Lessening the erosive influence of electrolyte sports drinks on teeth using L-arginine and aqueous Miswak extract

Excessive intake of electrolyte sports drinks (ESDs) among adolescents and athletes is associated with dental erosion due to their low pH, while their sugar content increases the risk of dental caries. This study aimed to evaluate and compare the protective effects of incorporating either L-arginine or Salvadora persica (Miswak) extract into an ESD on enamel surface properties.

Extracted human premolars were randomly assigned to three groups (n = 6): (1) plain ESD, (2) ESD with 1% L-arginine (Arg-ESD), and (3) ESD with 10% Salvadora persica extract (Mis-ESD). Each specimen was immersed in its respective solution for 5 min daily over 7 days. Post-treatment assessments included enamel microhardness (VHN), surface roughness (Sa), colour change (ΔE), Ca/P ratio, and scanning electron microscopy (SEM) for surface morphology. A taste acceptability survey was conducted in adult volunteers. Statistical analysis used one-way ANOVA (α = 0.05). In addition, a small panel of adult volunteers (n = 20) evaluated the taste acceptability of the modified formulations after providing informed consent.

Both Arg-ESD and Mis-ESD significantly increased enamel microhardness and reduced surface roughness compared to plain ESD (P < 0.01), with Mis-ESD showing the greatest improvements. Mis-ESD also enhanced colour stability (P < 0.001). SEM images confirmed preservation of enamel structure, particularly in Mis-ESD specimens. Taste testing indicated good palatability for both modified formulations.

Incorporating Salvadora persica extract into ESDs significantly improved enamel resistance to erosion and enhanced aesthetic properties. Miswak-enriched ESDs could serve as a preventive option for dental erosion.

Formulating ESDs with Salvadora persica may reduce their erosive potential while preserving taste acceptability, offering a novel, consumer-friendly strategy to protect enamel in high-risk populations.