Evaluation of cariogenic and erosive potential of prescribed pediatric medicaments in Northeast of Turkey: An in vitro study

Abstract

Aim: To purpose of the present study is to evaluate in vitro the cariogenic and erosive potential of the medicaments prescribed for pediatric use in the Northeastern Region of Turkey. Material and Methods: In the present study, 30 different medicaments of 14 different drug groups were selected among the medicaments prescribed by pediatricians. The pH, Total Titration Acidity (TTA), Total Soluble Solid Content (TSSC), Total Sugar Content (TSC) of the medicaments were measured. The data obtained in this way were analyzed by using the SPSS Statistics Software. The Pearson Chi-Square Test was used in all groups when comparing the pH, TTA and TSSC values. Results: It was determined that the median pH values of the medicaments that were tested ranged between 3.11 and 7.62; and 53.3 % of the medicaments had pH levels below the critical median value (5.5). It was found that the TTA values were low in all groups according to the median value. The highest TTA value was measured 23.8770 and the second was 22.9540.The lowest TSSC was found to be 1.3320, and the highest TSSC was 1.4450. Sugar content was detected in 33 % of the medicaments that were used in total sugar content analysis. Conclusions: The medicaments that were analyzed showed physical chemical properties showing cariogenic and erosive potentials in dental tissues. In this respect, healthcare professionals, drug manufacturers, and parents must be informed about the risks caused by the consumption of potentially harmful medicaments in dental tissues.

Keywords

• Erosion
• Enamel
• Oral liquid medicament

Türkiye'nin Kuzeydoğusunda reçete edilen pediatrik ilaçların karyojenik ve aşındırıcı potansiyelinin değerlendirilmesi: Bir in vitro çalışma

Abstract

Amaç: Çalışmanın amacı, Türkiye Kuzeydoğu bölgesinde pediatrik kullanım için reçete edilen ilaçların karyojenik ve eroziv potansiyelini in vitro olarak değerlendirilmesidir. Gereç ve yöntem: Çalışmada pediatristler tarafından reçete edilen ilaçlar arasından 14 farklı ilaç grubuna ait 30 farklı ilaç seçildi. İlaçların pH, total titrasyon asitliği (TTA), toplam çözünebilir katı içeriği (TSSC), toplam şeker içeriği (TSC) ölçüldü. Elde edilen veriler SPSS istatistik yazılımı kullanılarak analiz edildi. Tüm gruplarda pH ve TTA, TSSC değerleri açısından karşılaştırma yapılırken Pearson ki-kare testi uygulandı. Bulgu:Test edilen ilaçların pH ortanca değerleri 3.11 ile 7.62 arasında değiştiği; ilaçların % 53.3’nün pH ortanca değerinin kritik pH (5.5) in altında olduğu tespit edildi. Ortanca değere göre TTA değerleri tüm gruplarda düşük olarak bulgulandı. En yüksek TTA değeri 23.8770 ve ikinci olarak 22.9540 olarak ölçüldü. En düşük TSSC değerinin 1.3320 ve en yüksek TSSC değerinin 1.4450 olduğu saptandı. Toplam şeker içerikleri analizinde kullanılan ilaçların %33 ‘ünde şeker içeriği tespit edildi. Sonuç: Analiz edilen ilaçlar, diş dokularında karyojenik ve eroziv potansiyel gösteren fizikokimyasal özellikler gösterdi. Bu doğrultuda sağlık profesyonelleri, ilaç üreticileri ve ebeveynler diş dokularına potansiyel olarak zararlı ilaçların tüketilmesinden kaynaklanan riskler hakkında bilinçlendirilmelidir.

Keywords

• Erozyon
• Mine
• Oral likit ilaç

References

1. 1. 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: 143-146
2. 2. Neves BG, Farah A, Lucas E, de Sousa VP, Maia LC. Are paediatric medicines risk factors for dental caries and dental erosion? Community Dent Health 2010; 27: 46-51
3. 3. Bigeard L. The role of medication and sugars in pediatric dental patients. Dent Clin North Am 2000; 44: 443-456
4. 4. Pomarico L, Czauski G, Portela MB, de Souza IP, Kneipp L, de Araújo Soares RM, et al. Cariogenic and erosive potential of the medication used by HIV-infected children: pH and sugar concentration. Community Dent Health 2008; 25: 170-172
5. 5. Subramaniam P, Nandan N. Cariogenic potential of pediatric liquid medicaments--an in vitro study. J Clin Pediatr Dent 2012; 36: 357-362
6. 6. Standing JF, Tuleu C. Paediatric formulations--getting to the heart of the problem. Int J Pharm 2005; 300: 56-66
7. 7. Xavier AF, 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
8. 8. 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.

9. 9. Cavalcanti AL, De Sousa RI, Clementino MA, Vieira FF, Cavalcanti CL, et al. In vitro analysis of the cariogenic and erosive potential of paediatric antitussive liquid oral medications. Tanzan J Health Res 2012; 14: 139-145
10. 10. Cavalcanti AL, Ramos IA, Leite RB, da Costa Oliveira M, de Melo Menezes K, et al. Endogenous pH, Titratable Acidity and Total Soluble Solid Content of Mouthwashes Available in the Brazilian Market. Eur J Dent 2010; 4: 156-159
11. 11. Ball DW. Concentration scales for sugar solutions. J Chem Educ. 2006; 83: 1489.
12. 12. Al Humaid J. Sweetener content and cariogenic potential of pediatric oral medications: A literature. Int J Health Sci (Qassim) 2018; 12: 75-82.
13. 13. Çiftçi B, Aksoy M. Çocuklarda Akılcı İlaç Kullanımı ve Hemşirelerin Sorumlulukları. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 2017; 6: 191-194.
14. 14. Paramesh H. Epidemiology of asthma in India. Indian J Pediatr 2002; 69: 309-312
15. 15. Passos IA, Sampaio FC, Martínez CR, Freitas CH. Sucrose concentration and pH in liquid oral pediatric medicines of long-term use for children. Rev Panam Salud Publica 2010; 27: 132-137
16. 16. Lussi A, Jaeggi T. Occupation and sports. Monogr Oral Sci 2006; 20: 106-111
17. 17. 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: 231-238
18. 18. Babu KL, Doddamani GM, Naik LR, Jagadeesh KN. Pediatric liquid medicaments - Are they cariogenic? An in vitro study. J Int Soc Prev Community Dent 2014; 4: 108-112
19. 19. Babu KL, Rai K, Hegde AM. PH of medicated syrups--does it really matter?--an in-vitro study: Part-II. J Clin Pediatr Dent 2008; 33: 137-142
20. 20. Duggal MS, Toumba KJ, Amaechi BT, Kowash MB, Higham SM. Enamel demineralization in situ with various frequencies of carbohydrate consumption with and without fluoride toothpaste. J Dent Res 2001; 80: 1721-1724
21. 21. Mentes A. pH changes in dental plaque after using sugar-free pediatric medicine. J Clin Pediatr Dent 2001; 25: 307-312
22. 22. Noyola AS, Jimeno FG, Castelblanque VB, Dalmau LB. Frequency of dispensing paediatric medicines with high sugar content by pharmacists in Barcelona. Eur Arch Paediatr Dent 2010; 11: 38-40.