Pediatric liquid medicaments - Are they cariogenic? An in vitro study

Babu, K L Girish; Doddamani, Geeta Maruti; Naik, L R Kumaraswamy; Jagadeesh, KN

doi:10.4103/2231-0762.137637

Cited by 17 publications

(13 citation statements)

References 21 publications

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“…There is also a low level of awareness among pediatricians and pharmacists about the relationship of sweetened medicines and dental caries [31][32][33][34][35][36] In a survey conducted in Northen Ireland, just more than 17 percent of children are always provided with sugarfree liquid medicines. 37 The medical status of children is the only condition that influences pediatricians in making the decision to prescribe sugar-free medications (SFMs). 19 Specific campaigns to encourage the use of SFMs and further increase in their availability for all types of disease should be sought from manufacturers.…”

Section: Discussionmentioning

confidence: 99%

Relationship between pediatric liquid medicines (PLMs) and dental caries in chronically ill children

Goyal

Rani²,

Manjunath

et al. 2019

Padjadjaran J Dent

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Introduction: Purpose of this research is to assess the relationship between long-term pediatric liquid medicines (PLMs) consumption and dental caries in 2–12-years-old chronically ill children. Methods: A cross-sectional study was performed in a public pediatric hospital in India for a period of 6 months. A total of 455 children aged 2–12 years old with various chronic diseases who were receiving PLMs for more than 6 months were selected as the subjects in this study and compared with 531 children of similar age group and diseases who received other forms of medication. Dental caries was measured by DMFT/dmft and data collected were analyzed with SPSS (17th version) using statistical tests such as t-test and one-way ANOVA. Univariable logistic regression was used where the significance was fixed at a a p value of less than 0.001. Results: Children on PLMs had an increased risk of dental caries than those on other forms of medications (OR: 3.142, 95% CI: 2.37–4.15, p < 0.001). The prevalence of dental caries was higher (77.8%) in children consuming PLMs when compared to other forms of medication (52.7%). The mean DMFT and dmft scores were significantly higher in the study group when compared to the control group (p = 0.001). Conclusion: Long-term consumption of pediatric liquid medicines containing sucrose as a risk factor for dental caries among chronically ill children. sugar free options has to be used during prescription to prevent medication-triggered caries.Keywords: Paediatric liquid medicine, medication-triggered caries, sugar-free medication

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Section: Discussionmentioning

confidence: 99%

Relationship between pediatric liquid medicines (PLMs) and dental caries in chronically ill children

Goyal

Rani²,

Manjunath

et al. 2019

Padjadjaran J Dent

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“…Uma droga analisada apresentou pH básico de 9,60, (Fenobarbital), distante daquele valor considerado crítico para erosão. Girish Babu et al 9 e Nankar et al 10 também encontraram medicamentos com pH básico que variavam de 7,36 a 7,71. É importante salientar que o pH não é o suficiente para determinar o potencial erosivo 9 .…”

Section: Microscopia Eletrônica De Varreduraunclassified

“…A dificuldade e a falta de higienização bucal devido à disfunção motora dos pacientes com PC, e o alto grau de dependência em relação ao seu responsável podem ser um fator influenciador e agravante na condição de saúde bucal desses indivíduos frente ao potencial erosivo e cariogênico dessas drogas 1,7 . Um grande número de estudos tem apresentado preocupação com medicamentos de uso pediátrico devido à quantidade de açúcar, ao baixo pH endógeno e aos possíveis efeitos erosivos e cariogênicos [8][9][10][11][12][13] . Várias formulações farmacêuticas para uso infantil foram investigadas in vitro, em vários países do mundo, como antibiótico [9][10][11][12] , antifúngico 11 , analgésico 9,10,12 , anti-inflamatório 12 , suplemento vitamínico 9,10 , antirretroviral 11 , anti-histamínico 9,10,12,13 e anticonvulsivante 10 .…”

Section: Introductionunclassified

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Efeito sobre a morfologia do esmalte dental e análise físico-química de medicamentos utilizados por pacientes pediátricos com paralisia cerebral

