Dental and Medical Problems
2018, vol. 55, nr 3, July-September, p. 247–254
doi: 10.17219/dmp/91539
Publication type: original article
Language: English
License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)
Download citation:
Erosive and cariogenic potential of various pediatric liquid medicaments on primary tooth enamel: A SEM study
Erozyjny i próchnicotwórczy potencjał wybranych płynnych leków pediatrycznych w odniesieniu do szkliwa zębów mlecznych – badanie w mikroskopii elektronowej
1 Department of Oral Biology, Faculty of Oral and Dental Medicine, Suez Canal University, Ismailia, Egypt
2 Department of Pediatric Dentistry, Faculty of Oral and Dental Medicine, Cairo University, Egypt
Abstract
Background. Oral pediatric liquid medications (PLMs) are commonly used in children who suffer from chronic diseases. The physicochemical parameters of PLMs can have a deleterious effect on tooth structure.
Objectives. The purpose of the present study was to investigate the erosive and cariogenic effect of widespread PLMs on the surface roughness and structure of primary tooth enamel.
Material and Methods. The erosive potential of 8 common PLMs used in Egypt was assessed by measuring their inherent pH, using a digital pH electrode meter. The total sugar content was measured according to the Fehling method. The erosive effect of each liquid medicine on the enamel surface of primary teeth was assessed using scanning electron microscopy (SEM) and energy dispersive X-ray (EDX) microanalysis for calcium (Ca) and phosphorus (P) content.
Results. Most PLMs revealed an acidic nature, with pH values ranging between 3.47 and 6.92. About 93.8% of analgesics had pH values ≤5.5, critical for enamel demineralization, whereas most antitussives and 1 antibiotic (Augmentin®) had pH values ≥6.2. Sucrose was present in all the samples studied. The SEM analysis revealed observable differences in the tooth enamel in the experimental groups, with different degrees of surface roughness and erosion.
Conclusion. The current results suggest that the pH, sugar content and Ca dissolution ability of PLMs can significantly influence erosion in primary tooth enamel.
Key words
scanning electron microscopy, primary teeth, dental erosion, caries, pediatric liquid medications
Słowa kluczowe
skaningowy mikroskop elektronowy, zęby mleczne, erozja zębów, próchnica, płynne leki pediatryczne
References (34)
- Sharma A, Deshpande S. Effect of sucrose in different commonly used pediatric medicines upon plaque pH in human subjects. J Ind Soc Pedod Prev Dent. 2011;29(2):144–148.
- Lussi A, Megert B, Shellis RP, Wang X. Analysis of the erosive effect of different dietary substances and medications. Br J Nutr. 2012;107(2):252–262.
- Babu KL, Rai K, Hedge AM. Pediatric liquid medicaments: Do they erode the teeth surface? An in vitro study: Part I. J Clin Pediatr Dent. 2008;32(3):189–194.
- Nunn JH, Ng SK, Sharkey I, Coulthard M. The dental implications of chronic use of acidic medicines in medically compromised children. Pharm World Sci. 2001;23(3):118–129.
- Bigeard L. The role of medication and sugars in pediatric dental patients. Dent Clin North Am. 2000;44(3):443–456.
- Pierro VS, Abdelnur JP, Maia LC, Trugo LC. Free sugar concentration and pH of paediatric medicines in Brazil. Community Dent Health. 2005;22(3):180–183.
- Maguire A, Baqir W, Nunn JH. Are sugars-free medicines more erosive than sugars containing medicines? An in vitro study of paediatric medicines with prolonged oral clearance used regularly and long-term by children. Int J Paediatr Dent. 2007;17(4):231–238.
- Pomarico L, Czauski G, Portela MB, et al. Cariogenic and erosive potential of the medication used by HIV-infected children: pH and sugar concentration. Community Dent Health. 2008;25(3):170–172.
- Nankar M, Walimbe H, Ahmed Bijle MN, Kontham U, Kamath A, Muchandi S. Comparative evaluation of cariogenic and erosive potential of commonly prescribed pediatric liquid medicaments: An in vitro study. J Contemp Dent Pract. 2014;15(1):20–25.
- Xavier AFC, Moura EF, Azevedo WF, Vieira FF, Abreu MH, Cavalcanti AL. Erosive and cariogenicity potential of pediatric drugs: Study of physicochemical parameters. BMC Oral Health. 2013;13:71.
- Saeed S, Bshara N, Trak J, Mahmoud G. An in vitro analysis of the cariogenic and erosive potential of pediatric liquid analgesics. J Indian Soc Pedod Prev Dent. 2015;33(2):143–146.
- Gupta M, Panda S. Cariogenic potential of the commonly prescribed pediatric liquid medicaments in the Kingdom of Saudi Arabia: An in vitro study. J Contemp Dent Pract. 2017;18(4):307–311.
