Evaluation of sugar content in probiotics products prescribed for children - a review
Keywords:
Children; caries; dentistry; probiotics; sweetener.Abstract
The interest in nutritional supplement and functional food has risen significantly in recent years. Many of the products that are marketed to the consumers have the benefits of the probiotic for general good health and for a wide variety of conditions and situations. Although most of the products have been used safely for years, careful analysis and see scientific research should be conducted before routinely recommendation these products, especially for children.A basic understanding of intestinal flora, properties of probiotic and clinical research findings is necessary for clinicians to delineate probiotic agents in paediatric population. Therefore, the aim of this paper will be to summarize available evidence of probiotic use in well-defined clinical indications of importance for pediatricians. Sweetened oral medications are widely used for children to facilitate compliance. A variety of natural and artificial sweeteners are used in these drug formulations to augment the sweetness and thereby palatability of the product. There is growing concern among dentists about the increased consumption of sugars in these medications by children, especially those who are chronically ill as it may contribute to diabetes mellitus, dental erosion, and dental caries. This literature review provides information about the sweetener content and cariogenic potential of commonly prescribed pediatric oral medications that are used for managing acute and chronic conditions in children and measures for oral health prevention.
Downloads
References
Food and Agricultural Organization of the United Nations, World Health Organization. Health and nutritional properties of probiotics in food including powder milk with live lactic acid bacteria. Córboda: FAO, WHO; 2001.(Food and Agriculture Organization of the United Nations and World Health Organization, 2001*).
Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B, et al. Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014;11:506–514.
Reid G, Charbonnean D, ErbJ, Konchanowski B, Beuenuaum D, Pochnu R, et al. Oral use of lactobacillus rhamnosus GR. and L. Fermentum RC-14 significantly alters vaginal Flora, randomised, plaubo - controlled trail in 64 healthy women. Fems immunology and medical microbiology 2003; 35(2):134-4. ePub 2003/03/12.
Khalesi S, Sun J, Bys N, Jaya Singhe R. Effect on probiotics on BP: a structured review and meta – analysis of randomised, controlled trial. Hypertension. 2014; 64(4).
Guo Z, Liu XM, Zhang QX, Shen Z, Tian FW, Zhang H, et al. Influence of consumption of probiotic on the plasma lipids profile: A meta-analysis of randomised controlled trials. Nutrition, metabolism and cardiovascular disease: NMCD 2011;21(11): 844-50.
Tabuchi M, Ozaki M, Tamura A, Yamada N, Ishida T, Hosoda M, et al. Antidiabetic effects of lactobacillus GG in steptozotocin- induced diabetic rats. Bioscience, Biotechnology and biochemistry. 2003:67(6).
Cavalcanti AL, Desouza R, Clementrino MA, carcinogenic and erosive potential of paediatric anti- excessive liquid oral medication. Tanzania J health res 2012; 14:8.
Nunn JH, Ng Sk, Sharkey I, Coulhard M. The dental implications of chronic use of acidic medicine in medically compromised children. Pharm world sci 2001; 23: 118-9.
Peres KG, Oliveira CT, Peus MA Raymond Mdos S, Fete R. Sugar content in liquid oral medicine for children. Rev Sandy publica 2005;39:486-9.
Edgar WM. sugar Substitutes, chewing gum and dental caries - A review Br Dent J 1998;184:29-32.
Strickley RB, Iwata Q, Wu S, Dahl TC. Paediatric drug – a review of commercially available oral formulations, J pharm sci 2008;97: 1731-74.
Allen LV Jr. Dosage design and development.Clin ther 2008;30:2102-11.
Durward C, thou T. Dental caries and sugar - containing liquid medicines for children in New Zealand. New Zealand dent J 1997;93:124:9.
Russell, Pauline, “Physiological and functional properties of probiotics,”International Journal of Dairy Technology, vol. 429, pp. 2–6, 2008.
M. Saarela, G. Mogensen, R. Fondén, J. Mättö, and T. Mattila-Sandholm, “Probiotic bacteria: safety, functional and technological properties,” Journal of Biotechnology, vol. 84, no. 3, pp. 197–215, 2000.
Ibnou-Zekri N, et al. Divergent patterns of colonization and immune response elicited from two intestinal Lactobacillus strains that display similar properties in vitro. Infect Immun 2003;71:428-36.
Guarner F, Malagelada JR. Gut flora in health and disease. The Lancet. 2003;361(9356):512–519.
Jeevanandan G. Kedo-S Paediatric Rotary Files for Root Canal Preparation in Primary Teeth - Case Report. J Clin Diagn Res. 2017;11(3):ZR03‐ZR05.
