Erosive Potential of Fruit Juices on Primary Teeth

Erosive Potential of Fruit Juices on Primary dentitionIn Vitro evaluation of sulphurous potential of rooted(p) and liquefy harvest-time succuss on primary dentitionABSTRACT lucreal eroding has gained wideness now as a steadily growing public wellness problem world wide. Fruit succuss are an important etiological factor, particularly consumption in frozen forms, handle growth lollies and stick. Since this dietary economic consumption is more prevalent among children, primary teeth were selected for this study.AIMS To appraise pH and titratable sullenness of four payoff juices in frozen and unfreeze forms. Calcium looseness and sit of print of adorn by these juices in frozen and liquify forms were also determined.DESIGN pH of four different juices orchard apple tree, orange, musumbi and grapes were determined utilize a digital pH meter. The titratable sulkiness of these in frozen and unfrozen forms were determined by adding 0.5 ml of 1N NaOH to these, till a pH = louver and pH = seven were hited. Forty eight tooth decay free broad-leaved earlier teeth specimens were prepared to study the etching phase by s throw outning electron microscope SEM and calcium dissolution by atomic submerging spectrophotometer.STATISTICAL ANALYSIS One-Way Repeated Measures ANOVA and pair novel ninefold comparison with Bonferroni correction. RESULTS Increase in titratable sourness, irregular imitate of etching and calcium dissolution were found to be signifi basistly more in the initial thawed frozen increase juices. Grape juice recorded the last pH and more titratable blisteryity when compared to other juices. CONCLUSION This study highlights the noisome effect on teeth by the frequent consumption of proceeds juices and their frozen products. The study concluded that sucking on the frozen return juice products were more harmful than consuming in unfrozen plead because more of erosion occurs in frozen state. Key words nipping harvest-feast j uices, pH, titratable panellingity, erosion, etching, SEM. Introduction HEALTHY LIVING the key to survival has been accent by health professionals upon the old and childlike alike. The DIETARY FACTOR is gaining a good deal accolade and health drinks in the form of harvesting juices have gained fearsome popularity in this category. Parents regard these as being healthy and nutritious and a good source of Vitamin C.1. Experiments conducted on the animals to evaluate the erosive potential of product juices showed that these juices were ten times more destructive to the teeth than the whole output.2 virtually crop juices have a low pH and acids which can change the teeth.3 Hence, the frequent consumption of these fruit drinks is directly related to alveolar consonant morbidity, especially erosion.4 mother fuckeral erosion has been defined as superficial loss of dental consonant concent footstepd tissue by a chemical substance process non involving bacteria.5 The aetiopath ogenesis can be varied (intrinsic and adscititious factors),most important are dietary acids.6 A modern habit among consumers is to freeze and suck out fruit profit and candies.Sucking on frozen fruit juices has a great risk for erosion overdue to slow consumption and longer time required to waste it7.Sucking of the melting juices from the frozen product is a pleasurable experience along with increase in the initial acidity and buffering capacity.8Hence the frequent use of these could turn damaging effects on the teeth. Primary teeth were included in this study,because children are frequently involved in the consumption of frozen fruit juices and deciduous teeth are more susceptible to erosion than indissoluble teeth due to less mineralisation and immature decorate surface9 The study was performed to evaluate the pH of four fruit juices in a frozen and unfrozen form. The titratable acidity of these fruit juices to be checked. The total amount of calcium fade away in fruit j uices from the teeth and to study the pattern of etched enamel on teeth.MATERIALS AND METHODSPreparation of juices Two and half litres of four different odorous fruit juices namely apple, orange, grape and musumbi each were prepared with no added sugars or preservatives. These were allowed to equilibrate to populate temperature.Specimen preparation Fourty eight freshly extracted caries free deciduous anterior teeth were collected and were used in the study. Extracted teeth were completely coated with nail polish with the exception of a window on the enamel of the labial surface of approximately 2mm X 2mm in diameter.Method Two and half litres of apple juice were jolted for 15sec and this was divided into four samples of 600ml each. First sample (600ml) of this was interpreted and calcium minginess was assessed. From this, 100 ml was separated, pH and titratable acidity were determined.Then another 100 ml was interpreted and a prepared tooth specimen was sway subscribe in it for ii hrs.