Exploring safer energy drink recipes to protect dental enamel

Adding specific calcium compounds to a popular energy drink reduced dental enamel erosion in vitro, with a calcium/phosphorus/potassium complex offering the strongest protection, according to Universidade do Estado do Rio Grande do Norte researchers in Brazil.

Dental erosion can dissolve enamel and dentin through chemical processes unrelated to bacterial decay. Acid exposure reduces the mechanical resistance and hardness of tooth surfaces, causing partial demineralization that progresses toward more extensive wear.

Among extrinsic factors, frequent consumption of acidic beverages plays a central role, as drink pH, titratable acidity, mineral content, and temperature combine to degrade tooth structure.

Energy drinks are especially harmful because they carry high concentrations of acidulants that regulate pH and stabilize products but sharply lower enamel integrity. Resulting changes in the mouth include concavities, thinning of incisal edges, dentin exposure, and increased sensitivity.

Incorporating calcium into acidic drinks has been proposed as a practical measure to control dental erosion, though few investigations have focused on energy drinks in particular.

In the study, “Erosive potential of energy drink modified by calcium formulations on dental enamel: an in vitro study,” published on the pre-print server medRxiv, researchers conducted an in vitro experiment to evaluate whether adding different calcium formulations and concentrations to a commercial energy drink alters its erosive potential.

Sixty enamel specimens were prepared from 26 clinically-healthy molars donated by 23 patients (previously extracted due to various orthodontic issues) treated at the Dental Specialties Center in Caraúbas, Brazil.

Enamel specimens were randomly assigned to 12 groups and immersed for two minutes to either unmodified Red Bull, nine calcium-fortified variants, deionized water, or a calcium-supplemented orange juice comparison.

Surface roughness was assessed with a rugosimeter, and enamel microhardness was evaluated using a Vickers microhardness tester. Ten measurements per specimen were performed before and after exposure. Statistical analysis applied a significance level of 5%.

Rising concentrations of the calcium/phosphorus/potassium complex increased the pH of the energy drink, while higher amounts of dicalcium malate and calcium citrate malate decreased pH.

Specimens exposed to calcium-fortified drinks showed lower surface roughness compared to unmodified Red Bull, with significant differences observed in most comparisons (p < 0.004). Microhardness testing revealed that formulations containing 2.50 g of dicalcium malate and 2.15 g of the calcium/phosphorus/potassium complex preserved enamel hardness more effectively than the control drinks.

Loss of microhardness remained lower across all modified groups relative to unmodified energy drink and calcium-supplemented orange juice, with the calcium/phosphorus/potassium complex producing the most protective effect.

Authors conclude that fortifying energy drinks with calcium can effectively blunt acid erosion, with calcium/phosphorus/potassium complexes offering the greatest benefit. Reformulation of commercial beverages along these lines could help protect frequent consumers, particularly individuals already experiencing dental wear.

Future investigations are planned to define the minimal effective doses and assess real-world conditions, including demineralization cycles and sensory acceptance.

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