Govindaraju L, Jeevanandan G, Subramanian EMG. Comparison of quality of obturation and instrumentation time using hand files and two rotary file systems in primary molars: A single-blinded randomized controlled trial. Eur J Dent. 2017; 11(3):376‐379.
Govindaraju L, Jeevanandan G, Subramanian E. Knowledge and practice of rotary instrumentation in primary teeth among indian dentists: A questionnaire survey. J Int Oral Health 2017;9:45-8.
Somasundaram S, Ravi K, Rajapandian K, Gurunathan D. Fluoride Content of Bottled Drinking Water in Chennai, Tamilnadu. J Clin Diagn Res. 2015;9(10): ZC32‐ZC34.
Jeevanandan G, Govindaraju L. Clinical comparison of Kedo-S paediatric rotary files vs manual instrumentation for root canal preparation in primary molars: a double blinded randomised clinical trial. Eur Arch Paediatr Dent. 2018;19(4):273‐ 278.
Govindaraju L, Jeevanandan G, Subramanian E. Clinical Evaluation of Quality of Obturation and Instrumentation Time using Two Modified Rotary File Systems with Manual Instrumentation in Primary Teeth. J Clin Diagn Res. 2017;11(9): ZC55‐ZC58.
Ravikumar D, Jeevanandan G, Subramanian EMG. Evaluation of knowledge among general dentists in treatment of traumatic injuries in primary teeth: A cross-sectional questionnaire study. Eur J Dent. 2017;11(2):232‐237.
Panchal V, Jeevanandan G, Subramanian E. Comparison of instrumentation time and obturation quality between hand K-file, H-files, and rotary Kedo-S in root canaltreatmentof primary teeth: A randomized controlled trial. J Indian Soc Pedod Prev Dent. 2019;37(1):75‐79. doi:10.4103/JISPPD.JISPPD_72_18.
Aishwarya AS, Gurunathan D. Stress level in dental students performing pedodontic procedure. J Adv Pharm Edu Res 2017;7(1):34-38.
Packiri S, Gurunathan D, Selvarasu K. Management of Paediatric Oral Ranula: A structured Review. J Clin Diagn Res. 2017;11(9):ZE06‐ZE09.
Gurunathan D, Shanmugaavel AK. Dental neglect among children in Chennai. J Indian Soc Pedod Prev Dent 2016;34:364-9.
Govindaraju L, Gurunathan D. Effectiveness of Chewable ToothBrush in Children-A Prospective Clinical Study. J Clin Diagn Res. 2017;11(3):ZC31‐ZC34.
Subramanyam D, Gurunathan D, Gaayathri R, Vishnu Priya V. Comparative evaluation of salivary malondialdehyde levels as a marker of lipid peroxidation in early childhood caries. Eur J Dent. 2018;12(1):67‐70.
Mahesh R, Masitah M. Fluoride, fluoridated toothpaste efficacy and its safety in children - Review. International Journal of Pharmaceutical Research 2018; 10(4) : 109-114.
NAIR M, JEEVANANDAN G, Vignesh R, Subramanian EMG. Assessing the quality of root canal filling and instrumentation time using kedo-s files, reciprocating files and k-files. Braz Dent Sci 2020; 23(1):1-7.
Allen, L. V., Jr (2008) ‘Dosage form design and development’, Clinical therapeutics, 30(11), pp. 2102– 2111.
Cavalcanti, A. L. et al. (2012) ‘In vitro Analysis of the Cariogenic and Erosive Potential of Pediatric Antitussive Liquid Oral Medications’, Tanzania Journal of Health Research. doi: 10.4314/thrb.v14i2.7.
Deogade, S., Gupta, P. and Ariga, P. (2018) ‘Effect of monopoly-coating agent on the surface roughness of a tissue conditioner subjected to cleansing and disinfection: A Contact Profilometric In vitro study’, Contemporary Clinical Dentistry, p. 122. doi: 10.4103/ccd.ccd_112_18.
Dua, K. et al. (2019) ‘The potential of siRNA based drug delivery in respiratory disorders: Recent advances and progress’, Drug development research, 80(6), pp. 714–730.
Duraisamy, R. et al. (2019) ‘Compatibility of Nonoriginal Abutments With Implants: Evaluation of Microgap at the Implant-Abutment Interface, With Original and Nonoriginal Abutments’, Implant dentistry, 28(3), pp. 289–295.
Durward, C. and Thou, T. (1997) ‘Dental caries and sugar-containing liquid medicines for children in New Zealand’, The New Zealand dental journal, 93(414), pp. 124–129.
