Fluoride concentration in pediatric medicines and the risk of dental fluorosis / Concentração de flúor em medicamentos pediátricos e risco de fluorose dentária
AUTOR(ES)
Andrea Anzai
DATA DE PUBLICAÇÃO
2003
RESUMO
Owing to the increasing incidence of dental fluorosis, all possible fluoride sources consumed by children in the risk age group should be evaluated. Children with chronic health problems make routine use of medicines. This study aimed at analyzing the presence of total fluoride (TF) in 114 liquid pediatric medicines, through Taves´ HMDS-HCl facilitated diffusion method; evaluating the concentration of soluble fluoride in HCl 0.01 M (SF), after acid hydrolisis, of those which presented TF superior to the safe intake rate from 0.05 to 0.07 mg F/kg body mass/day, for a 12-kg child, as a simulation of the fluoride that would be bioavailable for absorption in the stomach; and researching the medicines that could be considered as risk factors to dental fluorosis, adopting for comparison, the same fluoride intake rate. Starting from these experimental conditions, it could be verified that 99.12% of the medicines presented TF in their composition, with variations between 0.0 and 97.8 ppm F. Amongst these, the medicines which revealed TF equal or superior to the intake rate for a 12-kg child after, considering the medicine volume consumed daily were: Kalyamon B-12 (97.80 ppm F; 0.244 mg F/kg/day), Epelin (57.89 ppm F; 0.072 mg F/kg/day), Irradiated Calcigenol (51.83 ppm F; 0.086 mg F/kg/day) and Combined Calcigenol B12 (25.62 ppm F; 0.064 mg F/kg/day). They also presented values of SF of 1.88 ppm F; 37.15 ppm F; 5.98 ppm F; and 3.58 ppm F, respectively, all inferior when compared to those of TF. No medicine presented a SF content equal or superior to that of the corresponding fluoride safe dose. Nevertheless, Epelin (0.046 mg F/kg/day) was close to that rate. It was concluded that fluoride was present without a clear purpose in most medicines. The three polivitaminic medicines showed a marked reduction of fluoride bioavailability in the stomach, for being enriched with mineral salts. Taking into account the gastric absorption, alone, Epelin could pose a risk to fluorosis when associated to other fluoride sources. However, caution is recommended regarding the other polivitaminics, for the rate of intestinal absorption is ignored, besides that it is not possible to control the associations with the other fluoride sources, which usually take place.
ASSUNTO(S)
fluorose dentária odontopediatria
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