Are Pediatric Antibiotic Formulations Potentials Risk Factors for Dental Caries and Dental Erosion?

Ana Carolina Valinoti1, Luiz Carlos da Costa Jr.2, Adriana Farah3, Valéria Pereira de Sousa4, Andréa Fonseca-Gonçalves1, Lucianne Cople Maia*, 1
1 Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, RJ, Brazil
2 Systems and Computing Engineering, COPPE/ Universidade Federal do Rio de Janeiro, RJ, Brazil
3 Institute of Nutrition, Universidade Federal do Rio de Janeiro, RJ, Brazil
4 Quality Control of Drugs and Medicines Laboratory, Department of Medicines, Universidade Federal do Rio de Janeiro, RJ, Brazil

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© Valinoti et al.; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

Correspondence: Address correspondence to this author at the Cidade Universitaria-CCS, Caixa, 68066, CEP: 21941-971, Rio de Janeiro, Brazil; Tel/Fax: 00 55 21 2562.2098; Email:



One of the most frequent parents’ concerns is that oral antibiotic formulations induce dental damage in their children’s. This study aimed to assess the cariogenic and erosive potentials of 29 pediatric antibiotics.

Materials and Methods:

Replicates of each antibiotic were analyzed for the concentration of sugars (sucrose, glucose and fructose) and sorbitol by high performance liquid chromatography (HPLC). The pH was determined by digital pHmeter. Titratable acidity was determined in triplicate using the same pHmeter by gradual addition of 0.1N sodium hydroxide (NaOH) until pH 7.0. Viscosity measurements were carried out using a viscosimeter. In order to rank the relative performance of each medicine, the DEA (Data Envelopment Analysis) methodology was used.


Sucrose was present in most samples (n=24) with concentrations ranging from 26 to ≈ 100g% (w/w). Only one antibiotic contained sorbitol (66.9g%). Twenty seven antibiotics presented pH values ranging from 4.1 to 6.9 and most of them (n=15) showed the pH below the critical value for dissolution of hydroxyapatite. The values of titratable acidity and viscosity ranged from 0.26 to 40.48 ml and from 20 to 1780cP, respectively. DEA methodology showed that two medicines were distant from the performance frontier (Klaricid® 50mg and Zinnat® 250mg), which means that these medicines showed the worst performance and, therefore, greater potential for dissolution of dental enamel.


Many antibiotics presented high concentration of sugars, high titratable acidity, pH below the critical value and high viscosity which can be considered risk factors for dental caries and erosion, when consumed frequently.

Keywords: Antibiotics, Dental caries, Pharmaceutical preparations, Sweetening agents, Tooth erosion, Viscosity.