- Shaw L, Glenwright HD. The role of medications in dental caries formation: Need for sugar-free medication for children. Paediatrician. 1989;16(3–4):153–155.
- Neves BG, Pierro VS, Maia LC. Perceptions and attitudes among parents and guardians on the use of pediatric medicines and their cariogenic and erosive potential [in Portuguese]. Cien Saude Colet. 2007;12(5):1295–1300.
- Peres KG, Oliveira CT, Peres MA, Raymundo Mdos S, Fett R. Sugar content in liquid oral medicines for children. Rev Saude Publica. 2005;39(3):486–489.
- Lane JH, Eynon L. Determination of reducing sugars by means of Fehling’s solution with methylene blue as internal indicator. J Soc Chem Ind Trans. 1923:32–36. Cited from: Cavalcanti AL, Sousa RIM, Clementino MA, Vieira FF, Cavalcanti CL, Xavier AFC. In vitro analysis of the cariogenic and erosive potential of paediatric antitussive liquid oral medications. Tanzan J Health Res. 2012;14(2):1–8.
- Cavalcanti AL, Sousa RIM, Clementino MA, Vieira FF, Cavalcanti CL, Xavier AFC. In vitro analysis of the cariogenic and erosive potential of paediatric antitussive liquid oral medications. Tanzan J Health Res. 2012;14(2):1–8.
- Passos IA, Sampaio FC, Martínez CR, Freitas CHM. Sucrose concentration and pH in liquid oral pediatric medicines of long-term use for children. Rev Panam Salud Publica. 2010;27(2):132–137.
- Cavalcanti AL, Fernandes LV, Barbosa AS, Vieira FF. pH, titratable acidity and total soluble solid content of pediatric antitussive medicines. Acta Stomatol Croat. 2008;42(2):164–170.
- Sunitha S, Prashanth GM, Shanmukhappa, Chandu GN, Subba Reddy VV. An analysis of concentration of sucrose, endogenous pH, and alteration in the plaque pH on consumption of commonly used liquid pediatric medicines. J Indian Soc Pedod Prev Dent. 2009;27(1):44–48.
- Rekola M. In vivo acid production from medicines in syrup form. Caries Res. 1989;23(6):412–416.
- Costa CC, Almeida IC, Raymundo MS, Fett R. Analysis of the endogenous pH, acidity and sucrose concentration in pediatric medicines. Rev Odonto Ciênc. 2004;19:164–169.
- Marquezan M, Marquezan M, Pozzobon RT, Oliveira MDM. Medicines used by pediatric dentistry patients and its cariogenic potential. RPG Rev Pós Grad. 2007;13(4):334–339.
- Neves BG, Farah A, Lucas E, Sousa VP, Maia LC. Are paediatric medicines risk factors for dental caries and dental erosion? Community Dent Health. 2010;27(1):46–51.
- Tupalli AR, Satish B, Shetty BR, Battu S, Kumar JP, Nagaraju B. Evaluation of the erosive potential of various pediatric liquid medicaments: An in vitro study. J Int Oral Health. 2014;6(1):59–65.
- Scatena C, Galafassi D, Gomes-Silva JM, Borsatto MC, Serra MC. In vitro erosive effect of pediatric medicines on deciduous tooth enamel. Braz Dent J. 2014;25(1):22–27.
- Johansson AK, Sorvari R, Birkhed D, Meurman JH. Dental erosion in deciduous teeth – an in vivo and in vitro study. J Dent. 2001;29(5):333–340.
- Shellis RP, Featherstone JD, Lussi A. Understanding the chemistry of dental erosion. Monogr Oral Sci. 2014;25:163–179.
- Barbour ME, Parker DM, Allen GC, Jandt KD. Enamel dissolution in citric acid as a function of calcium and phosphate concentrations and degree of saturation with respect to hydroxyapatite. Eur J Oral Sci. 2003;111(5):428–433.
- Attin T, Meyer K, Hellwig E, Buchalla W, Lennon AM. Effect of mineral supplements to citric acid on enamel erosion. Arch Oral Biol. 2003;48(11):753–759.
- West NX, Hughes JA, Addy M. The effect of pH on the erosion of dentine and enamel by dietary acids in vitro. J Oral Rehabil. 2001;28(9):860–864.
- Hunter M, West N, Hughes J, Newcombe R, Addy M. Erosion of deciduous and permanent dental hard tissues in the oral environment. J Dent. 2000;28(4):257–263.
- Dawes C. What is the critical pH and why does a tooth dissolve in acid? J Can Dent Assoc. 2003;69(11):722–724.
- Hemingway CA, Parker DM, Addy M, Barbour ME. Erosion of enamel by non-carbonated soft drinks with and without toothbrushing abrasion. Br Dent J. 2006;201(7):447–450.