Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Original Paper Caries Res 2007;41:68–73 DOI: 10.1159/000096108 Effects of Calcium on the Erosive Potential of Acidic Candies in Saliva T. Jensdottir a, b B. Nauntofte a C. Buchwald c A. Bardow a a Department of Oral Medicine, Faculty of Health Science, University of Copenhagen, b Toms Group, and c Department of Otolaryngology, Head and Neck Surgery, Rigshospitalet, Copenhagen, Denmark dersaturated. We conclude that saturation levels and critical pH may not fully reflect when dental erosion is expected to occur in saliva and that calcium addition reduces the erosive potential of acidic candies. Copyright © 2007 S. Karger AG, Basel Dental erosion is the chemical wear of dental hard tis- sue without involvement of bacteria [Eccles, 1979] and is often caused by extrinsic factors such as frequent con- sumption of acidic soft drinks [Johansson et al., 1997; Jensdottir et al., 2004]. The degree of soft drink-induced erosion is related to the properties of the drinks con- sumed [Larsen and Nyvad, 1999; Jensdottir et al., 2005a] as well as drinking frequency and drinking habits [Jo- hansson, 2002; Shellis et al., 2005]. Another extrinsic fac- tor for dental erosion may be acidic foodstuffs and food supplements [Giunta, 1983; Grobler et al., 1989] as the few existing studies on such foodstuffs have shown that they also have erosive potential [Holloway et al., 1958; Bibby and Mundorff, 1975; Lussi et al., 1997; Jensdottir et al., 2005b, 2006b]. However, determining the erosive poten- tial of solid acidic foodstuffs is more difficult than for soft drinks. Thus, solid acidic foodstuffs such as candies and lozenges first have to be dissolved in saliva to release their acidic compounds and thereby become erosive. In this case saliva becomes a matrix for the individual com- pounds released from the foodstuffs and saliva may thereby play a more important role for the effect of these foodstuffs on teeth than what is the case for soft drinks. The salivary variables that may affect the erosive poten- Key Words Critical pH  Dental erosion  Erosive potential  Food modification  Human saliva Abstract Theoretical calculations have shown that acidic candies may be potentially erosive upon consumption. However, little is known about the protective effect of adding calcium to po- tentially erosive candies and about the protective effects of saliva that cannot be fully accounted for by theoretical cal- culations. Therefore, the aims of this study were to (1) deter- mine the erosive potential of acidic candies with and with- out calcium and (2) to determine differences between theoretically calculated erosive potential and actual erosive potential in saliva. Twenty healthy test persons sucked acid- ic candy with and without calcium while their whole saliva was collected into a closed system at different times: base- line, candy-stimulated, and post-stimulated. The erosive po- tential of the candy was evaluated from candy-induced changes in saliva degree of saturation with respect to hy- droxyapatite (HAp) and directly by dissolution of HAp crys- tals in candy-stimulated saliva. The results showed that sim- ilar salivary stimulation was obtained with both candies. The modified candy released more than 13 mmol/l of calcium into saliva, resulting in a lower critical pH, and considerably lower erosive potential than the control (p ! 0.001). Although a significant correlation was obtained between theoretical calculation of DS HAp and dissolution of HAp crystals (r s = 0.65; p ! 0.001), many samples obtained by sucking modified can- dy showed no signs of HAp dissolution in spite of being un- Received: November 28, 2005 Accepted after revision: June 20, 2006 Thorbjörg Jensdottir, MSci, PhD Department of Oral Medicine, School of Dentistry Faculty of Health Sciences, University of Copenhagen Norre Alle 20, DK–2200 Copenhagen N (Denmark) Tel. +45 3532 6543, Fax +45 3532 6569, E-Mail tje@odont.ku.dk © 2007 S. Karger AG, Basel 0008–6568/07/0411–0068$23.50/0 Accessible online at: www.karger.com/cre