Edgar, W. M. (1998) ‘Sugar substitutes, chewing gum and dental caries--a review’, British Dental Journal, pp. 29–32. doi: 10.1038/sj.bdj.4809535.
Ezhilarasan, D. (2018) ‘Oxidative stress is bane in chronic liver diseases: Clinical and experimental perspective’, Arab journal of gastroenterology: the official publication of the Pan-Arab Association of Gastroenterology, 19(2), pp. 56–64.
Ezhilarasan, D., Apoorva, V. S. and Ashok Vardhan, N. (2019) ‘Syzygium cumini extract induced reactive oxygen species-mediated apoptosis in human oral squamous carcinoma cells’, Journal of oral pathology & medicine: official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 48(2), pp. 115–121.
Ezhilarasan, D., Sokal, E. and Najimi, M. (2018) ‘Hepatic fibrosis: It is time to go with hepatic stellate cell- specific therapeutic targets’, Hepatobiliary & pancreatic diseases international: HBPD INT, 17(3), pp. 192–197.
‘Fluoride, Fluoridated Toothpaste Efficacy And Its Safety In Children - Review’ (2018) International Journal of Pharmaceutical Research. doi: 10.31838/ijpr/2018.10.04.017.
Food and Agriculture Organization of the United Nations and World Health Organization (2001*) Report of the Joint FAO/WHO Expert Consultation on Evaluation of Health and Nutritional Properties of Probiotics in Food Including Powder Milk with Live Lactic Acid Bacteria, Córdoba, Argentina, 1-4 October 2001.
Gheena, S. and Ezhilarasan, D. (2019) ‘Syringic acid triggers reactive oxygen species-mediated cytotoxicity in HepG2 cells’, Human & experimental toxicology, 38(6), pp. 694–702.
Gomathi, A. C. et al. (2020) ‘Anticancer activity of silver nanoparticles synthesized using aqueous fruit shell extract of Tamarindus indica on MCF-7 human breast cancer cell line’, Journal of Drug Delivery Science and Technology, p. 101376. doi: 10.1016/j.jddst.2019.101376.
Govindaraju, L. and Gurunathan, D. (2017) ‘Effectiveness of Chewable Tooth Brush in Children-A Prospective Clinical Study’, Journal of clinical and diagnostic research: JCDR, 11(3), pp. ZC31–ZC34.
Govindaraju, L., Jeevanandan, G. and Subramanian, E. (2017) ‘Clinical Evaluation of Quality of Obturation and Instrumentation Time using Two Modified Rotary File Systems with Manual Instrumentation in Primary Teeth’, Journal of clinical and diagnostic research: JCDR, 11(9), pp. ZC55–ZC58.
Govindaraju, L., Jeevanandan, G. and Subramanian, E. M. G. (2017a) ‘Comparison of quality of obturation and instrumentation time using hand files and two rotary file systems in primary molars: A single-blinded randomized controlled trial’, European journal of dentistry, 11(3), pp. 376–379.
Govindaraju, L., Jeevanandan, G. and Subramanian, E. M. G. (2017b) ‘Knowledge and practice of rotary instrumentation in primary teeth among indian dentists: A questionnaire survey’, Journal of International Oral Health, p. 45. doi: 10.4103/jioh.jioh_4_17.
Guarner, F. and Malagelada, J.-R. (2003) ‘Gut flora in health and disease’, The Lancet, pp. 512–519. doi: 10.1016/s0140-6736(03)12489-0.
Guo, Z. et al. (2011) ‘Influence of consumption of probiotics on the plasma lipid profile: A meta-analysis of randomised controlled trials’, Nutrition, Metabolism and Cardiovascular Diseases, pp. 844–850. doi: 10.1016/j.numecd.2011.04.008.
Gurunathan, D. and Shanmugaavel, A. K. (2016) ‘Dental neglect among children in Chennai’, Journal of the Indian Society of Pedodontics and Preventive Dentistry, 34(4), pp. 364–369.
Hill, C. et al. (2014) ‘The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic’, Nature Reviews Gastroenterology & Hepatology, pp. 506–514. doi: 10.1038/nrgastro.2014.66.
Ibnou-Zekri, N. et al. (2003) ‘Divergent patterns of colonization and immune response elicited from two intestinal Lactobacillus strains that display similar properties in vitro’, Infection and immunity, 71(1), pp. 428–436.
Jeevanandan, G. (2017) ‘Kedo-S Paediatric Rotary Files for Root Canal Preparation in Primary Teeth - Case Report’, Journal of clinical and diagnostic research: JCDR, 11(3), pp. ZR03–ZR05.
