Erosive and cariogenicity potential of pediatric drugs: study of physicochemical parameters

Alidianne Fábia C Xavier,Waldeneide F Azevedo,Eline Ff Moura,Alessandro L Cavalcanti,Mauro Hng Abreu,Fernando F Vieira

doi:10.1186/1472-6831-13-71

Alidianne Fábia C Xavier, Waldeneide F Azevedo + Show 4 more

Open Access

https://doi.org/10.1186/1472-6831-13-71

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Abstract

BackgroundPediatric medications may possess a high erosive potential to dental tissues due to the existence of acid components in their formulations. The purpose was to determine the erosive and cariogenic potential of pediatric oral liquid medications through the analysis of their physicochemical properties in vitro.MethodsA total of 59 substances were selected from the drug reference list of the National Health Surveillance Agency (ANVISA), which belong to 11 therapeutic classes, as follows: analgesics, non-steroidal anti-inflammatory, corticosteroids, antihistamines, antitussives, bronchodilators, antibacterials, antiparasitics, antiemetics, anticonvulsants and antipsychotics. Measurement of pH was performed by potentiometry, using a digital pH meter. For the Total Titratable Acidity (TTA) chemical assay, a 0.1 N NaOH standard solution was used, which was titrated until drug pH was neutralized. The Total Soluble Solids Contents (TSSC) quantification was carried out by refractometry using Brix scale and the analysis of Total Sugar Content was performed according to Fehling’s method. In addition, it was analyzed the information contained in the drug inserts with regard to the presence of sucrose and type of acid and sweetener added to the formulations.ResultsAll drug classes showed acidic pH, and the lowest mean was found for antipsychotics (2.61 ± 0.08). There was a large variation in the TTA (0.1% - 1.18%) and SST (10.44% - 57.08%) values. High total sugar contents were identified in the antitussives (53.25%) and anticonvulsants (51.75%). As described in the drug inserts, sucrose was added in 47.5% of the formulations, as well as citric acid (39.0%), sodium saccharin (36.4%) and sorbitol (34.8%).ConclusionThe drugs analyzed herein showed physicochemical characteristics indicative of a cariogenic and erosive potential on dental tissues. Competent bodies’ strategies should be implemented in order to broaden the knowledge of health professionals, drug manufacturers and general consuming public about the risks from the consumption of medicines potentially harmful to dental tissues.

Highlights

Pediatric medications may possess a high erosive potential to dental tissues due to the existence of acid components in their formulations
Liquid formulations used for a three-month minimum period are considered a risk factor for increased levels of dental caries [9]
This study aimed to evaluate the erosive and cariogenic potential of pediatric oral liquid medications through the analysis of their physicochemical properties in vitro

Summary

Introduction

Pediatric medications may possess a high erosive potential to dental tissues due to the existence of acid components in their formulations. Oral liquid pharmaceutical dosage forms such as syrups, solutions and suspensions are the therapeutic choice for the treatment of pediatric patients [1]. The use of these liquid preparations, despite being generally for short periods, can be considered as prolonged occurrence [2], especially in patients who suffer from chronic conditions, such as respiratory allergies, asthma and convulsions, or recurrent acute diseases as tonsillitis, otitis, sinusitis and allergic rhinitis [3]. Children who use vitamin C supplements are 4.7 times more likely to develop dental erosion lesions [10]

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