(For assessment of calcium etching pattern at room temp). rest 400ml was taken in a bottle, sealed and placed in a recorded (-200c) deep freezer for 24 hrs. The bottle was taken and allowed to defrost. From this, initial 100ml was taken, pH and titratable acidity were determined. Then another 100 ml was taken and a prepared tooth was dipped in it for dickens hrs( For assessment of calcium etching pattern immediately by and by defrosting). Remaining 200 ml was defrosted for twain hours. Then 100 ml of this was taken and pH and titratable acidity were determined. Another 100 ml was taken and a prepared tooth was dipped in it for two hrs (For assessment of calcium etching pattern two hrs after defrosting). This was repeated for remaining three samples (600ml each) of apple juice. The akin affair was done for the other three juices musumbi, orange and grape juice and the determine recorded Table1,2,3Determination of pH and titratable acidity pH was determined by using a pH meter (digital pH meter good example EQ-612).After determining the pH, the juice was titrated against 1N( Na OH )Sodium hydroxide by adding 0.5ml of the same to the juice, mixed well and this were repeated until pH=five and pH=seven were reached to determine their titratable acidity.Assessment of calcium content The teeth were carefully get up out of the juices and the juices were centrifuged at 3500 rpm for five min. With the help of micropipette superfit 200l of each of these samples of fruit juices were pipetted into the polypropylene tubes. Then 40l distilled wet were rinsed into the polypropylene tubes with the fruit juices. Then concentrated nitric acid (120l) were added, the eyelid of the polypropylene tube sealed and the content of the tube were wet washed, by leaving it at 600c for 12hrs. After cooling, 50l of one breakwater/L KCl solution (an ionization suppressant) and 680l of distilled water were added. Then samples were agitate and the calcium concentrations were determined by the use of a flame (nitrous oxide/acetylene) atomic absorption spectrophotometer. To obtain calcium content of the fruit juices (without teeth), 200 l of the fruit juices were wet ashed and atomized exactly as mentioned above.Determination of etching pattern The teeth specimens were prepared for SEM observation by dehydration followed by throw together coating of 20 nm of gold (JEOL,JFC 1100 E-JAPAN) and examined under a see electron microscope (JEOL,JSM-840A-JAPAN).Instant photomicrographs were made at X850,X1000 magnifications. Subsequently the X1000 magnification pictures were selected to compare the pattern of etched enamel surfaces.Statistical digest The data obtained were subjected to statistical analysis by using One-Way Repeated Measures ANOVA and Pair wise multiple comparison with Bonferroni correctionRESULTS RECORDED pH VALUES OF quadruplet harvest JUICES (Table 1)Based on the results obtained in Table 1, the pH set of all the juices were less tha n 5.5, which is the critical pH, at a lower place which enamel dissolves. Grape juice recorded the lowest pH of 2.2 among the juices.TITRATABLE ACIDITY VALUES OF FOUR FRUIT JUICES (Table 2)For all the four fruit juices tested, the volume of 0.5 ml 1N NaOH needed to reach pH=five and pH= seven were more for immediate defrosted( initial thawed )juices than the juices at room temperature and that defrosted for two hrs. Hence, the immediate defrosted juices had more titratable acidity compared to the juices tested at other temperatures. Among the juices, grape juice had more titratable acidity. atomic number 20 CONCENTRATION IN FOUR SAMPLES OF FRUIT JUICES MEASURED BY atomic ABSORPTION SPECTROPHOTOMETER ( Table 3)The amount of calcium dissolution in the juices from the teeth were found to be significantly more in the immediate defrosted juices than the room temperature juices and that defrosted for two hours.Evaluation of SEM Images Representative SEM photomicrographs at magnification X1000.For teeth immersed in juices at room temperature, relatively smooth and slightly etched enamel surfaces were seen.Figures 1- 4Teeth dipped in juices immediately after defrosting, showed maximal erosion. Among these, apple showed eroded surface with enhanced porosityfigure5,a honeycomb enamel prism pattern noted in musumbi similar to that seen in acid etched enamelfigure 6.Teeth in orange and grapes showed more erosion resembling type II acid etching pattern figures 7,8.In case of teeth kept in juices two hrs after defrosting, the changes were similar to those seen at room temperature figures 9-12.DISCUSSIONThe awareness of the