Bhasin Saanya, Singh Simran, Thomas Manuel Sebastian, Mahabala Karuna Yarmunja, Shenoy Ramya
Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India.
Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India.
BMC Oral Health. 2025 Jan 27;25(1):141. doi: 10.1186/s12903-025-05523-3.
Due to their acidic nature, certain medications can have deleterious effects on tooth enamel. Fluoride is a popular method for reversing these effects. Therefore, this study aimed to assess the impact of acidic medications, specifically anti-asthmatic drugs and vitamin C tablets, on enamel surfaces and to investigate the effects of fluoride following drug exposure.
An in vitro experimental study was conducted on ninety-six healthy human posterior teeth. Forty-eight samples were tested for surface demineralization via quantitative laser fluorescence (QLF), and the other forty-eight samples were tested for enamel microhardness via a Vickers hardness tester. The samples were divided into six groups: (i) Group DW_NF- samples immersed in distilled water with no fluoride exposure; (ii) Group DW_F- samples immersed in distilled water with intermittent fluoride exposure; (iii) Group VC_NF- samples treated with vitamin C only; (iv) Group VC_F- samples treated with vitamin C and fluoride mouthwash; (v) Group SB_NF- samples exposed to salbutamol inhaler with no fluoride exposure; (vi) Group SB_NF- samples exposed to salbutamol inhaler followed by fluoride exposure. For the evaluation of surface morphology by scanning electron microscopy (SEM), two random samples used for QLF from each group were taken. The Wilcoxon signed-rank test, Kruskal‒Wallis test, and post hoc test were applied as appropriate. The p value was set at 0.05.
Following exposure to medication, significantly higher QLF values were observed in Group VC_F and Group SB_F than in Group DW-NF (control group) (p = 0.15 and 0.004, respectively). The difference in the QLF values was significantly greater in Group VC_NF than in the control group DW-NF, indicating greater demineralization with acidic medications (p = 0.034). Significant changes in surface microhardness were detected in Group VC_F compared with the control group (p = 0.024). Qualitative analysis of SEM images revealed erosion at the enamel surface in all groups except the control group, with the most prominent erosion in the vitamin C- and fluoride-treated groups (VC_F group).
This study demonstrated the erosive potential of vitamin C tablets on enamel surfaces. Furthermore, the use of acidic fluoride mouthwash immediately after exposure to acidic medication exacerbates enamel demineralization.
某些药物因其酸性性质，会对牙釉质产生有害影响。氟化物是逆转这些影响的常用方法。因此，本研究旨在评估酸性药物，特别是抗哮喘药物和维生素C片，对牙釉质表面的影响，并研究药物暴露后氟化物的作用。
对96颗健康人后牙进行体外实验研究。48个样本通过定量激光荧光（QLF）检测表面脱矿情况，另外48个样本通过维氏硬度测试仪检测牙釉质显微硬度。样本分为六组：（i）DW_NF组——样本浸泡在无氟暴露的蒸馏水中；（ii）DW_F组——样本浸泡在间歇性氟暴露的蒸馏水中；（iii）VC_NF组——仅用维生素C处理的样本；（iv）VC_F组——用维生素C和含氟漱口水处理的样本；（v）SB_NF组——暴露于沙丁胺醇吸入器且无氟暴露的样本；（vi）SB_F组——暴露于沙丁胺醇吸入器后再进行氟暴露的样本。为通过扫描电子显微镜（SEM）评估表面形态，从每组中随机选取两个用于QLF检测的样本。根据情况应用威尔科克森符号秩检验、克鲁斯卡尔-沃利斯检验和事后检验。设定p值为0.05。
药物暴露后，VC_F组和SB_F组的QLF值显著高于DW-NF组（对照组）（分别为p = 0.15和0.004）。VC_NF组的QLF值差异比对照组DW-NF组显著更大，表明酸性药物导致的脱矿更严重（p = 0.034）。与对照组相比，VC_F组的表面显微硬度有显著变化（p = 0.024）。SEM图像的定性分析显示，除对照组外，所有组的牙釉质表面均有侵蚀，维生素C和氟处理组（VC_F组）的侵蚀最为明显。
本研究证明了维生素C片对牙釉质表面的侵蚀潜力。此外，在暴露于酸性药物后立即使用酸性含氟漱口水会加剧牙釉质脱矿。
