Dental Caries Potential of Liquid Medications

Abstract

Cariogenicity of seven commonly prescribed liquid medications was studied. Sucrose content of the medications ranged from 0 to 70 gm/100 ml. Initial pH and buffering capacity were measured and found to vary widely among the medications. Intraoral microbial plaque pH changes were determined at intervals for 30 minutes following an oral rinse with each medication. These data were compared with plaque pH changes caused by rinsing with an established cariogenic challenge, 10% sucrose solution. Decreased plaque pH was caused by each medication tested. The extent and duration of the pH drop varied among the medications. Patterns of the pH curves are discussed in relation to sucrose content, endogenous pH, and buffering capacity of the medications. Intraoral pH response to several medications equaled or exceeded that seen when sucrose rinses alone were given. The findings are discussed in relation to dental caries-producing potential of long-term therapy with liquid medications, and two cases are presented that implicate liquid medications as a major etiologic factor leading to rampant dental decay. It is concluded that health practitioners should be aware of the sucrose content of pediatric medications. Patient education to ensure adequate oral clearance following each dose of medication is an essential first step in minimizing the risk of dental decay posed by long-term therapy with liquid medications.