Evaluation of Sugar Content and Erosive Potential of the Commonly Prescribed Liquid Oral Medications

Siddiq, Hanan; Pentapati, Kalyana Chakravarthy; Shenoy, Revathi P; Velayutham, Anupama; Acharya, Shashidhar

doi:10.1590/pboci.2020.023

Cited by 6 publications

(18 citation statements)

References 38 publications

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“…Acidic substances with low pH values can exacerbate erosive dissolution and lead to further demineralization [26]. Previous studies have found that medications for children's use presented low pH, as antibiotics [12,13,16,19], antihistamines [7,12,14,[16][17][18], mucolytics and bronchodilators [12,14], as well as analgesics [19,23]. This is in line with our results, which showed that all evaluated medicines were acidic with a pH ranging from 3.89 to 5.29, below the critical pH value of 5.5 for enamel dissolution.…”

Section: Discussionmentioning

confidence: 99%

“…An average of the three obtained values was calculated for each drug. This protocol was based on a previous study [17].…”

Section: Titratable Acidity Analysismentioning

confidence: 99%

“…In addition, it has been demonstrated that acidic medicines were able to reduce the hardness of primary teeth [6,12] and promote morphological changes in the enamel [13]. In previous in vitro studies, acidic antihistamines contributed to dental erosion [7,12,[14][15][16][17], as well as respiratory disease medications [7,[13][14][15][16][17][18][19][20]. Antibiotics for pediatric use have also been related to dental erosion [7,13,16,17,[19][20][21][22]; however, more studies are still needed to evaluate the erosive potential of analgesics on primary enamel [6,7,13,17,19,22,23].…”

Section: Introductionmentioning

confidence: 99%

“…In previous in vitro studies, acidic antihistamines contributed to dental erosion [7,12,[14][15][16][17], as well as respiratory disease medications [7,[13][14][15][16][17][18][19][20]. Antibiotics for pediatric use have also been related to dental erosion [7,13,16,17,[19][20][21][22]; however, more studies are still needed to evaluate the erosive potential of analgesics on primary enamel [6,7,13,17,19,22,23]. Furthermore, since some children may require frequent use of oral liquid medicines, evaluation of the primary enamel behavior exposed to these products becomes necessary.…”

Section: Introductionmentioning

confidence: 99%

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Erosive Effect of Analgesics on Primary Tooth Enamel - An in Vitro Study

Rocha

Nogueira

Almeida

et al. 2022

Pesqui. Bras. Odontopediatria Clín. Integr.

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Objective: To evaluate in vitro erosive effect of analgesics on primary tooth enamel. Material and Methods: The pH and the titratable acidity measurements of the medicines were performed in triplicate using a digital pH meter. Enamel slabs of primary teeth flat and polished were selected by initial surface microhardness analysis. Medications were selected and specimens were assigned into five groups (n=12): Dalsy; Magnopyrol; Paracetamol; Tylenol; and distilled water (negative control). Specimens were immersed in 5 ml of each group solution for 30 min, 4x/day for three days and stored in artificial saliva at 37 °C between immersions and at night. Final microhardness was determined. The data were submitted to Oneway ANOVA and Tukey's test. Scanning electron microscopy (SEM) analysis was performed in three specimens of each group. Results: Medicines showed acidic pH and mean values of titratable acidity ranged from 1.46 to 11.66 ml of 0.1N NaOH. The mineral loss of Magnopyrol was statistically significant in relation to the control group (p<0.01). Magnopyrol showed higher values when compared to Tylenol (p<0.05). SEM images displayed microstructure alterations in the Paracetamol group. Conclusion: Despite the low pH values, only Magnopyrol showed greater enamel softening. Paracetamol demonstrated morphological changes in primary tooth enamel.

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Section: Discussionmentioning

confidence: 99%

“…An average of the three obtained values was calculated for each drug. This protocol was based on a previous study [17].…”

Section: Titratable Acidity Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Erosive Effect of Analgesics on Primary Tooth Enamel - An in Vitro Study

Rocha

Nogueira

Almeida

et al. 2022

Pesqui. Bras. Odontopediatria Clín. Integr.

