 60s. There were 2 samples per group per subject. Surface loss was measured by contact profilometry.


RESULTS
23 subjects completed the study with no adverse events. The mean loss of enamel at 15days was: 0.08μm for water without licking, 0.10μm with water and licking; 1.55μm with orange juice alone, 3.65μm with orange juice and licking. In the absence of erosive challenge, licking had no detectable effect on enamel loss p=0.28. Without licking, orange juice had a highly significant effect on loss compared to water, p<0.001. Erosive challenge followed by licking more than doubled the loss of enamel p<0.001.


CONCLUSIONS
When enamel was exposed to orange juice prior to licking, tissue loss as a result of tongue abrasion of the eroded surface was increased, and double that of the erosive challenge alone. Licking enamel with the tongue had no perceptible effect on enamel loss in the absence of the erosive challenge.


CONCLUSIONS
Enamel wear resulting from tongue abrasion on tooth surfaces softened by acid challenge, can be an unavoidable consequence of oral function. This may account for the pattern of erosive toothwear on palatal and occlusal tooth surfaces, reinforcing the importance of restricting the frequency of dietary acid challenge in susceptible individuals.
Periodontology, Clinical Trials Unit, Bristol Dental School, Bristol, UK. Electronic address: j.seong@bristol.ac.uk.
J
J
Seong
Periodontology, Clinical Trials Unit, Bristol Dental School, Bristol, UK. Electronic address: n.claydon@bristol.ac.uk.
N
N
Claydon
Periodontology, Clinical Trials Unit, Bristol Dental School, Bristol, UK. Electronic address: e.l.madonald@bristol.ac.uk.
E
E
Macdonald
Periodontology, Clinical Trials Unit, Bristol Dental School, Bristol, UK. Electronic address: sarah.garner@bristol.ac.uk.
S
S
Garner
Institute of Primary Care and Public Health, Cardiff University, Cardiff UK. Electronic address: newcombe@cardiff.ac.uk.
R G
RG
Newcombe
Periodontology, Clinical Trials Unit, Bristol Dental School, Bristol, UK. Electronic address: n.x.west@bristol.ac.uk.
N
N
West
D000293:Adolescent; D000328:Adult; D001628:Beverages / Q000009:adverse effects; D032084:Citrus sinensis / Q000009:adverse effects*; D003743:Dental Enamel / Q000187:drug effects* / Q000473:pathology; D019587:Dietary Supplements; D005260:Female; D000067030:Fruit and Vegetable Juices / Q000009:adverse effects*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D016037:Single-Blind Method; D013499:Surface Properties; D013997:Time Factors; D014059:Tongue / Q000503:physiopathology*; D014072:Tooth Abrasion / Q000209:etiology*; D014077:Tooth Erosion / Q000150:complications* / Q000473:pathology; D014867:Water; D055815:Young Adult
D014867:Water
Abrasion; Acidic soft drink; Enamel; Erosion; In situ study; Tongue