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Sugar load of oral liquid medications on chronically ill children
Insights
Children with chronic illnesses often receive sugary liquid medications, leading to significant dental caries. This study found a median of eight decayed teeth in children by 31 months, highlighting a critical issue in pediatric care.
Area of Science:
- Pediatric Medicine
- Dental Public Health
- Pharmacology
Background:
- Children with chronic illnesses or congenital disorders often require oral liquid medications.
- These medications frequently contain high levels of sugar, posing a risk to dental health.
- Parental focus on managing serious medical conditions can overshadow dental hygiene concerns.
Purpose of the Study:
- To investigate the history of oral liquid medication use in children from birth to 36 months.
- To determine the incidence of dental caries in this vulnerable pediatric population.
- To quantify the sugar load from medications and its association with dental health outcomes.
Main Methods:
- A cohort of 20 children (up to 36 months) with chronic conditions was studied.
- Medication usage patterns, including frequency and timing, were recorded.
- Dental caries (def(t)) and cumulative sugar intake from medications were assessed.
Main Results:
- Children received an average of 8,696g of additional sugar from medications.
- The median number of decayed, extracted, or filled primary teeth (def(t)) was eight by 31 months.
- Two daily medication doses were often administered at nap or bedtime, increasing caries risk.
Conclusions:
- Oral liquid medications contribute significantly to sugar intake and dental caries in children with chronic illnesses.
- Current prescribing practices necessitate sugar-laden medications, exacerbating caries risk.
- There is a critical need for sugar-free alternatives in pediatric oral medications.
Abstract:
Children with congenital disorders or chronic illnesses receive additional sugar from oral liquid medications. The purpose of this study was to determine the history of oral liquid medication usage and the incidence of dental caries from birth until about 36 months of age in a population of 20 such children. A pattern appeared in the frequency and dispensing characteristics of the 44 different drugs used for these children. Parents gave daily doses of syrupy medications and elixirs 3-4 times a day and at least two of these doses were given just before or during a designated nap or bedtime. Parental concerns for the more serious medical condition naturally overrode the consideration of sound dental hygiene practices. In this study, diseased, extracted and filled primary teeth def(t) were recorded and the medicinal sugar load at the time of examination was calculated as well as the cumulative medicinal sugar load from birth. Average age on examination was 31 months and the median number of def(t) was eight. The mean total amount of additional sugar from oral liquid medications was 8,696 g and the maximum sugar consumed by one child was over 20 kg. Physicians currently have no choice but to prescribe certain medications that contain 30 to 70 per cent sugar for patients who are already at higher than usual risk for dental caries due to chronic illness.