Dental Health of Children Taking Antimicrobial and Non-Antimicrobial Liquid Oral Medication Long-Term

Abstract

A large number of liquid oral medicines contain sugars and there is concern for the dental health of children requiring this medication long-term for chronic medical problems. Ninety-four chronically sick children aged 2–17 years taking sugar-based or sugar-free liquid oral medication for 1 year or more, and their 92 siblings were dentally examined. The medical problems of the sick children included epilepsy, cystic fibrosis, chronic renal failure, asthma, recurrent urinary tract infections, cardiac disease and chronic constipation. Ordinal logistic regression analysis compared differences between sick children and their healthy siblings and showed the only significant confounding factors related to dental health to be age (for dmfs p = 0.013, DMFS p < 0.001) and exposure to fluoridation (for DMFS p = 0.0097, DFS (approximal) p = 0.013). Children taking long-term liquid oral medicines had significantly more caries of deciduous anterior teeth than their siblings (p = 0.046).

Sugar content in liquid oral medicines for children

“…It is thus an additional source of sugar for pediatric patients, especially those chronically ill, who receive a greater sugar load from liquid medications than healthy children do and, consequently, have high caries prevalence. 3 Most studies addressing this core issue have helped policy decision makers and health professionals to implement legislation and surveillance systems to control, avoid or replace sugar in medicines for noncariogenic sugar, and showed promising results. 4 The objective of this study was to assess the most prescribed and sold liquid oral medicines for children, verify their sugar concentration and to compare it to that in their directions for use.…”

“…It is thus an additional source of sugar for pediatric patients, especially those chronically ill, who receive a greater sugar load from liquid medications than healthy children do and, consequently, have high caries prevalence. 3 Most studies addressing this core issue have helped policy decision makers and health professionals to …”

Sugar-free medicines are counterproductive

“…2 The supporting evidence, quoted by the Department of Health publication, is an interesting, small, hypothesis generating study that should have led to larger studies evaluating overall benefit (or lack) of sugar-free medicines before a major change in public health policy. 3 This small case control study compared 94 diseased children and their healthy siblings.…”

Efficacy of an Oral Health-Promoting Program in Human Immunodeficiency Virus-Infected Children: A 7-year Longitudinal Study

“…Children infected with HIV have a higher prevalence of caries in both dentitions (Chen et al, 2003;Gelbier et al, 2000) compared to healthy counterparts (Madigan et al, 1996;Maguire et al, 1996;Ribeiro et al, 1998;Tofsky et al, 2000;Valdez et al, 1994). In addition, HIV-infected children show greater immunological impairment and thus are more likely to have higher caries activity (Castro et al, 2004).…”

“…In addition, HIV-infected children show greater immunological impairment and thus are more likely to have higher caries activity (Castro et al, 2004). Several factors may be involved, such as carbohydrate-rich diet for calorie/protein reposition, high intake of sugarcontaining compounds (Madigan et al, 1996;Maguire et al, 1996), decreased salivary flow (Ribeiro et al, 1998), low immune response to cariogenic bacteria (Madigan et al, 1996), inadequate oral hygiene and decreased salivary antibodies (Castro et al, 2004).…”