High fluoride and low pH level have been detected in popular flavoured beverages in Malaysia

Rahim, Zubaidah HA and Bakri, Marina M and Zakir, HM and Ahmed, IA and Zulkifli, NA (2014): High fluoride and low pH level have been detected in popular flavoured beverages in Malaysia. Published in: Pakistan Journal of Medical Sciences , Vol. 30, No. 2 (2014)

Abstract

Objective: In children, excessive ingestion of fluoride from different sources including bottled drinking water and flavoured beverages or soft drinks can lead to the development of dental fluorosis. In addition, the pH level of beverages is important. Low pH can cause dental erosion. In this study we explore the fluoride content and pH level of certain popular beverages available in Malaysian supermarkets and hawkers’ stalls. Methods: Bottled drinking water and selected popular flavoured packet drinks were purchased from a supermarket and the corresponding flavoured hawkers’ drinks, from a hawker’s stall in Kuala Lumpur. Fluoride and pH of the beverages were determined using digital fluoride meter and digital pH meter respectively. Results: It was found that fluoride content and pH level vary among the beverages. The mean fluoride content in both packet and hawkers’ drinks (7.64±1.88 mg/L, 7.51±1.60 mg/L, respectively) was approximately 7 times higher than the bottled drinking water (1.05±0.35 mg/L). Among the beverages, the tea packet drink was found to contain the highest amount of fluoride (13.02±0.23 mg/L). The mean pH of bottled-drinking water was near neutral (6.96±0.17), but acidic for both supermarket (4.78.00±0.49) and hawkers’ drinks (5.73±0.24). The lychee packet drink had the lowest pH level (2.97±0.03). Conclusions: Due to the wide variation of the fluoride content and pH level of the drinks tested in this study, it is recommended that steps should be taken to control the fluoride concentration and pH level in beverages if dental fluorosis and erosion are to be prevented.

• Item Type: MPRA Paper
• Language: English
• Keywords: Beverages, Dental Erosion, Dental Fluorosis, Fluoride, pH
• Subjects: I - Health, Education, and Welfare > I0 - General > I00 - General; I - Health, Education, and Welfare > I1 - Health

References

1. Chu CH, Mei ML, Lo EC. Use of fluorides in dental caries management. Gen Dent. 2010;58:37 43;quiz 44-35,79-80.

2. Pizzo G, Piscopo MR, Pizzo I, Giuliana G. Community water fluoridation and caries prevention: a critical review. Clin Oral Invest. 2007;11:189-193. http://dx.doi.org/10.1007/ s00784-007-0111-6

3. Shaharuddin MS, Kamil YM, Ismail YM, Firuz RM, Aizat IS Yunus AM. Fluoride Concentration in Malaysian Drinking Water. American-Eurasian J Agric Environ Sci.2009;6(4):417-420.

4. World Health Organization. Fluoride in Drinking Water: Background development of WHO Guidelines for Drinking- Water Quality. 2004. www.who.int/water_sanitation_ health/dwq/chemicals/en/fluoride.pdf

5. Dhar V, Bhatnagar M. Physiology and toxicity of fluoride. Indian J Dent Res. 2009;20:350-355. http://dx.doi.org/ 10.4103/0970-9290.57379

6. Aoba T, Fejerskov O. Dental fluorosis: chemistry & biology. Crit Rev Oral Biol Med. 2002;13:155 170. http://dx.doi. org/10.1177/154411130201300206

7. Ishii T, Suckling G. The appearance of tooth enamel in children ingesting water with a high fluoride content for a limited period during early tooth development. J Dent Res. 1986;65:974-977. doi: 10.1177/00220345860650071501

8. West NX, Hughes JA, Addy M. The effect of pH on the erosion of dentine and enamel by dietary acids in vitro. J Oral Rehabil. 2001;28:860-864. doi: 10.1111/j.1365- 2842.2001.00778.x

9. Murrell S, Marshall TA, Moynihan PJ, Qian F, Wefel JS. Comparison of in vitro erosion potentials between beverages available in the United Kingdom and the United States. J Dent. 2010;38:284-289. http://dx.doi.org/10.1016/j. jdent.2009.11.008

