Risk assessment of different drugs on the Malawi essential medicine list for drug induced dental caries
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Date
2021-06-16
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Kamuzu University of Health Sciences
Abstract
This is a laboratory based experimental study that is aimed at assessing risks of different drugs
from the Malawi Essential Medicines List on drug induced dental caries which is a public concern.
This will be achieved through the following specific objectives; to measure the pH and corrosion
capability of the orally taken drugs; to quantify the amount of sugars in the widely used oral
medicines labelled with sugar materials and to assess the risk of developing dental caries on the
patients taking vulnerable medicines. Qualitative and quantitative measures of acidity will be
measured using the pH parameter of the medicines in aqueous solutions using pH meter. A
qualitative measure of the presence of sugars will also be measured.in-vitro tests will also be
measured following incubation of the removed teeth to determine if the acidic and basic or neutral
medicines indeed translate to tooth corrosion. This will be followed by risk assessment using
appropriate risk assessment models in the literature.
It is expected that some drugs will be found to be at risk of causing dental caries due to the presence
of high sugar levels, low pH and corrosion of incubated tooth. The results will contribute to the
general body of knowledge in the scientific world as well as informing Malawians on the risks of
drugs they take on dental caries. These results will therefore be reported in peer reviewed journals
as well as in international and national research dissemination conferences.
2.0 INTRODUCTION
2.1 BACKGROUND
Dental caries is the most prevalent chronic disease worldwide (1). The Global Burden of Disease
Study 2016 estimated that oral diseases affected at least 3.58 billion people worldwide, with caries
of the permanent teeth being the most prevalent of all conditions assessed. Globally, it is estimated
that 2.4 billion people suffer from caries of permanent teeth and 486 million children suffer from
caries of primary teeth (2). There is no clear statistics on dental caries in Africa as their published
articles were limited. The prevalence of dental caries in Africa is rather low compared to its
existence in developed countries (3). This may be due to the low sugar intake in African diet and
the inability to access sugary snacks and confectioneries because most Africans live below poverty
line. However, an increase in urbanization in African cities and a global escalation in sugar intake
has caused sugar-rich diets to be more common, and there is a fear that the frequency of dental
caries is likely to rise, especially among children in Africa (3). A national Dental & Oral Health
Survey conducted in 2014 showed that 50% of school going children (6-9 years) had tooth decay the sugar into acid which destroys the enamel hence causing dental caries. This study will assess
the different drugs for drug induced dental caries.
In this study the potential of drugs to induce dental caries depends on the pH of the drug. Drugs
that are more acidic are more likely to induce dental caries. Therefore, the longer the drugs stay in
contact with the teeth the more the enamel dissolves. Drugs that are sugary also have a high
potential to induce dental caries because the sugars present will be converted to acid by the bacteria
therefore dissolve the teeth enamel. Drugs that are formulated in solution form are more likely to
induce dental caries than drugs formulated in tablets and capsules. This is because drugs in solution
form are more likely to make contact and stick to the teeth. Drugs that are in capsule and traditional
tablets are less likely to induce dental caries because they do not stay in contact with teeth for a
long time. However chewable tablets show a high risk of inducing dental caries because they get
stuck between the teeth enamel.
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Research Subject Categories::PHARMACY