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“…Other factors like recurrent intakes (i.e., two or more times daily), sleep times, and after meals. Also, the reduced salivary flow may also promote increasing the risk of dental erosion (3,4) .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Erosive Effect of Pediatric Liquid Medicinal Syrups on Primary and Permanent Enamel

Mahmoud

ELmalt²,

Mohamed³

2022

ADJ-for Girls

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Purpose: To evaluate the erosive effect of pediatric liquid medicinal syrups on primary and permanent enamel. Materials and methods: Eighty primary and permanent teeth were equally divided into eight subgroups (n=10), according to the immersion solutions: Depakine, Ventolin, Sansovit, and Artificial saliva. The immersion cycles of the drugs were conducted under a 1-min agitation three times daily for 28 days. Enamel microhardness measurements were taken place at 0,7,14,21, and 28 days. The pH, titratable acidity, buffering capacity, and viscosity of the solutions were evaluated. A Scanning electron microscopy and statistical analysis of enamel microhardness measurements were assessed. Results: All the tested groups of the drugs had proven to produce significant demineralization of enamel after 28 days of exposure. At baseline, the permanent enamel showed higher mean enamel microhardness values than primary teeth. Generally with all the tested drugs, the primary teeth showed more decrease in enamel microhardness than permanent but without significance. The primary group (0-28days), the highest decrease of enamel microhardness was recorded in Sansovit group, then Ventolin, followed by Depakine group without significant change between the tested drugs, while in the permanent group, the highest decrease of enamel microhardness was recorded in Sansovit, then Depakine, followed by Ventolin group without significant change between the tested drugs. Kruskall Wallis test revealed a significant difference between tested drugs and control groups in both substrates. Conclusion: This study revealed that medicines used in the study could erode teeth even though the pH was above critical pH if it had high sugar content and viscosity. Sugar-free formulations have the ability to produce an erosive effect if they have low pH, high titratable acidity, high buffering capacity, and viscosity. This study showed that permanent teeth had higher mean enamel microhardness values than primary teeth, however no significant difference in the erosive potential of both types of teeth.

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Sugar content and erosive potential of commonly prescribed Orodispersible tablets- An in vitro study.

et al. 2023

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Background: Dental caries is a major non-communicable disease of public health concern caused due to freely available dietary sugars. We aimed to compare the sugar content and erosive potential with duration of use and drug classes of orodispersible tablets (ODTs). Methods: We conducted an in vitro evaluation of the total sugar content (TSC), Potential of Hydrogen (pH), solubility, and Titratable Acidity (TA) of commonly prescribed 62 ODTs. TA was measured by titrating the samples with known amount of. 0.1N sodium hydroxide (NaOH) with phenolphthalein indicator and pH was determined by digital pH meter. TSC was evaluated by phenol sulphuric acid. Solubility was assessed by filtration. Results: Out of the 62 ODTs, majority were Antimicrobials (n=30). One-quarter of the ODTs (26%) had a mean pH below ≤5.5. No significant difference was seen in the mean pH with respect to different drug classes (p=0.082) and duration of use of ODTs. A significant difference was seen in the mean percentage solubility with respect to drug classes (p<0.001). Antimicrobials had the least percentage of solubility as compared to other drug classes. Antiemetics and proton pump inhibitors (24.33 ± 17.34) had significantly higher mean percentage sugar content than Antimicrobials (23.25 ± 17.16). No significant difference was seen in the mean TSC with respect to various drug classes (p=0.718) and between the duration of use of drugs (P=0.568) respectively. No significant difference was seen in the mean percentage TA with respect to drug class (p=0.123) and duration of use of drugs (p=0.424). Conclusion: Overall, we can conclude that one in four ODT formulations had a pH below 5.5 (critical pH). Only one ODT formulation did not have a sugar content. No difference was seen in the mean pH, sugar content, and TA with respect to duration of use of drugs and drug classes.

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Evaluation of Sugar Content and Erosive Potential of the Commonly Prescribed Liquid Oral Medications

Cited by 6 publications

References 38 publications

Erosive Effect of Analgesics on Primary Tooth Enamel - An in Vitro Study

Erosive Effect of Analgesics on Primary Tooth Enamel - An in Vitro Study

Evaluation of the Erosive Effect of Pediatric Liquid Medicinal Syrups on Primary and Permanent Enamel

Sugar content and erosive potential of commonly prescribed Orodispersible tablets- An in vitro study.

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