Evaluation of surface changes in deciduous enamel caused by commonly used pediatric liquid medicines, observed under scanning electron microscopy (sem): an in vitro study

Background: The present in-vitro study was a scanning electron microscope (SEM) study conducted in primary teeth in order to evaluate the erosive potential of two commonly used pediatric liquid medications (PLMs), the anti-biotics and the analgesics. The commonly used antibiotic in the study was Mox-redimix, Ranbaxy and Ibugesic Plus, cipla was choosen for the analgesic group. Materials and Methods: Thirty extracted teeth were randomly divided into 2 groups viz. Control group and Test Group. Control group (n=10) samples were immersed in 10 ml of artificial saliva whereas the Test Group was divided in to 2 subgroups viz. Antibiotic Group (n=10) and Analgesic Group (n=10). The teeth from the Test Group were maintained in the pediatric liquid medicines for 8 hours at 37 C. After 8 hours, the samples were rinsed with running water and observed under scanning electron microscopy (SEM) under the environmental setting of the microscopy. Results: Deciduous enamel treated with pediatric liquid medicaments at 8 hours was observed under SEM. Surface mapping was done according to Sharma et al. Control group samples, which were treated with artificial saliva, did not show any changes on the primary enamel. In the test group, i.e. the antibiotic and analgesic groups the SEM micrographs showed that the surface was smooth, etched and outlines of scales were seen. The enamel rods were clearly opened.In most of the samples of the analgesic group, the surface topography could be related to the Type III etching pattern, which is generally associated with an aprismatic type of enamel. While the samples of the antibiotic group, showed crater like formation. Conclusion: The pediatric liquid medicines are acidogenic in nature and their frequent use should be discouraged, unless absolutely necessary. Preventive protocol should be advised along with the use of pediatric liquid medicines eg., ingestion at mealtime if possible, avoid ingestion at bed time.