Oral health concerns with sweetened medicaments: Pediatricians' acuity

Estimation of the Efficacy of Remineralizing Agents on the Microhardness of Deciduous Teeth Demineralized Using Pediatric Formulations

AIM

This study aimed to evaluate the demineralizing effect of commonly used pediatric syrup formulations on primary teeth and the efficacy of two readily available remineralizing agents in treating this effect.

MATERIALS AND METHODS

Ninety primary teeth were used for sample preparation and divided into three groups: antibiotic syrup (group A), cough syrup (group B), and control (group C) groups. These groups were further categorized into intragroups according to the treatment with remineralizing agents: groups A1, B1, and C1 received GC Tooth Mousse (casein phosphopeptide-amorphous calcium phosphate, CPP-ACP paste) and groups A2, B2, and C2 received Clinpro Tooth Crème. The samples were subjected to a series of demineralization cycles for 14 days, and remineralization cycles until 30 days were performed using two remineralizing agents, that is, GC Tooth Mousse (CPP-ACP paste) and Clinpro Tooth Crème and were evaluated using Vicker's microhardness test.

RESULTS

Antibiotic syrup (group A) and cough syrup (group B) showed a significant decrease in surface microhardness compared with control (group C). All intragroups showed an increase in surface microhardness after treatment with remineralizing agents, which was significantly higher in intragroups A1, B1, and C1 treated with GC Tooth Mousse (CPP-ACP paste).

CONCLUSIONS

Oral liquid medications showed definite demineralization potential. CPP-ACP paste was found to be better than Clinpro Tooth Crème for demineralized teeth.

CLINICAL SIGNIFICANCE

The use of over-the-counter drugs has increased among the average Indian population, especially for the treatment of fever, cold, and cough. Unwise use of medications by the present population without proper medical guidance will lead to irreparable changes in future generations.

Clinical Study of the Change of pH Level in the Supragingival Plaque in Children after Taking Homeopathic Remedies

Objective: There are numerous publications on the parameters of conventional medications, which contribute to their cariogenic and erosive potential. Little is known about the homeopathic remedies (HR) and the changes in the oral cavity they lead to, especially during childhood.

Material and methods: The study involved 25 children (5-9 years of age). It monitored the change in plaque pH level after intake of three frequently used homeopathic remedies in five consecutive weeks. The pH level values were measured after the administration of the remedies, without HR intake, and after rinsing with 10% sucrose solution. Five groups were formed – two controls and three groups with results from the tested HR.

Results: A drop in the plaque pH level was observed after intake of all HR and in all tested individuals. The biggest decrease was observed at the 15th minute for all HR. At the 30th minute the greatest decrease was observed with the second remedy, and at 60th minute – with the first and second.

Conclusions: A dramatic decrease in the plaque pH level was observed after intake of each studied remedy. In many cases the drop was below the critical value of pH = 5.5. The low plaque pH values were maintained even at the 60th minute after the start of the study.

Dental attendance, restoration and extractions in adults with intellectual disabilities compared with the general population: a record linkage study

BACKGROUND

Oral health may be poorer in adults with intellectual disabilities (IDs) who rely on carer support and medications with increased dental risks.

METHODS

Record linkage study of dental outcomes, and associations with anticholinergic (e.g. antipsychotics) and sugar-containing liquid medication, in adults with IDs compared with age-sex-neighbourhood deprivation-matched general population controls.

RESULTS

A total of 2933/4305 (68.1%) with IDs and 7761/12 915 (60.1%) without IDs attended dental care: odds ratio (OR) = 1.42 [1.32, 1.53]; 1359 (31.6%) with IDs versus 5233 (40.5%) without IDs had restorations: OR = 0.68 [0.63, 0.73]; and 567 (13.2%) with IDs versus 2048 (15.9%) without IDs had dental extractions: OR = 0.80 [0.73, 0.89]. Group differences for attendance were greatest in younger ages, and restoration/extractions differences were greatest in older ages. Adults with IDs were more likely prescribed with anticholinergics (2493 (57.9%) vs. 6235 (48.3%): OR = 1.49 [1.39, 1.59]) and sugar-containing liquids (1641 (38.1%) vs. 2315 (17.9%): OR = 2.89 [2.67, 3.12]).

CONCLUSION

Carers support dental appointments, but dentists may be less likely to restore teeth, possibly extracting multiple teeth at individual appointments instead.

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.

Sweetener content and cariogenic potential of pediatric oral medications: A literature

Sweetened oral medications are widely used for children to facilitate compliance. A variety of natural and artificial sweeteners are used in these drug formulations to augment the sweetness and thereby palatability of the product. There is growing concern among dentists about the increased consumption of sugars in these medications by children, especially those who are chronically ill as it may contribute to diabetes mellitus, dental erosion, and dental caries. This literature review provides information about the sweetener content and cariogenic potential of commonly prescribed pediatric oral medications that are used for managing acute and chronic conditions in children and measures for oral health prevention.

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.