Prevention of erosion caused by pediatric medications in primary teeth with CPP-ACP and fluoride: an in vitro study

Background: Dental erosion is a significant issue in pediatric dental health, often resulting from the long-term use of pediatric liquid medications (PLMs). Preventive strategies are crucial to mitigate the erosive effects caused by these medications on primary teeth. This study aims to evaluate the preventive effects of fluoride varnish (FV) and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) against the erosive effects of common PLMs on primary teeth. Methods: Ninety caries-free deciduous molar teeth specimens were prepared and divided into three main experimental groups (artificial saliva (AS), FV and CPP-ACP), each with three subgroups exposed to one of three PLMs (amoxicillin trihydrate/clavulanic acid, multivitamin and salbutamol). The specimens underwent pH cycling to simulate daily oral environmental conditions. The surface microhardness of enamel specimens was measured at baseline and the end of the seventh day using a Vickers hardness testing machine. Statistical analyses were performed using SPSS Statistics for Windows (IBM Corp. Released 2015. IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY, USA). Results: Microhardness values did not differ significantly between groups at baseline. However, they did differ significantly among groups on the seventh day. They decreased significantly after the immersion cycle for all groups except those treated with FV. Microhardness values did not differ significantly between baseline and the seventh day in FV-treated groups. PLMs significantly reduced the microhardness of primary teeth. Conclusions: Among the tested preventive agents, 5% FV successfully prevented mineral loss of the enamel against PLMs and acid attacks. In contrast, CPP-ACP did not provide significant protection against dental erosion, failing to protect tooth specimens during erosive challenges. These findings underscore the importance of using FV in pediatric dental care to prevent erosion caused by long-term PLM use.

CPP-ACP; Fluoride varnish; Preventive dentistry; Tooth erosion

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