Journal of Dentistry 30 (2002) 313317

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The pH and titratable acidity of a range of diluting drinks and their

potential effect on dental erosion
A.M. Cairns, M. Watson, S.L. Creanor*, R.H. Foye
Hard Tissue Research Group, University of Glasgow Dental School, 378 Sauchiehall Street, Glasgow G2 3JZ, UK

Abstract
Objectives. To investigate, in vitro, the potential dental effects of diluting juices by measuring their acidity levels and to examine the effect
dilution has on the potential erosive properties of the drinks.
Methods. Four commonly available diluting drinks were assessed for both pH and titratable acidity at a variety of dilutions, reflecting the
range of concentrations over which such drinks may be consumed. Predetermined dilutions of citric acid and hydrochloric acid, with similar
pH values to those of the drinks, were used as positive control acidic solutions. The pH measurements throughout the study were made using
a pH electrode connected to an Orion EA940 IonAnalyser.
Results. All four drinks demonstrated a high degree of resistance to a rise in pH, indicating high intrinsic buffering capacity. The measured
pH changed very little with increasing dilution ratio when compared to the citric and hydrochloric acid controls, even when considered
extremely dilute. In contrast, the titratable acidity of each of the drinks reduced proportionally with increasing dilution, thereby reducing
considerably its erosive potential.
Conclusions. While dilution had very little effect on the measured pH values, the titratable acidity reduced as the drink became more dilute.
Since there appears to be a direct relationship between dilution and titratable acidity, the erosive potential of diluting juices may be reduced
substantially by the addition of water. It remains unlikely, however, that the drinks would ever be consumed at a safe level of dilution due to
diminished taste and colour.
q 2002 Elsevier Science Ltd. All rights reserved.
Keywords: Dental erosion; Soft drinks; Diluted soft drinks; Buffering capacity; pH

