The impact of long-term use of pediatric liquid medications on primary tooth enamel: an in vitro study

Background: Medication use is common among children, particularly those with chronic medical conditions. This study aimed to evaluate the effects of long-term use of pediatric liquid medications commonly prescribed in Saudi Arabia on extracted primary teeth. Methods: Eight medications were included in the study; Ospen, Exjade, Feromin, Predo, Bactrim, Keppra, Risperdal and Pediasure. The medications were analyzed for pH, viscosity and sugar content. Enamel microhardness was assessed at baseline and after a 24-hour immersion period in the tested medications. Samples were further examined using scanning electron microscope (SEM). Results: Most tested medications had an acidic pH ranging from 3.1 to 7.3, and viscosities varied from 15 to 925 centipoise. Sugar analysis revealed that all medications, except Keppra, contained one or more types of sugar. Enamel microhardness decreased for all teeth after immersion, indicating enamel surface demineralization. SEM analysis showed that all examined groups, except the Keppra and Predo groups, exhibited erosive effects on the enamel surface of primary teeth. Conclusions: The acidic pH, high viscosity, and sugar content of pediatric liquid medications may compromise enamel integrity, increasing the risk of enamel surface loss in children with chronic conditions who frequently consume these medications over extended periods.

Tooth erosion; Microhardness; pH; Scanning electron microscope; Children; Medication

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