Background Our data on more than 800 participants shows that dental erosion (DE) affects up to 45% of elite athletes and may have physical and psychosocial impacts. The condition is associated with consumption of sports drinks and is exacerbated by reduced salivary flow. The protein rich layer called dental pellicle (DP) may have a protective function for DE and this might prove to be a useful therapeutic target in elite sport.

Objectives To assess the protective function of DP against DE.

Design In vitro study.

Setting Laboratory.

Participants 40 bovine incisors

Interventions Two levels. 1: We exposed twenty bovine incisors to an energy drink (pH 3.1) at 24, 48 and 72 hours to create an in vitro erosion model. 2: We used fresh human saliva to form dental pellicle on the buccal surface of twenty incisors to create an in-vitro pellicle model. Erosive lesions were investigated both in the presence and absence of a layer of dental pellicle.

Main outcome measurement Mean depth of erosive lesions by optical coherence tomography (OCT) and X-ray Microtomography (XMT).

Results OCT showed the mean thickness of amorphous enamel before immersion in the erosive medium was 64 µm (SD 2.3, IQR 54.7 – 63.2). The mean depth of the erosive lesion after immersion was 240.8 µm (SD 32.7, IQR 244.6 – 263.8) (p<0.001) at 72 hours. In contrast, mean depth of lesion in the presence of the dental pellicle was 84.3 (SD 18.9, IQR 93.2 – 75.3) (p<0.03). XMT showed the mean depth of erosive lesions was 130 µm (SD 28.2), whereas in the presence of DP was 82.4 µm (SD 15.6) (p<0.001).

Conclusions Erosion was reduced but not prevented by presence of dental pellicle. This model shows promise as a method to investigate novel interventions to prevent DE in elite athletes.