303 erosion from cariogenic drinks

Sports drinks are…

high in sugar and acidic, increasing the pts risk of both caries and dental erosion.

The stephan curve shows that…

after sugar consumption, plaque bacteria produce acids, causing the plaque pH to fall below the critical threshold of 5.5, resulting in enamel demineralisation. Frequent sipping causes repeated drops in pH with less time for salivary neutralisation

A review by…

Rivers and Longlet (2018) highlight that sports drinks have a low pH and high erosive potential, which cause enamel demin. Over time, enamel loss may expose dentine and open tubules, resulting in hypersensitivity

Professional advice that a pt would benefit from:

• topical fluoride varnish application to increase enamel resistance to acid attack and promote remin

• discussion of making a mouth guard to protect dentition from trauma

• superseal for sensitivity, which contains potassium oxalate, which reacts with hydroxyapatite to form a precipitate that occludes the dentinal tubules

• fissure sealants/protects to create a physical barrier over plaque-retentive areas

• short recall of 6 months for high caries risk, to monitor enamel caries, apply naf routinely, and adjust OHI

OHI to give

• switching to sugar-free drinks

• Making water (or plain milk) the main beverage outside of training

• reducing the frequency of exposure by avoiding constant sipping of sports drinks, as it prolongs an acidic oral environment

• using a straw to reduce contact with teeth

• rinsing mouth with water after sports drink consumption for neutralisation

• brush after 30 minutes as brushing immediately after drink consumption can cause enamel abrasion as it would be relatively soft

• brushing 2x daily for 2 mins using soft bristled tb and naf tp

• recommending neutrafluor 5000

• spit, dont rinse, to maximise effects of naf from tp

• regular recall appts to monitor erosion and demin

• recommend desensitising tp

How to encourage behaviour change

• use a pt-centred and motivational interviewing approach rather than instructing the pt to stop drinking sports drinks

• first establish a conversation about what the pt believes about sports drink consumption, acidity, enamel erosion and caries in a way that would be relevant to them

• set realistic goals, e.g. replacing sports drinks with water for regular training sessions and reserving sports drinks for more intense sessions

• coming up with strategies that could make drinking water the easier choice, e.g. reusable water bottle

• positive reinforcement and monitoring at subsequent appts could aid in maintaining the behavioural change

• aim would not necessarily eliminate sports consumption but tailor advice so that behaviours are more beneficial towards their oral health and aid in general well-being