title: The dental implications of chronic use of acidic medicines in medically compromised children.
abstract: OBJECTIVE
  Liquid oral medicines form a significant proportion (11%) of the medicines used by the population as a whole, either prescribed or over the counter. The active agent, as well as some of the other ingredients, can pose a threat to oral health.
  
  
  METHODS
  Eight liquid oral medicines and two effervescent preparations routinely prescribed for long-term use by paediatric renal patients were assessed for titratable acidity and pH values.
  
  
  RESULTS
  All of the medicines tested were acidic and the majority were well below the critical pH of 5.5 at which enamel demineralisation takes place. The titratable acidity values, at a pH of 6.7, ranged between 0.01 and 1.54 for the liquid preparations but were 8.4 and 10.6 for the two effervescent tablets tested.
  
  
  CONCLUSIONS
  Surplus acid in effervescent preparations while ensuring palatability of medicines and thus compliance, may produce unwanted dental side effects in children who are already medically compromised.
authors.affiliation: Department of Child Dental Health, School of Dentistry, Framlington Place, Newcastle upon Tyne, NE2 4BW, UK. j.h.nunn@ncl.ac.uk
authors.forename: J H
authors.initials: JH
authors.lastname: Nunn
authors.forename: S K
authors.initials: SK
authors.lastname: Ng
authors.forename: I
authors.initials: I
authors.lastname: Sharkey
authors.forename: M
authors.initials: M
authors.lastname: Coulthard
mesh_terms: D000143:Acids / Q000008:administration & dosage / Q000009:adverse effects; D000284:Administration, Oral; D002648:Child; D019343:Citric Acid / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000188:drug therapy; D019999:Pharmaceutical Solutions / Q000008:administration & dosage / Q000009:adverse effects*; D014077:Tooth Erosion / Q000139:chemically induced* / Q000517:prevention & control
chemical_list: D000143:Acids; D019999:Pharmaceutical Solutions; D019343:Citric Acid