International journal of dental hygiene · 2026
Erosion Potential of Commercial Fluoride-Free Mouthwashes on Dental Hard Tissues.
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Valdivia-Tapia Astrid C, Kelly Adam B, Hara Anderson T, Cury Jaime Aparecido, Ricomini-Filho Antonio Pedro, Lippert Frank
Аннотация
PURPOSE: Mouthwashes often present acidic pH, which raises concerns about their potential contribution to erosive tooth wear. This study evaluated the erosive potential of commercial fluoride-free mouthwashes using a screening method.
METHODS: A convenience sample of 81 different mouthwashes was evaluated for their erosion potential (International Organization for Standardization, ISO/FDIS 28888:2013). This method measured the pH changes (ΔpH) of 25 mL of calcium phosphate solution (baseline pH 5.05 ± 0.05; mean ± standard deviation) once the test mouthwash was added (0.25 mL). Three citric acid/citrate buffers were used, with the maximum allowable ΔpH based on the strongest buffer. Each mouthwash was tested four times, and mean values, standard deviations, and the correlation/regression between the initial and final pH were calculated.
RESULTS: Mouthwashes presented a baseline pH range of 3.00-9.47. The reference solutions resulted in ΔpH of 0.58 ± 0.00, 0.89 ± 0.00, and 1.20 ± 0.01, respectively. None of the mouthwashes showed ΔpH higher than the strongest standard. Several unexpected results were observed: (i) nine mouthwashes with initial pH above 5.00 caused a pH drop when added to the screening solution; (ii) one mouthwash with initial pH 4.27 caused a pH drop to 4.17; and (iii) one with initial pH 4.93 caused a pH increase to 6.18. The correlation and regression values were: r = -0.81/r2 = 0.65 (p-value < 0.001).
CONCLUSION: Most mouthwashes showed no erosive potential, but unexpected pH shifts in over 10% highlight the need to refine testing methods for fluoride-free products.
CLINICAL SIGNIFICANCE: Some fluoride-free mouthwashes may contribute to dental erosion due to low pH. Identifying these products helps clinicians make safer recommendations for daily use.
METHODS: A convenience sample of 81 different mouthwashes was evaluated for their erosion potential (International Organization for Standardization, ISO/FDIS 28888:2013). This method measured the pH changes (ΔpH) of 25 mL of calcium phosphate solution (baseline pH 5.05 ± 0.05; mean ± standard deviation) once the test mouthwash was added (0.25 mL). Three citric acid/citrate buffers were used, with the maximum allowable ΔpH based on the strongest buffer. Each mouthwash was tested four times, and mean values, standard deviations, and the correlation/regression between the initial and final pH were calculated.
RESULTS: Mouthwashes presented a baseline pH range of 3.00-9.47. The reference solutions resulted in ΔpH of 0.58 ± 0.00, 0.89 ± 0.00, and 1.20 ± 0.01, respectively. None of the mouthwashes showed ΔpH higher than the strongest standard. Several unexpected results were observed: (i) nine mouthwashes with initial pH above 5.00 caused a pH drop when added to the screening solution; (ii) one mouthwash with initial pH 4.27 caused a pH drop to 4.17; and (iii) one with initial pH 4.93 caused a pH increase to 6.18. The correlation and regression values were: r = -0.81/r2 = 0.65 (p-value < 0.001).
CONCLUSION: Most mouthwashes showed no erosive potential, but unexpected pH shifts in over 10% highlight the need to refine testing methods for fluoride-free products.
CLINICAL SIGNIFICANCE: Some fluoride-free mouthwashes may contribute to dental erosion due to low pH. Identifying these products helps clinicians make safer recommendations for daily use.