Milk Reduces Enamel Staining Caused by Black Tea and Chlorhexidine Mouthwash
Round 1
Reviewer 1 Report
Dear Authors,
Thank you for the effort that you put in your work. The topic is really interesting and the work is well structured and explained.
Conclusion paragraph is missing! You will find my comments by clicking on the highlighted parts of the attached manuscript.
Best regards
Comments for author File: 
Comments.pdf
Author Response
Thank you very much for all the comments.
Point 1:Where did the individuals participating in the study came from? How many? You should specify it before mentioning them.
Response 1:Saliva samples were collected from four healthy dental professionals and this is corrected in the materials and methods section
Point 2:figures should be placed in the text right after the citation and with a description, as mentioned in the template instructions.
Response 2:Done accordingly to the reviewer's request
Point 3:I understand the solution of milk and tea, but how the solution of chx and tea could be replicated in real life? if anything it can be used as mouthwash right after. are you sure that creating the solutions keeps the experiment close to reality?
Response 3:The study was designed as CHX was used as mouth wash right after drinking milk tea in real life. The sentence is corrected in materials and methods section. The extracted tooth could be incubated in CHX after the incubation time in tea or milk tea solutions. However this would create more complicated study design. Our goal was to see the result of milk neutralizing the staining effect of CHX as well as tea. Although, there are limitless number of alternative solution combinations to test for example CHX plus milk, we have had to limit our combinations to some extent.
Point 4:STARTING FROM HERE, THESE FURTHER PARAGRAPHS SHOULD BE REARRANGED IN ONE SINGLE SEPARATED PARAGRAPH WITH TITLE ' CONCLUSIONS'
Response 4:Done
Point 5:what do you mean with this? because of flavour tastes?
Response 5:Yes, for example wine and coke. They are included in the sentence in conclusion section
Point 6:What about studies on patients? yes or no? and why?
Response 6:Further studies on patients are planned in our clinics. In discussion section line 323 the importance on the product development of further in vivo studies was mentioned and to avoid repetition we did not mention in the conclusion section.
Author Response File: 
Author Response.docx
Reviewer 2 Report
Congratulation to authors for this research and the protocol.
Nevertheless, the subject is not really determinant and fundamental : studying dental exposure of tea and/or milk and/or chlorhexidine is not really intersting. By the way, the affect of milk on dental straining was not evaluated in the litterature.
Moreover, effect of dental brushing is not studied on color changes after drinking tea milk and exposure to chlorhexidin, which could modify seriously the results…
Endly, less than 30 percent of the references are in the 10 last years.
Author Response
Point 1: Nevertheless, the subject is not really determinant and fundamental : studying dental exposure of tea and/or milk and/or chlorhexidine is not really intersting. By the way, the affect of milk on dental straining was not evaluated in the litterature.
Respone 1: Thank you very much for all the comments.
Point 2: Moreover, effect of dental brushing is not studied on color changes after drinking tea milk and exposure to chlorhexidin, which could modify seriously the results…
Response 2: The dental brushing effect will be evaluated and discussed in our next study. In the present study although we cleaned the teeth by using rubber cups and paste before each experiment and measured the tooth color before and after, we did not discuss the evaluations since the aim in this study was to determine whether milk would diminish the staining effect. We also have too many parameters to discuss and it would have been too complicated to include all.
Point3: Endly, less than 30 percent of the references are in the 10 last years.
Response3: Our study topic is not studied by many and hence the literature search was limited, but after your comment we have included one more study from 2014.
Author Response File: Author Response.docx
Reviewer 3 Report
The article in question although well structured and written does not bring much news to the dental field of "Tooth staining" so I would did some suggestions of alteratios to improvee the scientific soundness of the paper
Comments for author File: Comments.pdf
Author Response
Point 1:- In the Abstract: “Milk reduces the staining caused by tea, and that the color……” (cut)
Response 1: Corrected
Point 2: -In the end of the Introduction the objective is very convoluted, I would change it to a more precise one:
Consequently, the aim of the present study was to evaluate the color changes on the enamel surface of human teeth and if milk milk reduces the staining caused by Turkish and imported black tea, and chlorhexidine.
Response 2: Corrected
Point 3: - Instead of just mentioning teas from Turkey vs UK, the authors should point out any differences in their composition that are scientifically relevant to the article, eg PH?
Response 3: The tea produced in Turkey is considered as the same as tea produced in other parts of the world and therefore the composition is not considered well worth for investigating. There is no citable published article with these information on the international platform. However in domestic published papers Turkish tea pH is 5.6 and is similar with many other black tea.
Our next future research will be conducted together with the tea experts on the tea composition and health.
Point 4: - As well as the Turkish tea itself, do you know how to you mention anything else about its composition?
Response 4: Tea produced by both countries are same ordinary black tea. What makes the difference is the brewing technique and time, and the addition of milk into the tea. As it is mentioned in the article, Turkish people brew tea for too long.
As we mentioned in the above answer, whether there is difference in the composition of Turkish tea is not investigated well and there is no citable literature yet.
We think it will be a good to include in the article the preparation of our solutions as supplementary information. Please find it in the revised version of the manuscript.
Point 5: - Regarding the conclusions about milk you can already cite articles that refer to it as a substance that, when introduced, reduces the discoloration caused by certain beverages such as tea:
Lee RJ, Bayne A, Tiangco M, Garen G, Chow AK. Prevention of tea-induced extrinsic tooth stain. Int J Dent Hyg. 2014 Nov;12(4):267-72.
Response 5: It is done. Thank you very much for the recommendation.
Point 6: - Can you also speculate as to why? What are these substances? Casein? Talk about casein plus tannins?Have more profound scientific meaning
Response 6: We talk about it in our revised manuscript.
Point 7: -With regard to Chlorehidine, you have to be careful about "staining" your teeth. Most articles only talk about "black tongue", as do the articles the authors mention in the introduction (9-10). In the discussion the articles referred to (11, 26 and 27 do not mention it).
Response 7: Our references list was not ordered correctly.
We corrected this mistake. We are sorry for this confusion.
Point 8: -I would remove reference 10- not scientific and doesn`t mention teeth stainning by CH.
Response 8: We corrected the reference list.
Author Response File: Author Response.docx
