Comparison Of Erosion Effects Of OTC Paediatric Oral Liquid And Chinese Herbal Medicine On Children Teeth

ObjectiveIt is quite common for children to experience medicines during childhood,particularly for the treatment of inspiratory diseases and infection.This study evaluated and compared,in vitro,the erosive effects of four paediatric liquid medicines(two western medications and two Chinese herbal medicine)on primary teeth in a continuous scale.It would be necessary to offer a clinical guide in drug use to the clinicians and parents.Methods1.In the western medication groups,two different brands with the same main component(paracetamol)were selected as the testing medicines.For TCM,two different brands with different herbal compositions were chosen as the subject,which were commonly used to treat cold and fever.The four experimental groups and control group include:Paracetamol(A:Jean-syrup;120mg per 5ml,Jean-Marie Pharmacal Co.Ltd,Hong Kong);Paracetamol(B:Uni-Febrin;120mg per 5ml,Universal Pharmaceutical Lab.Ltd,Hong Kong);Xiao’er Chaigui Tuire Keli(C:granules;4mg per package,Guizhou Bailing Pharmacal Co.Ltd,China);Xiao’er Ganmao Keli(D:granules;6mg per package,Huarun 999 Pharmacal Co.Ltd,China);and one control group:deionized water.Using a digital pH meter(CyberScan pH500,Eutech Instruments,UK)to test the endogenous pH of the five liquids.2.Totally twenty sliced enamel blocks were prepared from ten sound extracted primary incisors,without cracks or hypomineralisation.The original surface roughness was set as baseline of each enamel specimen,measured by using the Vickers surface hardness tester,which the testing mode was set with load of 200g(1.962N)lasting for 15 s.The erosive potential of four medications would be evaluated and compared on a continuous scale by subjecting the specimen to different drugs or deionized water(DI)in twenty sequentially repeated rounds of immersion.Particularly,in each round,the enamel block was immersed into 10 ml testing liquid for 15s and followed by rinsing with DI water for 15s;and new drug liquid or DI water would be used for each new round of immersion.The 5th,10th,15th and 20th micro-hardness of enamel blocks after corresponding rounds of liquid immersion was measured.3.All the samples would be observed in SEM and also experienced the Energy Dispersive X-ray Spectrometry(EDS)analysis,which could analyze the percentage of chemical composition of surface enamel,before and after the medication challenge.Also the changes in morphology of all the samples,before and after drug emersion,would be compared by observing the pictures got from SEM.Results1.The endogenous pH of Jean-syrup was 4.97,SD=0.01 and the pH of Uni-Febrin liquid was 4.74,SD=0.01;while the pH in TCM groups was higher with in 5.04 Xiao’er Ganmao Keli,SD=0.0land 5.76 in Xiao’er Chaigui Tuire Keli,SD=0.01.And the mean endogenous pH of distilled water was 7.17,SD=0.06.2.In the TCM and control groups,the values mostly maintained stable with small variations and the curves were horizontally stable with no more than 5%decrease of MHR.The mean decreasing rate in GA reached nearly 13%,and the rate was less in GB compare with the GA,which was about 7%.3.Through the EDX analysis,we found the Ca/C ratio decreased after the drug immersion,while the Ca/P ratio and Mg,Na weight percentages remained stable.However,none of difference had been found statistically different(Wilxcon Signed-rank test),P>0.05.ConclusionA successive immersion of the two tested western OTC paediatric drugs would cause enamel loss,while the erosive potential seems to be much less in the TCM medications.From the descending trend of micro-hardness,the syrup with lowest endogenous pH caused the greatest effect.Thus,we should pay attention to the drug use in children,which could harm the oral health.Adequate dental health knowledge should given to the clinicians and parents.