Adverse Effects of Paediatric Liquid Medications on Primary Teeth: A Systematic Review

Introduction: Paediatric liquid medications are widely administered due to their ease of use and high compliance. Emerging evidence, however, suggests these formulations may have unintended oral health consequences. Specifically, the primary dentition may experience erosion, discolouration, and altered surface properties. Studying the adverse effects of different paediatric liquid medications on primary teeth reflects a growing understanding of the complex interactions between medications and dental health and ongoing efforts to mitigate potential risks to children’s oral health. Aim: The present systematic review was conducted to summarise and assess the effects of various paediatric drugs on primary teeth by reviewing the available literature. Materials and Methods: The present systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines and was registered on PROSPERO (CRD42023413689). The PROSPERO record is available at https://www.crd.york. ac.uk/prospero/display_record.php?ID=CRD42023413689. An extensive search of electronic databases was conducted covering January 2000 to December 2023 to identify studies reporting adverse effects of paediatric drugs on primary teeth. Quality assessment of the included studies was performed using the Quality Assessment Tool For In Vitro Studies (QUIN) tool. Results: After meeting the eligibility criteria 24 in-vitro studies were included. Each study analysed the effects of medications on primary teeth. Enamel erosion, increased surface roughness, and discolouration were observed with most paediatric liquid medications. Conclusion: This systematic review, included 24 studies, demonstrated associations between paediatric liquid medications and deleterious effects on the primary dentition. These adverse effects are likely driven by the acidic components, colouring additives, and prolonged contact time of the formulations. Despite methodological variations among studies, the consistent findings across different medication classes reinforce these conclusions. By integrating this knowledge into clinical practice, healthcare professionals can contribute to the promotion of optimal oral health in paediatric patients.