Chemical Factors

The chemical factors involved in the development of ETW relate to the parameters inherent to erosive beverages, food, or other products, such as their pH, buffering capacity, acid type, as well as the calcium, phosphate, and fluoride concentration.

pH and Buffering Capacity: With regards to the pH and buffering capacity of the products, the greater the buffering capacity of an edible item, the longer it will take for saliva to neutralize the product’s acid. So, a beverage with a higher buffering capacity will be more erosive than others within the same pH class. Even if a product is at a low pH, it is possible that other factors are strong enough to prevent ETW. Similarly, it is also possible that a less acidic product can cause ETW because it has the capacity to complex calcium, pulling the mineral out of the tooth surface to cause demineralization. While pH is an important factor, there is no specific pH of a product below which damage will occur.^11,44

Acid Type: The erosive character of lactic and citric acid in products is higher than that of acetic, maleic, phosphoric, and tartaric acids.^11,45

Calcium, Phosphate, and Fluoride Concentration: Solutions oversaturated with respect to dental hard tissue will protect against dental surface softening.^11,46,47 A low degree of undersaturation with respect to enamel or dentin leads to a very initial surface demineralization which is followed by a local rise in pH and increased mineral content in the liquid surface layer adjacent to the tooth surface. This layer will then become saturated with respect to enamel and will not demineralize further. A high degree of undersaturation with respect to dental tissue will demineralize the tooth surface considerably more.^11,46,47

Consistency of the product: The stickiness of the product being consumed, with more sticky products generally being linked to higher erosion risk.¹¹