Pediatric Liquid Medications and Dental Caries: A Narrative Review.

Background and Aims: Children with chronic conditions such as heart diseases, asthma, severe respiratory infections, epilepsy, organ failure, tumors, and recurring acute diseases such as sinusitis, otitis media, tonsillitis, or even iron and vitamin supplements are taking pediatric liquid medications (PLMs) for long durations. There is a growing concern and evidence in the literature about the harmful effects of PLMs on dentitions. This narrative review aims to provide a comprehensive update on PLM consumption as a risk factor for dental caries. Methods: An electronic search was conducted across various databases such as PubMed, Embase, Web of Science, Cochrane, Scopus and Google Scholar using the relevant MeSH terms and keywords "liquid medication," "pediatric liquid medication," "chronically ill children," "children," "dental caries," "dental erosion," "sugar content of medications," and "endogenous pH of medications". Results: A total of 33 studies were included in this narrative review. Some reports have linked the usage of PLMs in chronically ill children to dental erosion and caries. Physiochemical properties of PLM solutions, such as their sugar content and endogenous pH define their carcinogenicity and erosive potential. Indeed, several in vitro studies reported the erosive potential of PLMs on dental hard tissue structure when viewed under scanning electron microscopes. Some other studies have focused on the role of pediatricians, dentists, and families/parents. Conclusion: Studies support a positive association and suggest a higher caries risk experience among chronically ill children that consume PLMs. A multidisciplinary collaboration is needed between pediatricians, dentists, manufacturers and families to maximize the benefits of PLMs and minimizing its possible harms on oral health.