&lt;i&gt;In vitro&lt;/i&gt; Analysis of the Cariogenic and Erosive Potential of Pediatric Antitussive Liquid Oral Medications

Cavalcanti, Alessandro Leite; Sousa, Rayanne Izabel Maciel de; Clementino, Marayza Alves; Vieira, Fernando Fernandes; Cavalcanti, Christiane Leite; Xavier, Alidianne Fábia Cabral

doi:10.4314/thrb.v14i2.7

Cited by 28 publications

(48 citation statements)

References 22 publications

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“…Considering the cariogenic and erosive potential of sweetened and acidic medications prescribed to children, it is important that health professionals, especially paediatricians and paediatric dentists, are engaged in educating parents to ensure adequate oral clearance after each dose of medication as a primary step for minimizing the risk of dental caries and erosion of dental structures related to long-term, and sometimes unsupervised, regimens with sugar-containing liquid oral medications 9 . Further laboratorial and clinical investigations are required to evaluate other physicochemical proprieties and determine the mechanism de action of pediatric liquid oral medications on dental substrates.…”

Section: Results Discussionmentioning

confidence: 99%

“…Several pediatric liquid oral medications present a low pH, high concentration of sugars and high acidity, which result in erosive 6,13,14 and cariogenic potential to the dental structure 6,9 . In the present study, 13 16 .…”

Section: Introduction Materials and Methodsmentioning

confidence: 99%

“…The pH meter accurate to 0.1 was first calibrated according to the manufacturer's instructions, using buffer standards of pH 7 and pH 4. As much as 10 mL of each medicine was placed in a beaker, the pH meter was immersed into the syrup and the value was recorded 8,9 .…”

Section: Ph Measurementmentioning

confidence: 99%

“…In practice, titratable acidity is measured potentiometrically with a standardized NaOH or KOH solution of a known concentration at a temperature of 20°C 8,9 . Although information on the type and amount of sugar contained in the medications are not easily assessed and/or provided, extensive carious lesions allied to long-term and highly frequent of ingestion of pediatric liquid oral medications may be a sufficiently serious argument to consider them as adverse effects of these medications 10 .…”

mentioning

confidence: 99%

“…A 10 mL aliquot of the diluted product was titrated (10% solution of the sample) with the 0.1 N KOH solution until the substance reached a pH value between 8.2-8.4, corresponding to the end-point of the phenolphthalein. Readings were done with a pH meter (TEC-2R; Tecnal, São Paulo, SP, Brazil) 8,9 . When this value was reached, the spent KOH volume was recorded and the acid percentage of the substance was calculated using the following equation, with the result being expressed as percentage of citric acid.…”

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confidence: 99%

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In vitro Evaluation of Different Physicochemical Properties of Pediatric Medicines

Cavalcanti¹,

VIEIRA²,

Souto³

et al. 2013

Pesq Bras Odontoped Clin Integr

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Objective: To evaluate in vitro the endogenous pH, the total titratable acidity (TTA) and o Brix of pediatric medicines. Method: The sample consisted of 22 pediatric medicines belonging to five classes: antibiotics, antihistamines, anthelmintics, non-steroid antiinflammatory drugs and corticoids. The pH was measured with a potentiometer, total acidity was obtained by the AOAC method and o Brix was determined by refractometry. The data were expressed as means and the differences among the groups were analyzed by ANOVA. The significance level was set at 0.05 with a 95% confidence level. Results: As much as 59.1% of the medicines presented pH lower than 5.5, being therefore potentially erosive to the dental tissues. Benflogin (1.75) and Predsim (7.35) presented the lowest and the highest pH means, respectively. As for TTA, the lowest mean was obtained for Cataflan (0.01%) and the highest for Infectrin (0.98%). Evaluation of o Brix revealed that Alersin presented the lowest mean (6.25%) and Cataflan (74.33%) presented the highest mean. There was no statistically significant difference among the medicine classes regarding the pH (p=0.950) or regarding the o Brix (p=0.477). On the other hand, there were statistically significant differences among the medicine classes for TTA (p=0.000); the greatest differences were found between the antibiotics and the anti-inflammatory drugs (p=0.002), the anthelmintics (p=0.003) and the corticoids (p=0.005). Conclusion:The pediatric medicines may be considered as potentially erosive to the dental tissues. In view of the statistically significant differences among the medicine classes regarding the TTA, it is recommended that the control and follow up be directed to the erosive potential of each class. The antibiotics are the class of medicine with the highest pH and acidity, and so its intake should be followed by an adequate oral hygiene. (74,33%). Não se verificou diferença estatisticamente significativa entre as variáveis pH e a classe de medicamento (P=0,950) e entre o °Brix e a classe de medicamento (P=0,477). Todavia, verificou-se diferenças estatisticamente significante em relação à acidez total e a classe de medicamento (P = 0,000), de modo que as diferenças maiores ficaram entre as médias dos antibióticos com: os antiinflamatórios (P=0,002), os antiparasitários (P=0,003) e os corticóides (P=0,005). Conclusão: Os medicamentos pediátricos analisados podem ser considerados potencialmente erosivos aos tecidos dentais. Em virtude das diferenças estatisticamente significativas entre as classes de medicamentos em relação à acidez total é necessário que o controle e o acompanhamento sejam direcionados ao potencial erosivo de cada classe, apontando os antibióticos como a classe com maiores médias de pH e acidez, devendo a sua administração ser controlada e acompanhada por uma adequada higiene oral. ABSTRACT RESUMO KEY-WORDS DESCRITORES 60Pesq Bras Odontoped Clin Integr, João Pessoa, 13(1):69-

