Barbour Michele E, Lussi Adrian
School of Oral and Dental Sciences, University of Bristol, Bristol, UK.
Monogr Oral Sci. 2014;25:143-54. doi: 10.1159/000359941. Epub 2014 Jun 26.
When considering the erosive potential of a food or drink, a number of factors must be taken into account. pH is arguably the single most important parameter in determining the rate of erosive tissue dissolution. There is no clear-cut critical pH for erosion as there is for caries. At low pH, it is possible that other factors are sufficiently protective to prevent erosion, but equally erosion can progress in acid of a relatively high pH in the absence of mitigating factors. Calcium and phosphate concentration, in combination with pH, determine the degree of saturation with respect to tooth minerals. Solutions supersaturated with respect to enamel or dentine will not cause them to dissolve, meaning that given sufficient common ion concentrations erosion will not proceed, even if the pH is low. Interestingly, the addition of calcium is more effective than phosphate at reducing erosion in acid solutions. Today, several calcium-enriched soft drinks are on the market, and acidic products with high concentrations of calcium and phosphorus are available (such as yoghurt), which do not soften the dental hard tissues. The greater the buffering capacity of the drink or food, the longer it will take for the saliva to neutralize the acid. A higher buffer capacity of a drink or foodstuff will enhance the processes of dissolution because more release of ions from the tooth mineral is required to render the acid inactive for further demineralization. Temperature is also a significant physical factor; for a given acidic solution, erosion proceeds more rapidly the higher the temperature of that solution. In recent years, a number of interesting potentially erosion-reducing drink and food additives have been investigated.
在考虑食物或饮料的侵蚀潜力时,必须考虑多个因素。pH值可以说是决定侵蚀性组织溶解速率的最重要参数。与龋齿不同,目前尚无明确的侵蚀临界pH值。在低pH值时,其他因素可能具有足够的保护作用以防止侵蚀,但同样,在没有缓解因素的情况下,侵蚀也可能在相对较高pH值的酸性环境中发生。钙和磷酸盐浓度与pH值共同决定了牙齿矿物质的饱和度。相对于牙釉质或牙本质过饱和的溶液不会导致它们溶解,这意味着在有足够的共同离子浓度时,即使pH值较低,侵蚀也不会发生。有趣的是,在酸性溶液中添加钙比添加磷酸盐在减少侵蚀方面更有效。如今,市场上有几种富含钙的软饮料,还有高钙和高磷的酸性产品(如酸奶),它们不会使牙齿硬组织软化。饮料或食物的缓冲能力越强,唾液中和酸所需的时间就越长。饮料或食品的缓冲能力越高,溶解过程就会增强,因为需要从牙齿矿物质中释放更多离子才能使酸失去活性以进一步脱矿。温度也是一个重要的物理因素;对于给定的酸性溶液,溶液温度越高,侵蚀进行得越快。近年来,人们对一些有趣的、可能减少侵蚀的饮料和食品添加剂进行了研究。