Sugar content, cariogenicity, and dental concerns with commonly used medications

Oral adverse events such as cariogenicity are often overlooked as drug-associated effects because the sugar content of many medications may be negligible compared with the patients' overall dietary intake of sugar. There are, however, several liquid formulations of medications with significantly high sugar content that are commonly used in patients with swallowing difficulties. These medications may be associated with negative oral health sequelae and should be considered part of the oral health care providers' differential diagnosis of oral pathologies.

We reviewed the literature regarding the sugar content of oral liquid medications commonly prescribed by oral health care providers, with consideration to their caries potential. Where not available via public sources, pharmaceutical companies were contacted directly for additional information on the sugar (carbohydrate) content of these oral liquid medication formulations.

Over 50 commonly used oral liquid medications prescribed for patients with swallowing difficulties were reviewed and found to contain sugar in varying amounts up to 4 grams per dose (usually 1 teaspoon or 5 milliliters). Patients who are required to take multiple doses per day of these sugar-containing oral liquid medications may be at increased risk for caries and associated oral health consequences.

Recognition and avoidance of sugar-containing oral liquid medications can help clinicians optimize patient treatment, decreasing the risk for potential drug-induced caries while emphasizing patient safety and improved oral health.