Jeevanandan, G. and Govindaraju, L. (2018) ‘Clinical comparison of Kedo-S paediatric rotary files vs manual instrumentation for root canal preparation in primary molars: a double blinded randomised clinical trial’, European Archives of Paediatric Dentistry, pp. 273–278. doi: 10.1007/s40368-018-0356-6.
J, P. C. et al. (2018) ‘Prevalence and measurement of anterior loop of the mandibular canal using CBCT: A cross sectional study’, Clinical implant dentistry and related research, 20(4), pp. 531–534.
Khalesi, S. et al. (2014) ‘Green tea catechins and blood pressure: a systematic review and meta-analysis of randomised controlled trials’, European Journal of Nutrition, pp. 1299–1311. doi: 10.1007/s00394-014- 0720-1.
Lakshmanan, L. et al. (2020) ‘Assessing the quality of obturation and instrumentation time using Kedo-S files, Reciprocating files and Hand K-files’, Brazilian Dental Science. doi: 10.14295/bds.2020.v23i1.1822.
Malli Sureshbabu, N. et al. (2019) ‘Concentrated Growth Factors as an Ingenious Biomaterial in Regeneration of Bony Defects after Periapical Surgery: A Report of Two Cases’, Case reports in dentistry, 2019, p. 7046203.
Mathew, M. G. et al. (2020) ‘Evaluation of adhesion of Streptococcus mutans, plaque accumulation on zirconia and stainless steel crowns, and surrounding gingival inflammation in primary …’, Clinical oral investigations. Available at: https://link.springer.com/article/10.1007/s00784-020-03204-9.
Mehta, M. et al. (2019) ‘Oligonucleotide therapy: An emerging focus area for drug delivery in chronic inflammatory respiratory diseases’, Chemico-biological interactions, 308, pp. 206–215.
Menon, S. et al. (2018) ‘Selenium nanoparticles: A potent chemotherapeutic agent and an elucidation of its mechanism’, Colloids and Surfaces B: Biointerfaces, pp. 280–292. doi: 10.1016/j.colsurfb.2018.06.006.
Nunn, J. H. et al. (2001) ‘Pharmacy World and Science’, pp. 118–119. doi: 10.1023/a:1011202409386.
Packiri, S., Gurunathan, D. and Selvarasu, K. (2017) ‘Management of Paediatric Oral Ranula: A Systematic Review’, Journal of clinical and diagnostic research: JCDR, 11(9), pp. ZE06–ZE09.
Panchal, V., Jeevanandan, G. and Subramanian, E. (2019) ‘Comparison of instrumentation time and obturation quality between hand K-file, H-files, and rotary Kedo-S in root canal treatment of primary teeth: A randomized controlled trial’, Journal of the Indian Society of Pedodontics and Preventive Dentistry, 37(1), pp. 75–79.
Panchal, V., Jeevanandan, G. and Subramanian, E. M. G. (2019) ‘Comparison of post-operative pain after root canal instrumentation with hand K-files, H-files and rotary Kedo-S files in primary teeth: a randomised clinical trial’, European archives of paediatric dentistry: official journal of the European Academy of Paediatric Dentistry, 20(5), pp. 467–472.
Pc, J., Marimuthu, T. and Devadoss, P. (2018) ‘Prevalence and measurement of anterior loop of the mandibular canal using CBCT: A cross sectional study’, Clinical implant dentistry and related research. Available at: https://europepmc.org/article/med/29624863.
Peres, K. G. et al. (2005) ‘Sugar content in liquid oral medicines for children’, Revista de Saúde Pública, pp. 486–489. doi: 10.1590/s0034-89102005000300022.
Prabakar, J. et al. (2018) ‘Comparative Evaluation of Retention, Cariostatic Effect and Discoloration of Conventional and Hydrophilic Sealants - A Single Blinded Randomized Split Mouth Clinical Trial’, Contemporary clinical dentistry, 9(Suppl 2), pp. S233–S239.
Rajendran, R. et al. (2019) ‘Comparative Evaluation of Remineralizing Potential of a Paste Containing Bioactive Glass and a Topical Cream Containing Casein Phosphopeptide-Amorphous Calcium Phosphate: An in Vitro Study’, Pesquisa Brasileira em Odontopediatria e Clínica Integrada, pp. 1–10. doi: 10.4034/pboci.2019.191.61.
Rajeshkumar, S. et al. (2018) ‘Biosynthesis of zinc oxide nanoparticles usingMangifera indica leaves and evaluation of their antioxidant and cytotoxic properties in lung cancer (A549) cells’, Enzyme and microbial technology, 117, pp. 91–95.