1. Introduction titratable acidity is a more accurate measure of the total acid

Dental erosion can be defined as painless irreversible loss
of dental hard tissue due to a chemical process (chelation or
dissolution) without the involvement of microorganisms
[1 3]. The aetiology of dental erosion is complex and
multi-factorial, being attributed to a wide range of factors
that may be either extrinsic or intrinsic [2]. In western
societies diet is thought to be a major factor in the aetiology
of dental erosion and has received most attention in the
dental literature [4]. The main dietary components thought
to be involved are citrus fruits and soft drinks [5].
It has been traditionally understood that acidity, the
measured pH, is an accurate indicator of the erosive
potential of a food or drink [6]. Baseline pH values give
only a measure of the initial hydrogen ion concentration and
provide, therefore, no indication as to the presence of
undissociated acid. It is now widely accepted that the total
* Corresponding author. Tel.: 44-141-2119756; fax: 44-141-
3531593.
E-mail address: s.creanor@dental.gla.ac.uk (S.L. Creanor).
0300-5712/02/$ - see front matter q 2002 Elsevier Science Ltd. All rights reserved.
PII: S 0 3 0 0 - 5 7 1 2 ( 0 2 ) 0 0 0 4 4 - 1
content of a drink, and may, therefore, be a more realistic
means of predicting erosive potential [7,8].
Concentrates that require dilution before consumption
have received little attention in the literature despite their
popularity. Case reports of gross tooth destruction linked to
the consumption of diluting juices have appeared in the
literature [9]. Such reports seem to have been largely
overlooked and diluting drinks have had the image of being
a safer form of soft drink, with one paper even describing
them as being diluted and therefore of reduced erosive
potential [10]. The lack of evidence supporting the above
statement leaves an opening for the investigation of this
important but largely ignored group of soft drinks.
Concentrates differ from most other soft drinks in the
market because the consumer has control over the
composition of the drink by diluting it to his/her own
personal taste. The few studies published on these drinks
tend to examine them at the dilution recommended by the
manufacturer [11 14]. Although the manufacturers rec-
ommendation gives a standard for comparison of the drinks,
it is not known how many people follow the instructions and
314 A.M. Cairns et al. / Journal of Dentistry 30 (2002) 313317
therefore, the juices may be consumed in a more
concentrated or dilute form.
Another complicating factor is the addition of further
acids to soft drinks, which are strong buffers and are added
to maintain the drinks high intrinsic acidity, for a whole
range of reasons. Dilution will have, therefore, an
unpredictable effect on the total acidity and the measured
pH of the drink.
Two questions were asked in this study: the first being
how does dilution of a soft drink affect its measured pH at
the point of dilution? The second was what is the
relationship between dilution of a soft drink and the total
acid present, that is its total titratable acidity. This study
aimed, therefore, to investigate the effect of dilution of four
different commercially available diluting drinks on their
measured acidity levels, that is pH. First the baseline pH of a
series of dilutions for each drink was determined to establish
whether or not the drinks were buffered and what dilution
would be required to reach a pH of 5.5 (the so-called
critical pH for tooth mineral dissolution) and pH 7 (neutral).
Secondly the titratable acidity of the drinks was measured
for the same series of dilutions, to give an accurate
assessment of the total acid present and, therefore, a more
realistic measure of the erosive potential of the drinks.
2. Materials and methods
Four popular diluting drinks were investigated in this
study: Robinsons Whole Orange Drink, Robinsons Special
R No Added Sugar Orange, Ribena Original Blackcurrant
and Ribena ToothKind Blackcurrant. The pH measurements
throughout the study were made using a pH electrode
(Microelectrodes Inc., MI-410, NH, USA) connected to an
Orion EA940 IonAnalyser (Orion Research, Cambridge,
England). The electrode was calibrated at the start of each
session using standard buffers of pH 4.0 and 7.0. Twenty
millilitres of the newly opened drink (or freshly prepared
dilution) was placed in a beaker and stirred using a non-
heating magnetic stirrer until a stable reading was obtained.
Several readings were taken of the drinks from each group
to give a mean measurement for that drink or dilution.
2.1. Baseline acidity and the effect of dilution
A series of dilutions of each drink was prepared using
water as the diluent. Concentrations of juice prepared
ranged from neat to one part juice in 100,000 parts water.
The pH of each dilution was measured using the pH
electrode. Each of these samples was diluted further and the
dilution ratios that gave pH values of 5.5 and 7.0 were noted.
Control solutions of hydrochloric acid and citric acid with
similar baseline pH values to those of the neat drinks were
also prepared and diluted to the same concentration as each
of the juices. The pH of each sample and its subsequent
dilution was measured as described earlier.
2.2. Titratable acidity
Twenty millilitres of each of the first 13 dilutions (neat,
1:1 10, 1:20 and 1:50) for each drink were then titrated by
adding increments of 1N sodium hydroxide (NaOH) and
measuring the pH until pH 10 was reached. Volume of
sodium hydroxide added was then plotted against pH and
the amount required to reach pH values of 5.5 and 7.0
determined to give a measure of the titratable acidity of each
sample. These amounts were then compared for the various
drinks using Mann Whitney tests.
3. Results
3.1. Baseline acidity
All four drinks were significantly buffered, with the pH
changing very little with increasing dilution ratio, compared
to the citric and hydrochloric acid controls. The hydrochloric
acid required to be diluted to a ratio of between 1:6 and 1:7 to
reach pH 5.5 and between 1:50 and 1:100 to reach pH 7. The
citric acid reached pH 5.5 at a ratio of 1:20 and pH 7 at 1:500.
Greater dilutions were required to reduce the measured
acidity of the juices, indicated by the more gradual changes
in pH: for example, the difference in pH value between the
neat drink and a dilution of 1:10 was around 0.2 for all the
drinks tested. To attain a pH of 5.5 the Whole Orange Drink
and Ribena ToothKind required to be diluted to a ratio
between 1:500 and 1:750. Special R Orange was diluted
1:1000 and Ribena Original required to be diluted to
between 1:1000 and 1:2000.
A pH value of 7 was not reached until even greater ratios
of drink to water were used: Whole Orange and Ribena
ToothKind needed to be diluted between 1:5000 and
1:10,000, while Special R and Ribena Original required a
ratio of 1:10,000. Whilst the measured pH of the drinks
changed very little with dilution, the appearance of the drink
became less coloured with increasing dilution, and at a ratio
of around 1:100 all the drinks appeared virtually indis-
tinguishable from water, despite the pH remaining below 5
in all cases.
3.2. Titratable acidity
Both the hydrochloric and citric acid controls demon-
strated a rapid response to the addition of the NaOH,
indicating a relatively low titratable acidity. The hydro-
chloric acid solution required only 30 ml NaOH to bring the
pH value to 7, whilst the citric acid required 50 ml to reach
the equivalent pH value.
In all cases diluting the drinks reduced their titratable
acidity in proportion with the dilution ratio, i.e. half as much
NaOH was required to raise the pH of a dilution of 1:1 as was
required for the neat drink, and so on. Comparing the four
drinks indicated that the Whole Orange Drink and Special R
 A.M. Cairns et al. / Journal of Dentistry 30 (2002) 313317
Fig. 1. (a) Volume of 1 M NaOH required to reach pH 5.5 for various dilutions of the drinks up to 1:50. (b) Volume of 1 M NaOH required to reach pH 7 for
various dilutions of the drinks up to 1:50.
No Added Sugar Orange had very similar titratable acidities
requiring approximately 3.5 ml NaOH to reach pH 7. Ribena
Original gave the greatest titratable acidity, requiring 4.0 ml
NaOH to become neutral and Ribena ToothKind showed the
lowest titratable acidity, reaching pH 7 after the addition of
2.2 ml NaOH. Fig. 1(a) and Table 1 illustrate the volumes of
sodium hydroxide required to reach pH 5.5 for the various
dilutions of each drink. Fig. 1(b) and Table 1 demonstrate the
equivalent volumes required to reach pH 7. Table 2 lists the P
values for the individual comparisons made between each
drink for the number of millilitres of NaOH required to raise
the pH to 7. A students paired t-test has been used. As shown
in Fig. 1(a) and (b), the volumes of NaOH required to raise the
measured pH of all the drinks at the ratios of 1:50 are small
and therefore, no greater dilution ratios are shown.
4. Discussion
The results demonstrate that all the drinks tested were
highly acidic, even when dilute. In comparison to
315
the hydrochloric and citric acid controls, the significant
buffering effect of the juices is evident, particularly at a
dilution of 1:50 where three of the four drinks still have
greater titratable acidities than the undiluted control
solutions.
Two controls were used in this study. Citric acid is the
main acid in all the drinks tested. It is a tribasic acid with
some buffering between pH 5.5 and 7 where its three pKa
values are close together. To contrast this, hydrochloric acid
was also used. It is a strong acid that dissociates completely,
demonstrating the behaviour of an unbuffered solution.
Whilst a recent paper [15] suggested that the baseline
acidity is a major factor in determining erosive potential, it
is still generally accepted that titratable acidity is a better
indicator of erosive potential than pH alone [7,8].
The method used in this study to determine titratable
acidity has been employed in a number of studies [2,16,17]
and is known to give a realistic measure of buffering
capacity of drinks by quantifying the amount of alkali
required to bring the pH to a chosen value. Various end
points have been used in previous studies from pH 5.5
316 A.M. Cairns et al. / Journal of Dentistry 30 (2002) 313317