10. Behrendt A, Oberste V, Wetzel WE. Fluoride concentration and pH of iced tea products. Caries Res. 2002;36:405-410. http://dx.doi.org/10.1159/000066532

11. Al-Majed I, Maguire A, Murray JJ. Risk factors for dental erosion in 5-6 year old and 12-14 year old boys in Saudi Arabia. Community Dent Oral Epidemiol. 2002;30:38-46. http://dx.doi.org/10.1034/j.1600-0528.2002.300106.x

12. Firempong C, Nsiah K, Awunyo-Vitor D, Dongsogo J. Soluble fluoride levels in drinking water-a major risk factor of dental fluorosis among children in Bongo community of Ghana. Ghana Med J. 2013;47(1):16-23 . 13. Kaczmarek U. PH values and fluoride levels in some tea brands. Annales Academiae Medicae Stetinensis. 2004;50(Suppl 1):58-61.

14. Stannard JG, Shim YS, Kritsineli M, Labropoulou P, Tsamtsouris A. Fluoride levels and fluoride contamination of fruit juices. J Clin Pediatr Dent. 1991;16:38-40.

15. Kiritsy MC, Levy SM, Warren JJ, Guha-Chowdhury N, Heilman JR, Marshall T. Assessing fluoride concentrations of juices and juice-flavored drinks. J Am Dent Assoc. 1996;127:895-902.

16. Emekli-Alturfan E, Yarat A, Akyuz S. Fluoride levels in various black tea, herbal and fruit infusions consumed in Turkey. Food Chem Toxicol. 2009;47:1495-1498. doi: 10.1016/j.fct.2009.03.036.

17. Choi AL, Sun G, Zhang Y, Grandjean P. Developmental fluoride neurotoxicity: a systematic review and metaanalysis. Environmental Health Perspectives. 2012;120:1362- 1368. doi: 10.1289/ehp.1104912.

18. Mullenix PJ, Denbesten PK, Schunior A, Kernan WJ. Neurotoxicity of sodium fluoride in rats. Neurotoxicol Teratol. 1995;17(2):169-177. http://dx.doi. org/10.1016/0892-0362(94)00070-T

19. U.S. EPA. EPA and HHS Announce New Scientific Assessments and Actions on Fluoride: Agencies Working Together to Maintain Benefits of Preventing Tooth Decay while Preventing Excessive Exposure. 2011, http:// yosemite.epa.gov/opa/admpress.nsf/bd4379a92ceceeac85 25735900400c27/86964af577c37ab285257811005a8417!Open Document.

20. Dolatshahi S, Malakootian M, Akbari H. Acidity rate and fluoride content of consumed beverages in Kerman/Iran. J Res Health Sci. 2009;9:41-47.

21. Steffen JM. The effects of soft drinks on etched and sealed enamel. Angle Orthod. 1996;66(6):449-456.

22. Johansson AK. On dental erosion and associated factors. Swed Dent J Suppl. 2002;(156):1-77.

23. Grobler SR, Senekal PJ, Kotze TJ. The degree of enamel erosion by five different kinds of fruit. Clin Prev Dent. 1989;11:23-28.

24. Cheng R, Yang H, Shao MY, Hu T, Zhou XD. Dental erosion and severe tooth decay related to soft drinks: a case report and literature review. J Zhejiang Uni Sci. 2009;10:395-399. doi: 10.1631/jzus.B0820245.

25. Luo Y, Zeng XJ, Du MQ, Bedi R. The prevalence of dental erosion in preschool children in China. J Dent. 2005;33:115- 121. http://dx.doi.org/10.1016/j.jdent.2004.08.007

26. Peres KG, Armenio MF, Peres MA, Traebert J, De Lacerda JT. Dental erosion in 12-year-old schoolchildren: a crosssectional study in Southern Brazil. Int J Paediatr Dent. 2005;15(4):249-255. doi: 10.1111/j.1365-263X.2005.00643.x