Effect of dietary combinations on plaque pH recovery after the intake of pediatric liquid analgesics

Evaluation of the Erosive and Cariogenic Potential of Over-the-Counter Pediatric Liquid Analgesics and Antipyretics

To evaluate the cariogenic and erosive potentials of over-the-counter pediatric oral liquid antipyretics and analgesics, we tested nine over-the-counter pediatric oral liquid medications classified as antipyretic or analgesic medicines available in Korea. For each substance, we measured the pH with a pH meter and the sugar content with a sugar content meter. We determined the titratable acidity (TA) levels based on the volumes of NaOH solution that had to be added to reach a pH of 7.0. We also evaluated the dental erosion potentials with an International Organization for Standardization method based on observing changes in the pH of a CaPO₄ solution upon introducing a small volume of the solution to be tested. The oral liquid medications had pH values of 3.40–5.68. In the TA assessments, several oral liquid medications required greater volumes of NaOH solution to reach a pH of 7.0. The dental erosion potentials varied but correlated strongly with the NaOH volumes needed to reach a neutral pH (r = 0.84; p < 0.0001). Many oral liquid antipyretics and analgesics have features that can promote dental erosion. A correct understanding of pediatric antipyretics and analgesics is required in dentistry for children’s oral health.

Rinsing with water for 1 min after milk formula increases plaque pH

PURPOSE

Parents find it challenging to follow recommendations to brush young children after feeds at night despite the increase caries risk. This study compared three clinical recommendations (dilution, rinsing and wiping) on plaque pH after formula consumption.

METHODS

Eighteen subjects were recruited. The five interventions with 2-week washout between visits included: Rinse with undiluted formula for 30 s (UF); rinse with 50% diluted formula for 30 s (DF); rinse with undiluted formula for 30 s, followed by rinsing with water for 1 minute (UF/R); rinse with undiluted formula for 30 s, followed by wiping (UF/W); rinse with 10% sucrose for 30 s as control (C). Plaque samples were collected at baseline, 2, 5, 10, 20 and 30 min after the intervention and pH measured using the plaque sampling method.

RESULTS

UF/R resulted in significantly smaller pH drops at 5, 10 and 20 min compared to UF. It also resulted in higher minimum pH (UF/R: 6.34 ± 0.36 Vs UF: 6.06 ± 0.40, p = 0.02), smaller maximum pH drop (UF/R: 0.63 ± 0.35 Vs UF: 0.90 ± 0.49, p = 0.03), smaller sum of change of hydrogen ion concentration (UF/R: 9.22 × 10^-7 ± 7.8 × 10^-7 Vs UF: 2.30 × 10^-6 ± 2.6 × 10^-6, p = 0.04), and smaller area under the curve (UF/R: 7.70 ± 5.44 Vs UF: 13.44 ± 9.44, p = 0.02). DF and UF/W did not result in any significant pH change compared to UF.

CONCLUSIONS

Of the three clinical recommendations, only rinsing with water for 1 min after undiluted formula reduced plaque acidogenicity. Teeth wiping with a moist cloth and 50% dilution of infant formula did not have an effect on plaque acidity.

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.

Anticariogenic potential of white cheese, xylitol chewing gum, and black tea

Objective

This study aimed to examine the effects of these foods on plaque pH and the potential development of tooth decay.

Materials and Methods

Plaque pH was measured using the sampling method before and after 1, 5, 10, 20, 30, 45, and 60 min following consumption of these foods individually and after rinsing with a 10% sucrose solution. Statistical analysis was performed using one-way ANOVA and Tukey honestly significant difference post hoc tests (α = 0.05).

Results

Although there were statistically significant differences in all test groups except the BT (P = 0.620) and sucrose + XCG (P = 0.550) groups in time, none of the participants chosen for this study were having a plaque pH value anywhere close to the critical value (pH = 5.5).

Conclusion

WC, BT, and XCG are advisable as anticariogenic foods because pH values are not below critical value.

Knowledge, attitude, and practice of pediatricians regarding pediatric liquid medicaments

OBJECTIVE

To assess the knowledge, attitude, and practice of pediatricians regarding pediatric liquid medicaments (PLMs) and its effect on dental health.

MATERIALS AND METHODS

A convenience sample of 103 pediatricians was asked to answer a questionnaire.

RESULTS

A total number of 87 pediatricians completed the questionnaires. They considered age and body weight of the child (58%), cost of the medicine (40%), and pharmaceutical company (37%) to be relevant while prescribing. Eighty-eight percent of pediatricians knew that the PLM was sweet in nature. Sixty-seven percent of pediatricians stated that pH of PLM is responsible for deleterious effect on teeth. Seventy-two percent of pediatricians were aware of hidden sugars present in PLM. Only 48% of pediatricians were aware of availability of sugar-free medicine. Seventy percent of pediatricians were of the opinion that sugar-free medicine is not as sweet as sugar-containing medicines and is more expensive (65%).

CONCLUSION

Knowledge, attitude, and practice of pediatricians regarding PLMs and its effect on dental health were not satisfactory.

Frequency of sucrose exposure on the cariogenicity of a biofilm-caries model

OBJECTIVE

Although sucrose is considered the most cariogenic carbohydrate in the human diet, the question of how many exposures are needed to induce damage on the hard dental tissues remains unclear. To approach this question, different frequencies of daily sucrose exposure were tested on a relevant biological caries model.

MATERIALS AND METHODS

Biofilms of the Streptococcus mutans were formed on enamel slabs and exposed to cariogenic challenges with 10% sucrose for 5 min at 0, 1, 3, 5, 8, or 10 times per day. After 5 days, biofilms were retrieved to analyze biomass, protein content, viable bacteria, and polysaccharide formation. Enamel demineralization was evaluated by percentage of microhardness loss (percentage surface hardness loss [%SHL]).

RESULTS

Biomass, protein content, polysaccharide production, acidogenicity of the biofilm, and %SHL proportionally increased with the number of daily exposures to sucrose (P < 0.05). One daily sucrose exposure was enough to induce 20% more demineralization than the negative unexposed control. Higher frequencies induced greater demineralization and more virulent biofilms, but eight and ten exposures were not different between them in most of the analyzed variables (P > 0.05).

CONCLUSIONS

Higher sucrose exposure seems to increase cariogenicity, in a frequency-dependent manner, by the modification of bacterial virulent properties.