Erosive Effect of Analgesics on Primary Tooth Enamel - An in Vitro Study

Authors

  • Cristiane Tomaz Rocha
  • Ana Sarah Bôto Nogueira
  • Jordana de Andrade Almeida
  • Lidiany Karla Azevedo Rodrigues
  • Beatriz Gonçalves Neves

Keywords:

Tooth Erosion, Analgesics, Dental Enamel, Tooth, Deciduous, Child

Abstract

Objective: To evaluate in vitro erosive effect of analgesics on primary tooth enamel. Material and Methods: The pH and the titratable acidity measurements of the medicines were performed in triplicate using a digital pH meter. Enamel slabs of primary teeth flat and polished were selected by initial surface microhardness analysis. Medications were selected and specimens were assigned into five groups (n=12): Dalsy; Magnopyrol; Paracetamol; Tylenol; and distilled water (negative control). Specimens were immersed in 5 ml of each group solution for 30 min, 4x/day for three days and stored in artificial saliva at 37 °C between immersions and at night. Final microhardness was determined. The data were submitted to One-way ANOVA and Tukey's test. Scanning electron microscopy (SEM) analysis was performed in three specimens of each group. Results: Medicines showed acidic pH and mean values of titratable acidity ranged from 1.46 to 11.66 ml of 0.1N NaOH. The mineral loss of Magnopyrol was statistically significant in relation to the control group (p<0.01). Magnopyrol showed higher values when compared to Tylenol (p<0.05). SEM images displayed microstructure alterations in the Paracetamol group. Conclusion: Despite the low pH values, only Magnopyrol showed greater enamel softening. Paracetamol demonstrated morphological changes in primary tooth enamel.

References

Schlueter N, Amaechi BT, Bartlett D, Buzalaf MAR, Carvalho TS, Ganss C, et al. Terminology of Erosive Tooth Wear: Consensus Report of a Workshop Organized by the ORCA and the Cariology Research Group of the IADR. Caries Res 2020; 54(1):2-6. https://doi.org/10.1159/000503308

Al-Dlaigan YH, Al-Meedania LA, Anil S. The influence of frequently consumed beverages and snacks on dental erosion among preschool children in Saudi Arabia. Nutr J 2017; 16(1):80. https://doi.org/10.1186/s12937-017-0307-9

Moazzez R, Bartlett D. Intrinsic causes of erosion. Monogr Oral Sci 2014; 25:180-96. https://doi.org/10.1159/000360369

Hellwig E, Lussi A. Oral hygiene products, medications and drugs-hidden aetiological factors for dental erosion. Monogr Oral Sci 2014; 25:155-62. https://doi.org/10.1159/000359942

Carvalho TS, Lussi A. Chapter 9: Acidic Beverages and Foods Associated with Dental Erosion and Erosive Tooth Wear. Monogr Oral Sci 2020; 28:91-8. https://doi.org/10.1159/000455376

Costa CC, Almeida ICS, Costa Filho LC. Erosive effect of an antihistamine-containing syrup on primary enamel and its reduction by fluoride dentifrice. Int J Paediat Dent 2006; 16(3):174-80. https://doi.org/10.1111/j.1365-263X.2006.00713.x

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 Paediat Dent 2007; 17(4):231-8. https://doi.org/10.1111/j.1365-263X.2007.00826.x

Lussi A, Carvalho TS. Analyses of the erosive effect of dietary substances and medications on deciduous teeth. PLoS ONE 2015; 10(12):e0143957. https://doi.org/10.1371/journal.pone.0143957

Carvalho TS, Lussi A, Jaeggi T, Gambon DL. Erosive tooth wear in children. Monogr Oral Sci 2014; 25:262-78. https://doi.org/10.1159/000360712

Assunção CM, Schlueter N, Rodrigues JA, Carvalho TS, Lussi A. Do fluoride toothpastes have similar preventive effect in permanent and primary teeth against erosive tooth wear? Int J Paediatr Dent 2019; 29(2)-228-36. https://doi.org/10.1111/ipd.12449

Assunção CM, Lussi A, Rodrigues JA, Carvalho TS. Efficacy of toothpastes in the prevention of erosive tooth wear in permanent and deciduous teeth. Clin Oral Investig 2019; 23(1):273-84. https://doi.org/10.1007/s00784-018-2434-x

Scatena C, Galafassi D, Gomes-Silva JM, Borsatto MC, Serra MC. In vitro erosive effect of pediatric medicines on deciduous tooth enamel. Braz Dent J 2014; 25(1):22-7. https://doi.org/10.1590/0103-6440201302344

Babu KLG, Rai K, Hegde AM. Pediatric liquid medicaments – do they erode the teeth surface? An in vitro study: part I. J Clin Pediatr Dent 2008; 32(3):189-94. https://doi.org/10.17796/jcpd.32.3.j22m7t8163739820

Neves BG, Farah A, Lucas E, De Sousa VP, Maia LC. Are paediatric medicines risk factors for dental caries and dental erosion? Community Dental Health 2010; 27(1):46-51.