Table 1
Volume of 1N NaOH required to reach pH 5.5 and volume of 1 M NaOH (ml) required to reach pH 7 for various dilutions of the drinks

Dilution Whole Orange Special R Orange Ribena Original Ribena ToothKind

(a) Volume of NaOH to reach pH 5.5 (standard deviation)

Neat 2.77 (0.2) 2.89 (0.271) 3.36 (0.235) 1.82 (0.22)
1:1 1.23 (0.18) 1.46 (0.134) 1.64 (0.211) 0.79 (0.05)
1:2 0.92 (0.06) 0.94 (0.062) 1.13 (0.128) 0.52 (0.03)
1:3 0.59 (0.031) 0.65 (0.043) 0.88 (0.097) 0.39 (0.023)
1:4 0.39 (0.03) 0.49 (0.027) 0.75 (0.033) 0.3 (0.024)
1:5 0.35 (0.023) 0.39 (0.027) 0.54 (0.03) 0.3 (0.023)
1:6 0.29 (0.02) 0.38 (0.027) 0.39 (0.028) 0.26 (0.024)
1:7 0.28 (0.019) 0.29 (0.015) 0.39 (0.027) 0.23 (0.015)
1:8 0.25 (0.016) 0.25 (0.02) 0.37 (0.025) 0.17 (0.014)
1:9 0.23 (0.015) 0.23 (0.018) 0.29 (0.02) 0.16 (0.013)
1:10 0.2 (0.021) 0.19 (0.02) 0.28 (0.02) 0.14 (0.012)
1:20 0.13 (0.02) 0.09 (0.02) 0.14 (0.014) 0.06 (0.01)
1:50 0.04 (0.019) 0.03 (0.015) 0.06 (0.017) 0.01 (0.006)
(b)Volume of NaOH to reach pH 7 (standard deviation)
Neat 3.4 (0.127) 3.6 (0.156) 4.0 (0.241) 2.2 (0.23)
1:1 1.6 (0.18) 1.85 (0.231) 2.0 (0.211) 1.1 (0.105)
1:2 1.1 (0.105) 1.2 (0.1) 1.3 (0.126) 0.7 (0.03)
1:3 0.8 (0.021) 0.85 (0.051) 1.1 (0.098) 0.55 (0.03)
1:4 0.55 (0.03) 0.65 (0.027) 0.95 (0.03) 0.37 (0.027)
1:5 0.45 (0.043) 0.55 (0.047) 0.75 (0.030) 0.35 (0.023)
1:6 0.4 (0.065) 0.55 (0.071) 0.5 (0.067) 0.3 (0.031)
1:7 0.4 (0.01) 0.45 (0.015) 0.5 (0.018) 0.25 (0.016)
1:8 0.35 (0.028) 0.3 (0.03) 0.45 (0.025) 0.2 (0.014)
1:9 0.3 (0.025) 0.3 (0.023) 0.4 (0.02) 0.15 (0.019)
1:10 0.3 (0.023) 0.3 (0.019) 0.35 (0.02) 0.15 (0.012)
1:20 0.17 (0.02) 0.14 (0.019) 0.2 (0.014) 0.08 (0.011)
1:50 0.08 (0.02) 0.05 (0.02) 0.08 (0.017) 0.02 (0.008)