Alves

Cardoso

Cavalcanti

et al. 2016

Rev. odontol. UNESP

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Efeito sobre a morfologia do esmalte dental e análise físico-química de medicamentos utilizados por pacientes pediátricos com paralisia cerebral ResumoIntrodução: Muitos medicamentos pediátricos líquidos são considerados fatores de risco para a estrutura dentária. Esse potencial pode aumentar quando ingeridos de forma crônica, como é o caso do tratamento de algumas condições, tal como a paralisia cerebral. Objetivo: Avaliar o efeito sobre a morfologia do esmalte dental e as propriedades físico-químicas de medicamentos de uso contínuo indicados a pacientes infantis com Paralisia Cerebral. Material e método: A amostra foi constituída por quatro medicamentos: Fenobarbital (M1), Carbamazepina (M2), Oxcarbazepina (M3) e Domperidona (M4), todos em suspensão oral. Analisaram-se o pH, o teor de Sólidos Solúveis Totais (SST) e a viscosidade dos medicamentos. Todos os testes foram realizados em duplicata. Para análise em microscopia eletrônica de varredura (MEV), 15 blocos de esmalte bovino foram distribuídos aleatoriamente e imersos em oxcarbamazepina (n=5), carbamazepina (n=5) e saliva artificial (n=5). Os ciclos de imersão foram feitos por seis dias, durante cinco minutos, duas vezes ao dia, com intervalos de 12 horas, quando ficavam mantidos em saliva artificial. O grupo controle permaneceu em saliva artificial. Os dados foram analisados descritivamente. Resultado: Em relação ao pH endógeno, os valores variaram de 2,82 (M3) a 9,60(M1). Para o SST, as médias de maior e menor valor foram, respectivamente, de 20,5% (M3) e 46% (M1). A viscosidade variou de 6,89 mm 2 /s (M1) a 58 mm 2 /s (M3). Em MEV, observaram-se alterações sugestivas de perda de estrutura no esmalte dental em oxcarbamazepina e carbamazepina, proveniente da ação dos medicamentos analisados. Conclusão: Concluiu-se que os medicamentos líquidos pediátricos analisados, indicados a pacientes com paralisia cerebral, apresentam potencial cariogênico e erosivo, destacando-se a Oxcarbazepina.Descritores: Paralisia cerebral; uso de medicamentos; erosão dentária; cárie dentária. AbstractIntroduction: Many liquid pediatric medicines are considered risk factors for tooth structure. This potential may increase when taken chronically as is the case of some conditions such as cerebral palsy. Objective: To evaluate the effect on the morphology of dental enamel and the physicochemical properties of continuous use of drugs given to pediatric patients with cerebral palsy. Material and method: The sample consisted of three drugs for epilepsy: Phenobarbital (D1), Carbamazepine (D2), Oxcarbazepine (D3); and one drug for gastroesophageal reflux: Domperidone (D4). All in oral suspension. The pH, content of total soluble solids (TSS), and viscosity of the drugs were analyzed. The tests were made two measurements. For SEM analysis, 15 bovine enamel blocks were randomly distributed and immersed in oxcarbazepine (n=5); carbamazepine (n=5); and artificial saliva (n=5). The immersion cycles were made for 6 days, during 5 minutes, 2 times a day with intervals of 12 hours, when they we...

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“…However, frequent use of syrups sweetened with sucrose or fructose or with a combination of both has been linked to dental caries and a drop of plaque pH in the long term [ 15 , 16 , 17 , 18 , 19 , 20 ], and the cariogenic potential of paediatric liquid medicines is probably the result of a high concentration of fermentable carbohydrates and their acidogenicity [ 21 ]. It has been reported in one study that about half of 97 regularly-used paediatric medication formulations have an endogenous pH below 5.5 and thus are capable of damaging tooth enamel [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Paediatric Over-the-Counter (OTC) Oral Liquids Can Soften and Erode Enamel

et al. 2017

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This study investigated the softening and erosive effects of various paediatric over-the-counter (OTC) oral liquids on deciduous teeth. Twenty sectioned and polished deciduous enamel blocks were ground on the buccal surface (2 × 2 mm2) and randomly divided into five groups, immersed into four commercially-available paediatric OTC oral liquids (two for paracetamol, both sugared; and two for chlorpheniramine, one sugared and one sugar-free), with deionized water as control. The pH of the oral liquids ranged from 2.50 to 5.77. Each block was immersed into the test or control groups for 15 s, rinsed with deionized water, and Vickers micro-hardness (n = 5) was measured. After twenty cycles of immersion and hardness measurements, Scanning Electron Microscope (SEM) and Energy Dispersive X-ray Spectrometry (EDS) were used to evaluate the surface morphology and chemistry of the tooth blocks, respectively. The pH values of the liquids were also recorded. Rapidly descending trends in the micro-hardness ratios of the four test groups were observed that were statistically different from the control group (p < 0.001). EDS showed an increase of Ca/C ratio after drug immersion, whereas SEM showed an enamel loss in all the test groups. Paediatric OTC oral liquids could significantly soften the enamel and render them more susceptible to caries, such that the formulation of the oral liquids is the major factor.

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Pediatric liquid medicaments - Are they cariogenic? An in vitro study

Cited by 17 publications

References 21 publications

Relationship between pediatric liquid medicines (PLMs) and dental caries in chronically ill children

Relationship between pediatric liquid medicines (PLMs) and dental caries in chronically ill children

Efeito sobre a morfologia do esmalte dental e análise físico-química de medicamentos utilizados por pacientes pediátricos com paralisia cerebral

Paediatric Over-the-Counter (OTC) Oral Liquids Can Soften and Erode Enamel

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