Comparative Evaluation on the Effects of Three Pediatric Syrups on Microhardness, Roughness and Staining of the Primary Teeth Enamel: An In-Vitro Study

Abstract

​​​​​Introduction One of the most prevalent oral diseases is dental caries. Syrups are commonly used by children who have difficulty swallowing tablets and capsules. Some medications can make dental caries worse and cause the enamel to erode. Most of the time, parents are unaware that a number of foods, drinks, and syrup-formulated pediatric drugs include sugar, which can cause erosion of primary teeth, resulting in plaque accumulation and dental caries. Henceforth, the aim of this study is to assess the effects of pediatric syrups on the microhardness, roughness, and staining ability of primary tooth enamel as a result of daily intake of syrup. Methods Eighty primary teeth, including both anterior and posterior, that required extraction due to pre-shedding mobility were randomly divided into four groups of twenty samples each. Samples were exposed to multivitamin syrup (Rudimin), iron syrup (C Pink), and diuretic syrup (Furosemide). The samples were submerged in 10 mL of the respective medication once daily for five minutes for 21 days. On days 0 and 21, enamel surfaces were assessed for changes in microhardness, roughness, and staining. The microhardness was assessed using a Micro Vickers microhardness tester machine; the roughness was assessed using a Mitutoyo surface roughness tester; and the staining ability was assessed using a spectrophotometer, and data processing was done using the analysis of variance (ANOVA) test and Tukey's post hoc analysis. Results The changes in enamel surface for microhardness, roughness, and staining were assessed twice, at days 0 and 21. Group 4 (Furoped) showed a significant difference in surface microhardness and staining ability of enamel surfaces with a statistically significant p-value (<0.05). When roughness was compared, all three interventions had a significant difference from the control group, whereas there was no statistically significant difference between the intervention groups. Conclusion This study concludes that pediatric syrups can significantly weaken the enamel of primary teeth, resulting in loss of enamel surface microhardness and roughness making them vulnerable to caries. Since frequent consumption of these syrups is correlated with tooth decay, certain precautions like oral hygiene maintenance and rinsing with water after taking the syrup should be done to prevent dental caries, as consumption of medicinal syrups by children cannot be avoided.

Effect of lactoferrin on enamel characteristics of primary and permanent teeth: an in-vitro study

“…The pH range of routinely advised pediatric liquid medications (PLM) was 4.22 to 6.10. Sucrose is also present in the PLM and in the samples in concentrations ranging from 5.38 to 11.41 gm%; thus, they have the potential to cause caries [ 7 ].…”

“…Considering the difficulty of swallowing tablets, liquid oral medication is the most widely prescribed form of medication for juveniles. However, oral medications in the form of suspensions influence the hardness of enamel and change its morphological pattern [ 7 ]. Acidic preparations are required to preserve chemical stability, facilitate medicine dispersion, assure physiological compatibility, and enhance flavor.…”