Pierro VSS, Furtado BR, Villardi M, Cabral LM, Silva EM, Maia LC. Erosive effect of an antihistamine liquid formulation on bovine teeth: influence of exposure time. Braz J Oral Sci 2010; 9(1):20-4.

Valinoti AC, Pierro VSS, Silva EM, Maia LC. In vitro alterations in dental enamel exposed to acidic medicines. Int J Paediat Dent 2011; 21(2):141-50. https://doi.org/10.1111/j.1365-263X.2010.01104.x

Siddiq H, Pentapati KC, Shenoy R, Velayutham A, Acharya S. Evaluation of sugar content and erosive potential of the commonly prescribed liquid oral medications. Pesqui Bras Odontopediatria Clín Integr 2020; 20:e5025. https://doi.org/10.1590/pboci.2020.023

Scatena C, de Mesquita-Guimarães KSF, Galafassi D, Palma-Dibb RG, Borsatto MC, Serra MC. Effects of a potentially erosive antiasthmatic medicine on the enamel and dentin of primary teeth: An in situ study. Microsc Res Tech 2018; 81(9):1077-83. https://doi.org/10.1002/jemt.23074

Babu KLG, Rai K, Hegde AM. pH of medicated syrups–does it really matter? – An in-vitro study: part-II. J Clin Pediatr Dent 2008; 33(2):51-6. https://doi.org/10.17796/jcpd.33.2.q5280t3744827v0h

Passos IA, Sampaio FC, Martínez CR, Freitas CHSM. Sucrose concentration and pH in liquid oral pediatric medicines of long-term use for children. Rev Panam Salud Publica 2010; 27(2):132-7. https://doi.org/10.1590/s1020-49892010000200007

Valinoti AC, da Costa LC Jr, Farah A, Pereira de Sousa V, Fonseca-Gonçalves A, Maia LC. Are pediatric antibiotic formulations potentials risk factors for dental caries and dental erosion? Open Dent J 2016; 22(10):420-30. https://doi.org/10.2174/1874210601610010420

Nankar M, Walimbe H, Bijle MNA, Kontham U, Kamath A, Muchandi S. Comparative evaluation of cariogenic and erosive potential of commonly prescribed pediatric liquid medicaments: an in vitro study. J Contemp Dent Pract 2014; 15(1):20-5. https://doi.org/10.5005/jp-journals-10024-1481

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(2):143-6. https://doi.org/10.4103/0970-4388.155129

Amaechi BT, Higham SM. In vitro remineralization of eroded enamel lesions by saliva. J Dent 2005; 29(5):371-6. https://doi.org/10.1016/s0300-5712(01)00026-4

Neves BG, Pierro VSS, Maia LC. Perceptions and attitudes among parents and guardians on the use of pediatric medicines and their cariogenic and erosive potential. Ciênc Saúde Colet 2007; 12(5):1295-1300. https://doi.org/10.1590/s1413-81232007000500027

Shaw L, Smith J. Dental erosion – the problem and some practical solutions. Br Dent J 1998; 186(3):115-8. https://doi.org/10.1038/sj.bdj.4800037

Shellis RP, Ganss C, Ren Y, Zero DT, Lussi A. Methodology and models in erosion research: discussion and conclusions. Caries Res 2011; 45(1):69-77. https://doi.org/10.1159/000325971

Mahmoud EF, Omar OM. Erosive and cariogenic potential of various pediatric liquid medicaments on primary tooth enamel: A SEM study. Dent Med Probl 2018; 55(3):247-54. https://doi.org/10.17219/dmp/91539

Alexandria AK, Meckelburg NA, Puetter UT, Salles JT, de Souza IPR, Maia LC. Do pediatric medicines induce topographic changes in dental enamel. Braz Oral Res 2016; 30:e11. https://doi.org/10.1590/1807-3107BOR-2016.vol30.0011

Tupalli AR, Satish B, Shetty BR, Battu S, Kumar JP, Nagaraju B. Evaluation of the erosive potential of various pediatric liquid medicaments: an in-vitro study. J Int Oral Health 2014; 6(1):59-65.

Laskarides C. Update on analgesic medication for adult and pediatric dental patients. Dent Clin N Am 2016; 60(2):347-66. https://doi.org/10.1016/j.cden.2015.11.006

Ganss C, Klimek J, Schäffer U, Spall T. Effectiveness of two fluoridation measures on erosion progression in human enamel and dentine in vitro. Caries Res 2001; 35(5): 325-30. https://doi.org/10.1159/000047470

Attin T, Wegehaupt FJ. Methods for assessment of dental erosion. Monogr Oral Sci 2014; 25:123-42. https://doi.org/10.1159/000360355

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Published

2022-11-23

How to Cite

Rocha, C. T., Nogueira, A. S. B., Almeida, J. de A., Rodrigues, L. K. A., & Neves, B. G. (2022). Erosive Effect of Analgesics on Primary Tooth Enamel - An in Vitro Study. Pesquisa Brasileira Em Odontopediatria E Clínica Integrada, 22, e210149. Retrieved from https://revista.uepb.edu.br/PBOCI/article/view/1595

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Original Articles