Rajeshkumar, S. et al. (2019) ‘Antibacterial and antioxidant potential of biosynthesized copper nanoparticles mediated through Cissus arnotiana plant extract’, Journal of photochemistry and photobiology. B, Biology, 197, p. 111531.
Ramadurai, N. et al. (2019) ‘Effectiveness of 2% Articaine as an anesthetic agent in children: randomized controlled trial’, Clinical oral investigations, 23(9), pp. 3543–3550.
Ramakrishnan, M., Dhanalakshmi, R. and Subramanian, E. M. G. (2019) ‘Survival rate of different fixed posterior space maintainers used in Paediatric Dentistry - A systematic review’, The Saudi dental journal, 31(2), pp. 165–172.
Ramesh, A. et al. (2018) ‘Comparative estimation of sulfiredoxin levels between chronic periodontitis and healthy patients - A case-control study’, Journal of periodontology, 89(10), pp. 1241–1248.
Ravikumar, D., Jeevanandan, G. and Subramanian, E. M. G. (2017) ‘Evaluation of knowledge among general dentists in treatment of traumatic injuries in primary teeth: A cross-sectional questionnaire study’, European journal of dentistry, 11(2), pp. 232–237.
Reid, G. et al. (2003) ‘Oral use ofLactobacillus rhamnosusGR-1 andL. fermentumRC-14 significantly alters vaginal flora: randomized, placebo-controlled trial in 64 healthy women’, FEMS Immunology & Medical Microbiology, pp. 131–134. doi: 10.1016/s0928-8244(02)00465-0.
Russell, P. (2009) ‘Physiological and Functional Properties of Probiotics (2008) - by International Dairy Federation’, International Journal of Dairy Technology, pp. 290–291. doi: 10.1111/j.1471- 0307.2009.00488.x.
Saarela, M. et al. (2000) ‘Probiotic bacteria: safety, functional and technological properties’, Journal of Biotechnology, pp. 197–215. doi: 10.1016/s0168-1656(00)00375-8.
Samuel, S. R., Acharya, S. and Rao, J. C. (2020) ‘School Interventions-based Prevention of Early- Childhood Caries among 3-5-year-old children from very low socioeconomic status: Two-year randomized trial’, Journal of public health dentistry, 80(1), pp. 51–60.
Sharma, P. et al. (2019) ‘Emerging trends in the novel drug delivery approaches for the treatment of lung cancer’, Chemico-biological interactions, 309, p. 108720.
Somasundaram, S. (2015) ‘Fluoride Content of Bottled Drinking Water in Chennai, Tamilnadu’, JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH. doi: 10.7860/jcdr/2015/14691.6594.
Sridharan, G. et al. (2019) ‘Evaluation of salivary metabolomics in oral leukoplakia and oral squamous cell carcinoma’, Journal of oral pathology & medicine: official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 48(4), pp. 299–306.
Strickley, R. G. et al. (2008) ‘Pediatric Drugs-A Review of Commercially Available Oral Formulations’,
Journal of Pharmaceutical Sciences, pp. 1731–1774. doi: 10.1002/jps.21101.
Subramanyam, D. et al. (2018) ‘Comparative evaluation of salivary malondialdehyde levels as a marker of lipid peroxidation in early childhood caries’, European journal of dentistry, 12(1), pp. 67–70.
Tabuchi, M. et al. (2003) ‘Antidiabetic Effect ofLactobacillusGG in Streptozotocin-induced Diabetic Rats’,
Bioscience, Biotechnology, and Biochemistry, pp. 1421–1424. doi: 10.1271/bbb.67.1421.
Varghese, S. S., Ramesh, A. and Veeraiyan, D. N. (2019) ‘Blended Module-Based Teaching in Biostatistics and Research Methodology: A Retrospective Study with Postgraduate Dental Students’, Journal of dental education, 83(4), pp. 445–450.
Vijayashree Priyadharsini, J. (2019) ‘In silico validation of the non-antibiotic drugs acetaminophen and ibuprofen as antibacterial agents against red complex pathogens’, Journal of periodontology, 90(12), pp. 1441–1448.
Vishnu Prasad, S. et al. (2018) ‘Report on oral health status and treatment needs of 5-15 years old children with sensory deficits in Chennai, India’, Special care in dentistry: official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry, 38(1), pp. 58–59.
Wahab, P. U. A. et al. (2018) ‘Scalpel Versus Diathermy in Wound Healing After Mucosal Incisions: A Split-Mouth Study’, Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons, 76(6), pp. 1160–1164.
Downloads
Published
How to Cite
Issue
Section
License
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation .
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
