Abstract
BACKGROUND: The increasing popularity of fruit juices as part of perceived healthy dietary choices has raised concerns regarding their erosive effects on dental enamel. While prior in vitro studies have largely relied on commercial fruit drinks and non-human enamel samples, this study adopts a more ecologically valid approach by using fresh local fruit juices and extracted human teeth to evaluate enamel erosion. OBJECTIVES: This study aimed to assess the consumption patterns, oral hygiene behaviours, and awareness of the erosive potential of fruit juices among Malaysian adults and to evaluate the erosive effects of freshly squeezed local fruit juices on human dental enamel under simulated oral conditions. METHODS: A questionnaire-based cross-sectional survey (n = 189) was conducted among dental clinic attendees to assess fruit juice intake habits, oral health practices, and awareness levels. In parallel, an in vitro study was performed using 40 extracted premolar teeth immersed in lime juice, pineapple juice, citric acid (positive control), or distilled water (negative control) over a 10-day period. Enamel volume loss, surface roughness, and microhardness were analysed pre- and post-immersion. RESULTS: Fruit juice consumption was highly prevalent, with lime (57.7%) being the most commonly consumed, followed by watermelon (53.0%), star fruit (15.9%), and pineapple (15.4%). The majority of respondents preferred sweetened juices (75.7%) and demonstrated only moderate oral hygiene, with just 53.4% reporting brushing their teeth twice daily. Awareness of the dental effects of acidic beverages was limited. In vitro results confirmed that both lime and pineapple juices significantly reduced enamel microhardness and increased surface roughness (p < 0.0001), with lime juice causing the greatest enamel volume loss due to its higher acidity. CONCLUSIONS: These findings highlight the need for public health strategies that raise awareness on the implications of dietary acids and promote protective oral health behaviours. Dental practitioners should incorporate dietary counselling in routine care, particularly for populations at higher risk.