pH changes in dental plaque after using sugar-free pediatric medicine

The Effects of Different Pediatric Drugs and Brushing on the Color Stability of Esthetic Restorative Materials Used in Pediatric Dentistry: An In Vitro Study

The aim of the current study is to observe how different pediatric drugs and tooth brushing affect the color stability of different esthetic restorative materials. Three restorative materials (composite, compomer, and glass ionomer cement (GIC)) were each used to produce 72 specimens (10 mm × 2 mm). The specimens were divided into six groups and immersed in distilled water and five different pediatric drugs (amoxicillin, ibuprofen, ventolin, paracetamol, and multivitamins). Each group was divided into two subgroups (brushed and non-brushed). Over the course of two weeks, the specimens were agitated for one minute every eight hours. Color changes in all the specimens were evaluated using a spectrophotometer at 1 and 2 weeks. GIC showed a change in color that was significantly greater than that in all the other materials in each solution, except for those in amoxicillin. After a period of 1 to 2 weeks, the most noticeable change in color was detected in the amoxicillin composite and amoxicillin GIC unbrushed groups, and after 2 weeks, a significant difference was found in the ventolin GIC unbrushed group. The color stability of the restorative materials used in pediatric dentistry can be influenced by using popular liquid pediatric medications. GIC was the least color-stable material when subjected to liquid medications.

Knowledge, Attitude, and Practice of Pediatricians Regarding Pediatric Liquid Medicaments on Long-Term Oral Health: A Cross-sectional Study in Bhubaneswar, Odisha

Background

A pediatrician is supposed to be one of the first clinician who sees a child from infancy through adolescence. This study was carried for pediatricians serving in medical colleges and tertiary hospitals in Bhubaneswar City, Odisha, India.

Materials and Methods

A questionnaire was distributed among 30 pediatricians serving in various medical colleges and tertiary hospitals in Bhubaneswar City area. It consisted of questions regarding knowledge of pediatricians on the awareness of detrimental effects of long-term liquid medicaments use on oral cavity, including delivery of oral hygiene instructions and regular dental checkup. The data as obtained were subjected to statistical analysis using Statistical Package for the Social Sciences (SPSS) software, version 17.0, for Microsoft Windows (Chicago, Illinois).

Results

The results showed that there is a good amount of awareness among the pediatricians working in medical colleges in Bhubaneswar regarding pediatric liquid medication and their ill effects on teeth. Most pediatricians considered age and body weight of the child (87%). Sixty five percent of pediatricians were aware that pediatric liquid medication (PLM) can cause dental caries. Ninety five percent of them were aware of PLMs with sugar substitutes are available in market.

Conclusion

The overall awareness among the pediatricians regarding the ill effects of pediatric liquid medications on teeth is satisfactory.

Health outcomes of non-nutritive sweeteners: analysis of the research landscape

BACKGROUND

Food products containing non-nutritive sweeteners (NNSs) instead of sugar have become increasingly popular in the last decades. Their appeal is obviously related to their calorie-free sweet taste. However, with the dramatic increase in their consumption, it is reasonable and timely to evaluate their potential health benefits and, more importantly, potential adverse effects. The main aim of this scoping review was to map the evidence about health outcomes possibly associated with regular NNS consumption by examining the extent, range, and nature of research activity in this area.

METHODS

We systematically searched Ovid MEDLINE, EMBASE and the Cochrane CENTRAL databases for studies on NNSs (artificial sweeteners or natural, non-caloric sweeteners, either used individually or in combination) using text terms with appropriate truncation and relevant indexing terms. All human studies investigating any health outcomes of a NNS intervention or exposure were eligible for inclusion. No studies were excluded based on language, study design or methodological quality. Data for each health outcome were summarized in tabular form and were discussed narratively.

RESULTS

Finally, we included 372 studies in our scoping review, comprising 15 systematic reviews, 155 randomized controlled trials (RCTs), 23 non-randomized controlled trials, 57 cohort studies, 52 case-control studies, 28 cross sectional studies and 42 case series/case reports. In healthy subjects, appetite and short term food intake, risk of cancer, risk of diabetes, risk of dental caries, weight gain and risk of obesity are the most investigated health outcomes. Overall there is no conclusive evidence for beneficial and harmful effects on those outcomes. Numerous health outcomes including headaches, depression, behavioral and cognitive effects, neurological effects, risk of preterm delivery, cardiovascular effects or risk of chronic kidney disease were investigated in fewer studies and further research is needed. In subjects with diabetes and hypertension, the evidence regarding health outcomes of NNS use is also inconsistent.

CONCLUSIONS

This scoping review identifies the needs for future research to address the numerous evidence gaps related to health effects of NNSs use.It also specifies the research questions and areas where a systematic review with meta-analyses is required for the proper evaluation of health outcomes associated to regular NNSs consumption.

Effects of Different Pediatric Drugs on the Color Stability of Various Restorative Materials Applicable in Pediatric Dentistry

Background. The chronic recommendation of pediatric drugs could exhibit erosive and cariogenic problems. Objective. To evaluate the effects of different pediatric drugs on the color stability of various restorative materials. Methods. Five specimens (1 mm × 3 mm) were prepared and immersed in ten different pediatric drugs and agitated every 8 hours daily for 2 min up to 1 week. Between immersion periods, the samples were stored in artificial saliva. After 1-week period, ΔE^⁎ values were calculated. Two-way ANOVA and Fisher's LSD test were used for statistical analysis at a level of p < 0.05. Results. ΔE^⁎ values were only significantly influenced by restorative material factor (p < 0.001) and varied in the range of 2.08 and 6.55 units for all drugs/restorative materials. The highest ΔE^⁎ was found in Ferrosanol B-composite (6.55 ± 1.38) and the lowest one was found in Dolven-glass ionomer (2.08 ± 0.40) pairwise. The most prominent ΔE^⁎ value elevations were obtained in composite material compared to the compomer and/or glass ionomers in Macrol, Ferrosanol B, and Ventolin (p < 0.001; for all) and also for other drugs (p < 0.05). Dolven exhibited significantly higher values compared to Augmentin (p = 0.021), Macrol (p = 0.018), and Ventolin (p = 0.013) in compomer group. Conclusion. The clinically perceptible color changes for tested composite/pediatric drug pairwise can be more problematic than compomer and glass ionomers in pediatric dentistry.

