Effects of calcium on the erosive potential of acidic candies in saliva

Theoretical calculations have shown that acidic candies may be potentially erosive upon consumption. However, little is known about the protective effect of adding calcium to potentially erosive candies and about the protective effects of saliva that cannot be fully accounted for by theoretical calculations. Therefore, the aims of this study were to (1) determine the erosive potential of acidic candies with and without calcium and (2) to determine differences between theoretically calculated erosive potential and actual erosive potential in saliva. Twenty healthy test persons sucked acidic candy with and without calcium while their whole saliva was collected into a closed system at different times: baseline, candy-stimulated, and post-stimulated. The erosive potential of the candy was evaluated from candy-induced changes in saliva degree of saturation with respect to hydroxyapatite (HAp) and directly by dissolution of HAp crystals in candy-stimulated saliva. The results showed that similar salivary stimulation was obtained with both candies. The modified candy released more than 13 mmol/l of calcium into saliva, resulting in a lower critical pH, and considerably lower erosive potential than the control (p < 0.001). Although a significant correlation was obtained between theoretical calculation of DS(HAp) and dissolution of HAp crystals (r(s) = 0.65; p < 0.001), many samples obtained by sucking modified candy showed no signs of HAp dissolution in spite of being undersaturated. We conclude that saturation levels and critical pH may not fully reflect when dental erosion is expected to occur in saliva and that calcium addition reduces the erosive potential of acidic candies.