Traditional Chinese Granule Medications are Safe for Decidious Teeth

Abstract

Objectives: This study aims to compare and evaluate the in vitro teeth erosive effects of over-the-counter paediatric medication for fever relief, namely two western oral liquids that contains paracetamol and two traditional Chinese granule form medications, on decidious teeth in a continuous scale. Methods: Twenty enamel block obtained from ten deciduous incisors were randomly assigned into 5 groups (n=4): Group A: paracetamol (Jean marie); Group B: paracetamol (Universal); Group C: Xiao’er Ganmao Keli (Huarun 999); Group D: Xiao’er Chaigui Tuire Keli (Guizhou Bailing); Group E: deionized water (control group). The traditional Chinese medication (Groups C and D) in guanule form were reconstituted in water according to manufacturers' instruction before use. Immersion model was used for 20 rounds for all teeth: in each round i the teeth were immersed to one group of liquid for 15 seconds and then rinsed with deionized water, and then Vickers microhardness (H) were measured. Mean hardness ratio at i-round (MHRi) was established by comparing the hardness at i-round (Hi) divided by 0 round (H0), i.e. before the immersion. In addition, the initial and final surface morphology and chemical analysis of each sample were performed by Scanning Electron Microscope (SEM) and Energy Dispersive X-ray spectroscopy (EDX). The pH of each drugs were measured by pH meter. All statistics were performed at α=0.05. Results: All groups of drugs exhibited acidic pH (4.74-5.76). After 20 rounds of immersion, the MHR20 of groups A (0.886) and B (0.930) were decreased significantly from the MHR0, whilst groups C (0.978) and D (0/985) illustrated a similar trend with control group E (0.985). SEM revealed distinctive enamel loss with irregular craters in Group A, and Group B showed a corroded surface and the fracture lines along the border of prism heads. Groups C and D were alike, that erosive changes were barely seen, similar to Group E. EDX did not show any significant changes on Ca/P ratio. Despite Ca/C were decreased in all groups, no significant differences were found. Conclusions: The pH of liquid medication may not be a significant factor that contribuite to enamel softening. Traditional Chinese granule medications might be a safer option for decidious teeth.