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Section: Results Discussionmentioning

confidence: 99%

Section: Introduction Materials and Methodsmentioning

confidence: 99%

Section: Ph Measurementmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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In vitro Evaluation of Different Physicochemical Properties of Pediatric Medicines

Cavalcanti¹,

VIEIRA²,

Souto³

et al. 2013

Pesq Bras Odontoped Clin Integr

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The Effect of Usage of Antiasthmatic Inhalers on Color Stability and Surface Roughness of Dental Restorative Materials: An In Vitro Study

Subramaniam,

Bhat,

Gupta

et al. 2023

Eur J Dent

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Objectives Increased demand for esthetics by parents and children has resulted in the use of tooth-colored restorative materials. Children with chronic respiratory conditions like asthma use inhalers which have shown to affect the surface of restorative materials. Hence, the aim of the present study was to evaluate the effect of antiasthmatic inhalers on color stability and surface roughness of three restorative materials. Materials and Methods Forty samples each of three dental restorative materials: group A: glass ionomer cement (GIC), group B: alkasite restorative material, and group C: composite resins were prepared. Each group was further divided into two subgroups of 20 samples each according to the inhaler used. All the specimens were polished using polishing discs and stored in artificial saliva in order to simulate the oral environment. The baseline color value and surface roughness of all the samples were measured using a spectrophotometer and a profilometer, respectively. Group 1 and group 2 were exposed to 0.31 mg of salbutamol sulfate and 20 mg formoterol fumarate in combination with budesonide, respectively, for every 12 hours, for a period of 15 days following which the samples were evaluated for color changes and surface roughness. Statistical Analysis The data obtained was subjected to statistical analysis and level of significance was set at p < 0.05. Results Exposure to both the inhalers caused a change in color and surface roughness in all three restorative materials. There was a significant change in the color of GIC and composite resin (ΔE > 3.3), following exposure to both the inhalers (p < 0.05). The change in color of alkasite restorative material was not significant. A significant increase in the surface roughness of composite resin from 0.56 ± 0.14 to 0.67 ± 0.19 was seen following 15 days' exposure to formoterol in combination with budesonide inhaler (p < 0.05). Conclusion Following exposure, both the inhalers had an equal effect on color and surface roughness of all three restorative materials. Alkasite restorative material showed greater resistance to change in color and surface roughness when exposed to antiasthmatic inhalers, compared to GIC and composite resin. Thus, children who use inhalers and nebulizers should be advised to implement more precautionary oral hygiene measures and periodic dental visits.

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Erosive and cariogenicity potential of pediatric drugs: study of physicochemical parameters

et al. 2013

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BackgroundPediatric medications may possess a high erosive potential to dental tissues due to the existence of acid components in their formulations. The purpose was to determine the erosive and cariogenic potential of pediatric oral liquid medications through the analysis of their physicochemical properties in vitro.MethodsA total of 59 substances were selected from the drug reference list of the National Health Surveillance Agency (ANVISA), which belong to 11 therapeutic classes, as follows: analgesics, non-steroidal anti-inflammatory, corticosteroids, antihistamines, antitussives, bronchodilators, antibacterials, antiparasitics, antiemetics, anticonvulsants and antipsychotics. Measurement of pH was performed by potentiometry, using a digital pH meter. For the Total Titratable Acidity (TTA) chemical assay, a 0.1 N NaOH standard solution was used, which was titrated until drug pH was neutralized. The Total Soluble Solids Contents (TSSC) quantification was carried out by refractometry using Brix scale and the analysis of Total Sugar Content was performed according to Fehling’s method. In addition, it was analyzed the information contained in the drug inserts with regard to the presence of sucrose and type of acid and sweetener added to the formulations.ResultsAll drug classes showed acidic pH, and the lowest mean was found for antipsychotics (2.61 ± 0.08). There was a large variation in the TTA (0.1% - 1.18%) and SST (10.44% - 57.08%) values. High total sugar contents were identified in the antitussives (53.25%) and anticonvulsants (51.75%). As described in the drug inserts, sucrose was added in 47.5% of the formulations, as well as citric acid (39.0%), sodium saccharin (36.4%) and sorbitol (34.8%).ConclusionThe drugs analyzed herein showed physicochemical characteristics indicative of a cariogenic and erosive potential on dental tissues. Competent bodies’ strategies should be implemented in order to broaden the knowledge of health professionals, drug manufacturers and general consuming public about the risks from the consumption of medicines potentially harmful to dental tissues.

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<i>In vitro</i> Analysis of the Cariogenic and Erosive Potential of Pediatric Antitussive Liquid Oral Medications

Cited by 28 publications

References 22 publications

In vitro Evaluation of Different Physicochemical Properties of Pediatric Medicines

In vitro Evaluation of Different Physicochemical Properties of Pediatric Medicines

The Effect of Usage of Antiasthmatic Inhalers on Color Stability and Surface Roughness of Dental Restorative Materials: An In Vitro Study

Erosive and cariogenicity potential of pediatric drugs: study of physicochemical parameters

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