# A Comparative Evaluation of the Erosion Level of Commonly Prescribed Pediatric Liquid Medicines on Primary Teeth: An In-Vitro Surface Profilometry and Scanning Electron Microscopic Study

## TL;DR

This study evaluates how commonly prescribed liquid medicines for children can erode primary teeth enamel, using microscopic and profilometric analysis.

## Contribution

The study provides a comparative in-vitro assessment of pediatric liquid medications' erosive effects on primary teeth enamel.

## Key findings

- Significant enamel erosion was observed in teeth exposed to pediatric liquid medications compared to controls.
- Different medications caused varying levels of enamel erosion, indicating differing cariogenic potentials.

## Abstract

Introduction

Maintaining good oral health is crucial for the overall health, growth, and development of children. Dental caries is the most widespread oral disease and the most common infectious condition affecting the mouth. Epidemiological studies have shown a frequent occurrence of enamel erosion in young people. Pediatric liquid analgesics (PLAs) are frequently prescribed and well-accepted by young patients. However, prolonged use of these medications can increase the risk of dental caries and dental erosion. This study aims to evaluate the erosive potential of commonly prescribed pediatric liquid medicinal syrups on primary teeth enamel. The objectives include assessing changes in the enamel prismatic pattern of deciduous teeth using scanning electron microscopic (SEM) analysis and comparing the erosive effects of these medications through surface profilometric analysis.

Methodology

The current study model was designed to stimulate clinical erosion of tooth surfaces when exposed to frequently prescribed medications. Test samples - a convenient sampling of 40 caries-free extracted primary incisors - were used for the study. The commonly prescribed pediatric medications were selected: (a) Ibugesic plus syrup, (b) Novomox syrup, (c) Dexorange syrup, (d) Benadryl syrup, and (e) Asthalin syrup. The agitation of pediatric liquid medicaments (PLMs) was done for about one minute. The teeth samples were changed accordingly, from artificial saliva to respective PLM, and agitated for one minute. Teeth samples in PLMs were processed by changing them periodically, thrice daily, for five consecutive days. PLMs were changed every day; the air-tight containers were washed and wiped with sterile cotton. Processed samples were sent for surface profilometry analysis (27 teeth) and SEM study (9 teeth). The results from the profilometric analysis and SEM analysis were tabulated, and data were analyzed using the software SPSS.

Results

The results showed marked changes in the levels of erosion between the control and test groups. It shows that there was a significant difference between the control and other test groups (p-value: 0.028). Different levels of erosion were seen on the tooth samples with different medications. This study reveals that these combinations of drugs have a high erosive potential, which shows increased cariogenicity.

Conclusion

Based on the experimental conditions of this study, it can be concluded that acidic medications contribute to enamel erosion. The intake of medicinal syrups by children is often necessary, and their harmful effects on oral and dental structures are unavoidable.