Pediatricians’ Perceptions of the Use of Sweetened Medications Related to Oral Health

Objective: To evaluate pediatricians' perceptions and attitudes about the use of liquid pediatric medicines and their relationship with dental caries and dental erosion. Study design: A cross sectional study was conducted. Data was collected by questionnaires handed out in hospitals, medical clinics and offices. A convenience sample of 104 pediatricians was obtained. Results: Most respondents (80.8%) stated that pediatric medicines could be related with dental disorders. Dental caries (64.7%) and tooth discoloration (43.7%)were the most frequent mentioned alterations, while only 3 (4.2%) respondents pointed out dental erosion. A considerable number of respondents (62.5%) recognized the presence of fermentable carbohydrates as a contributing factor to tooth decay, however not all of them recommended oral hygiene after their consumption(50.8%). Besides, 48 respondents (46.2%) also believed that pediatric medicines could cause dental wear. Conclusions: Pediatricians in this study did not perceive the correct relationship between the presence of acidity in medicines and dental erosion; however, most of them presented a reasonable awareness about the relationship between sugared pediatric medicines and dental caries. Besides, they were unaware about the need of recommending oral hygiene after medicines' use.

dental caries, tooth erosion, perception, attitude, pediatricians, liquid medication

1. Costa CC, Almeida ICS, Costa Filho LC. Erosive effect of an antihistamine- containing syrup on primary enamel and its reduction by fluoride dentifrice. Int J Paediatr Dent, 16: 174–180, 2006.

2. Nunn JH, Ng SKF, Sharkey, Coulthard M. The dental implications of chronic use of acidic medicines in medically compromised children. Pharm World Sci, 23: 118–119, 2001.

3. Duward C, Thou T. Dental caries and sugar containing liquid medicines for children in New Zealand. N Z Dent J, 93: 124–129, 1997.

4. Bigeard L. The role of medication and sugars in pediatric dental patients. Dent Clin North Am, 44: 443–456, 2000.

5. Kenny DJ, Somaya P. Sugar load of oral liquid medications on chronically ill children. J Can Dent Assoc, 55: 43–46, 1989.

6. Maguire A, Rugg-Gunn AJ. Prevalence of long-term use of liquid oral medicines by children in the northern region, England. Community Dent Health, 11: 91–96, 1994.

7. Shaw L, Glenwright HD. The role of medications in dental caries formation: need for sugar-free medication for children. Pediatrician, 16: 153–155, 1989.

8. Linnett V, Seow WK. Dental erosion in children: a literature review. Pediatr Dent, 23: 37–43, 2001.

9. Pierro, VSS, Barcelos, R, Maia, LC, Silva AN. Pediatricians’ perception about the use of antibiotics and dental caries – a preliminary study. J Public Health Dent, 64: 244–248, 2004.

10. Krol, DM. Educating pediatricians on children’s oral health: past, present and future. Pediatrics, 13: 487–493, 2004.

11. Minayo, MCS. O desafio do conhecimento: pesquisa qualitativa em saúde. 8th ed. São Paulo: Hucitec; Rio de Janeiro: Abrasco; 2004.

12. Committee on Drugs. “Inactive” Ingredients in Pharmaceutical Products: Update (Subject Review). Pediatrics, 99: 268–278, 1997.

13. Bentley E, Mackie IC, Fuller, SS. The rationale, organization and evaluation of a campaign increase the use of sugar-free paediatric medicines. Community Dent Health, 14: 36–40, 1997.

14. Evans, DJ, Howe, D, Maguire A, Rugg-Gunn AJ. Development and evaluation of a sugar-free medicines campaign in North Eat England: analysis of findings from questionnaires. Community Dent Health, 16: 131–137, 1999.

15. Lewis, CW, Grossman, DC, Domoto PK, Deyo RA. The role of the pediatrician in the oral health of children: a national survey. Pediatrics, 106: 1–7, 2000.

16. Krol, DM. Dental caries, oral health and pediatricians. Curr Probl Pediatr Adolesc Health Care, 33: 253–270, 2003.

17. Mackie IC, Worthington HV, Hobson P. An investigation into sugar containing and sugar-free over-the-counter medicines stocked and recommended by pharmacists in the north western region of England. Br Dent J, 175: 93–98, 1993.

18, Lima KT, Almeida ICS, Senna ETL. Medicamentos pediátricos – agentes edulcorantes e pH. J Bras. Odontopediatr. Odontol. Bebê, 3: 457–463, 2000.

19. Neiva A, Silva VS, Maia LC, Soares EL, Trugo LC. Análise in vitro da concentração de sacarose e pH de antibacterianos de uso pediátrico. Pesqui. Bras. Odontopediatria Clín. Integr, 1: 9–16, 2001.

20. Peres, KG, Oliveira ,CT, Peres, MA, Raymundo FS, Fett R. Sugar content in liquid oral medicines for children. Rev Saúde Pública, 39: 486–9, 2005.

21. Pierro VSS, Abdelnur JP, Maia LC, Trugo LC. Free sugar concentration and pH of paediatric medicines in Brazil. Community Dent Health, 22: 180–183, 2005.

22. Neves, BG, Pierro VSS, Maia LC. Percepções e atitudes de responsáveis por crianças frente ao uso de medicamentos infantis e sua relação com cárie e erosão dentária. Rev C S Col 12: 1295–300, 2007.

23. Pierro, VSS, Maia, LC, Silva, EM. Effect of pediatric syrups on roughness and erosion of enamel. J Dent Res, 83 (Spec Iss A): 0896–0896, 2004.

24. Johansson AK, Sorvari R, Birkhead D, Meurman JH. Dental erosion in deciduous teeth – an in vivo and in vitro study. J Dent, 29: 333–340, 2001.