Sugar load of oral liquid medications on chronically ill children.

Children with congenital disorders or chronic illnesses receive additional sugar from oral liquid medications. The purpose of this study was to determine the history of oral liquid medication usage and the incidence of dental caries from birth until about 36 months of age in a population of 20 such children. A pattern appeared in the frequency and dispensing characteristics of the 44 different drugs used for these children. Parents gave daily doses of syrupy medications and elixirs 3-4 times a day and at least two of these doses were given just before or during a designated nap or bedtime. Parental concerns for the more serious medical condition naturally overrode the consideration of sound dental hygiene practices. In this study, diseased, extracted and filled primary teeth def(t) were recorded and the medicinal sugar load at the time of examination was calculated as well as the cumulative medicinal sugar load from birth. Average age on examination was 31 months and the median number of def(t) was eight. The mean total amount of additional sugar from oral liquid medications was 8,696 g and the maximum sugar consumed by one child was over 20 kg. Physicians currently have no choice but to prescribe certain medications that contain 30 to 70 per cent sugar for patients who are already at higher than usual risk for dental caries due to chronic illness.