Oral health concerns with sweetened medicaments: Pediatricians' acuity

BACKGROUND

Administration of sweetened medicaments poses many oral health related problems in children due to the lack of awareness among the pediatricians regarding their ill effects.

PURPOSE

To assess pediatricians' awareness and attitudes toward the use of liquid pediatric medicines and their relationship with dental caries and erosion.

MATERIALS AND METHODS

A cross-sectional descriptive study was conducted among the pediatricians residing in Nellore city. Data were obtained from 55 pediatricians using questionnaires.

RESULTS

Among the respondents, 95.6% prescribed liquid medicaments, 51.1% expressed that they may be associated with dental effects, 60% were not aware regarding the sweetness of medicaments, whereas majority of them (77.8%) opined that children complained regarding the taste, 73.3% stated that sugar substitutes were used as sweetening agents, 70.9% believed that they were not acidic, 68.9% did not recommend brushing after intake of medicines, 90% failed to deliver oral health instructions, and 54.5% believed that lack of oral hygiene was a contributing factor for development of dental caries.

CONCLUSION

Majority of the respondents prescribed liquid medicaments and were unaware regarding the sweetening agents and acidity, which cause ill effects on the dental hard tissues. Most of them neither recommended nor delivered oral hygiene instructions (OHI) after prescribing sweetened liquid medicaments. Hence, OHI should be delivered to enhance the oral health related quality of life in children.

Pediatric medicines and their relationship to dental caries

The aim of this study was to evaluate mothers' knowledge about the cariogenic potential of pediatric medicines. A total of 111 mothers were interviewed using a standardized form containing 15 questions relating to the association of pediatric drug use with dental caries and oral hygiene care. Descriptive and inferential statistics (Chi-square test and Fisher's exact) were used at a significance of 5%. Most of the mothers were aged 40 years or under (77.4%), high school educated (30.6%) and not working (50.5%). The association between medication use and dental caries or defects in teeth structure was mentioned by 35 (43.2%) mothers, 33 of whom (40.7%) cited this was due to the presence of sugar in the formulations. Only 32 mothers (28.8%) performed oral hygiene for the child after drugs ingestion, although 81.1% (n = 90) had never received guidance on the importance of this practice. The type of occupation and maternal education level were not significant in these issues (p> 0.05). Pediatric medicines can create problems for the teeth and a high percentage of mothers are unable to establish a clear cause and effect relationship with this association. Therefore, the pharmaceutical industry needs to be more aware of this and should prepare pediatric medicines without the presence of sucrose.

Teat tablet with sodium ibuprofen: the effect of sorbitol on therapeutic agent pharmaceutical availability and on physicochemical parameters of a drug form

Dosing pediatric drugs available on pharmaceutical markets of analgesic, antifebrile and anti-inflammatory activity to children up to 3 years of age is not precise and frequently causes problems. The aim of the study was to work out a pediatric teat form of a drug with sodium ibuprofen and to determine the effect of sorbitol content on pharmaceutical availability of the therapeutic agent. Three variants of tablets containing 50 mg of sodium ibuprofen differing in the percentage content of sorbitol (from 37% - batch I to 79% - batch III) were produced. Quality tests of the produced forms of drugs (PPVI) were performed and the tests of therapeutic agent pharmaceutical availability by spatula method and by a method with a teat. Tablets of all batches had a smooth surface and same shape. The content of the therapeutic agent was within the limit of 95-105% of the declared value. The highest value of Q coefficient in the release test by pharmacopeal method and the shortest disintegration time (12 minutes) were obtained for tablets with 79% content of sorbitol. In conclusion, teat tablets with sodium ibuprofen of the highest sorbitol content (79%) demonstrated the expected physicochemical parameters and high pharmaceutical availability.

[Perceptions and attitudes among parents and guardians on the use of pediatric medicines and their cariogenic and erosive potential]

The study assesses the perceptions of parents/guardians on the use of pediatric medicines and their cariogenic/erosive potential, interviewing them on the relationship between the use of pediatric medicines and cavities/dental erosion, as well as oral hygiene procedures after the medication. Among the interviewed parents/guardians (n=86), 24 (27.9%) mentioned the sour taste of pediatric medication, 51 (59.3%) the bitter taste, and 56 (65.1%) considered them sweet, although only 16 (28.6%) of these parents/guardians brushed their children's teeth after the medication (Fisher's Exact; p>0.05). Moreover, only 18 (20.9%) of the parents/guardians performed oral hygiene practices after the medication, of whom 8 (44.4%) received previous instructions (Fisher's Exact; p<0.05). The association between taking medications and dental caries or structural dental defects was mentioned by 61 (70.9%) of the parents/guardians, with 24 (39.3%) of them justifying this association through the presence of sugar in the formulations. Although parents/guardians consider medicines to be sweet substances and relate their use to dental caries and tooth structure flaws, most of them do not brush their children's teeth after taking medications and are unable to establish a clear cause/effect relationship for this association.