commonwealth about health has lead to an change magnitude consumption of natural fodder products, especially fruits and fruit juices. But fruit juices contain substantial acids(eg citric acid in citrus fruits, malic acid in apples, tartaric acid in grapes)10which have the potential to cause loss of tooth tissue.1112 Various extrinsic and intrinsic fa ctors contribute to dental erosion like diet, medicaments, occupation, sports, GERD, peptic ulcer, azotemia etc.1314But most significant among these are dietary acids .3415 starting lineal erosion due to dietary acids are influenced by a variety of factors like pH, titratable acidity, temperature, concentration, frequency, and motion picture time16.Many host factors also modify erosion, most important is saliva17.Reduced salivary head for the hills rate leads to inadequate oral clearance of dietary acids. Consumption of juices at night increases the erosive potential as salivary flow rate is diminished during this period. 18.Also different studies on salivary flow rate indicated that young children have lower flow rate, resulting in defective oral clearance. 19. use of dietary acids decreases pH of the oral environment. Gregory-Head B et al20 suggested that the pH of the oral perdition affected the solubility of the dental tissues. The critical pH at which the chemical dissolutio n of enamel occurs is accepted to be 5.50.3.421In this study, all the four fruit juices namely in the order of grape, orange, musumbi and apple showed a pH below five, thus enhancing the enamel dissolution capacity.22Titratable acidity which denotes the hydrogen ion availability has been admit as a true indicator of erosive potential sort of than pH value alone23.Studies conducted by Touyz etal8 have shown that fruit juices have a high intrinsic buffering capacity.Modifying the form in which the fruit drinks are taken (sweets or frozen lollies) is expected to increase erosion2425. Sucking frozen fruit juices could be more erosive than unfrozen fruit juices because of increase in buffering capacity of initial thawed juice826..The acidity increases on freezing, as the somatic state of the residual juice changes. When juice is frozen, water alone is curdled to ice without the solute. The solutes accumulates undiluted (concentrated). When juice is defrosted, the initial(concentrated) melt is more acidic with increased buffering capacity Thus sucking on these could cause a greater fall in oral pH and requires more buffering action to temper the oral environment pH .As the remaining ice melts and dilutes the solution back to pre-freezed state, the buffering capacity diminishes.8The calcium dissolution potential of these fruit juices was analyzed. It was found to be more in the initial thawed fruit juices than juices tested at other temperatures. This is in accordance with the findings of M.Silove 826 who suggested that sucking frozen fruit juices can lead to more calcium dissolution than unfrozen juices. Also in our study, lowest calcium concentration was found in grape juice which is in accordance with studies stating that the erosive potential of drinks are associated with low calcium concentration27SEM was done to qualitatively estimate enamel surface alterations. Irregular and oppose enamel surface were observed in teeth exposed to frozen juices than at room temperature and after two hours of defrosting. Different etching patterns as described earlier were observed. 28-30Similar studies were done on commercially on hand(predicate) fruit juices and they are found to be 6-8 times more erosive than homemade juices. 31-33The significance of this study was that, it was done in pure fruit juices, in frozen and unfrozen forms and multiple parameters were analyzed. The results showed that even pure fruit juices had erosive potential, especially in frozen forms.This study was done in vitro conditions, the results cannot be completely extrapolated to in vivo process, as interplay of various oral factors like salivary buffering capacity and flow rate to counteract erosion were not included in the study. 17Recommendations Although fruit juices are good for health, the frequency, method of inebriation and the form in which they are consumed are important factors in dental erosion. Since children are frequently involved in the sucking of frozen fr uit juice products, pediatric dentists should strongly discourage them from practicing this form of habit. Advise them to stay off fruit juices at bedtime and always rinse mouth with water after consumption of juices. Another point to consider is the use of additives which alter the pH and titratable acidity, thereby reducing the erosive potential of fruit juices. This requires further study.References1. 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