to 10. The definition of the exact value of pH below which
enamel dissolution may occur is controversial [18], since in
the mouth it is the degree of undersaturation with respect to
tooth mineral that is the crucial point. The end point
chosen, therefore, for this study was pH 7. This end point is
nevertheless limited as it lies in an area where there is a
rapid rise in pH. Thus, the increments added were not
sufficiently gradual over this part of the graph to allow an
exact value of alkali required to reach pH 7.
Whilst the measurement of acidity can provide a
reasonable guide to erosive potential of drinks, it has been
shown that the acid type and concentration are important in
determining the amount of damage, even when the pH
values are similar [19]. It has been suggested that citric and
ascorbic acids may be particularly harmful [3,6,20].
High levels of acidity are interpreted as being
potentially the most harmful. The consumption of an
acidic drink will, however, stimulate salivary flow [21].
It is possible, therefore, that a more acidic drink may be
either cleared from the mouth or neutralised more
rapidly, due to the increased salivary washing action
and buffering capacity, and so will spend less time in
contact with the teeth. Clearance of a drink from the
mouth will also depend on the ability of a drink to
adhere to the enamel [22]. A more viscous drink is likely
to adhere and will, therefore, be held in the mouth for
longer. It may be reasonable to suggest that a diluted
juice will have lowered viscosity due to the increased
proportion of water, and with salivary stimulation
remaining unaffected due to the low pH dilution, may
aid clearance from the oral environment. This particular
parameter was not addressed in this study.
The presence of certain inorganic ions in drinks is
believed to have a protective role [23] by maintaining a high
level of saturation with respect to tooth mineral. Many
studies have found the erosive potential of drinks to be
associated with their calcium and phosphate concentrations
[2,24 27]. Dilution will, however, reduce the concen-
trations of such inorganic ions and will, therefore, diminish
their protective effect.
Although the erosive potentials of various drinks can be
compared, it is not possible to define the degree to which
any drink will damage teeth, since this will vary
enormously between individuals. Some people are more
Table 2
Comparisons of level of dilution required to reach pH 7
Whole Orange Special R Orange Ribena Original
Special R Orange P 0.02
Ribena Original P 0.02 P 1.000 (NS)
Ribena ToothKind P 0.009 P 0.021 P 0.001
 A.M. Cairns et al. / Journal of Dentistry 30 (2002) 313317
susceptible to dental erosion than others and a number of
risk factors have been identified [22]. The main factors that
seem to increase the likelihood of an individual suffering
from dental erosion include salivary flow rate, pH,
buffering capacity and pellicle formation [6,17,28,29].
Soft drinks confined to meal times are less likely to be
harmful than if consumed alone [4] and continual sipping
of the drink is more harmful than drinking the whole drink
at one time [4,11]. Drinking through a straw minimises
contact of the drink with the teeth and so may cause less
erosion in susceptible individuals. A narrow straw placed
behind the front teeth and as far back in the mouth as
possible has been advocated [30]. Some abnormal drinking
habits may lead inevitably to increased harm. These
include holding the drink in the mouth for prolonged
periods, swishing around the mouth or sucking juice
through the teeth [4,9].
5. Conclusions
1. While dilution had very little effect on the measured pH
values, the titratable acidity fell considerably as the drink
became more dilute. It is possible, therefore, because
there appears to be a direct relationship between dilution
and titratable acidity, that erosive potential of diluting
juices may be reduced by the addition of considerable
amounts of water.
2. All the drinks tested showed significant buffering
capacity, maintaining the pH at low acidic values even
when considerably diluted. Although it was possible to
dilute the drinks to a point where neutrality was reached,
the dilution ratios were so immense that they were not
applicable to the range of concentrations over which the
drinks would be consumed.
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