Sweeteners In Medication

The Canadian Dental Association is concerned about the high levels of sugar used as sweeteners in both prescription and over-the-counter drugs. The sugar content of the formulations is from 20% to 80%.

Patients particularly at risk include those with special needs and infants on long-term medications who have not yet established proper oral hygiene. The presence in the mouth of sweet syrupy medications can contribute to high rates of dental caries (such as those seen in early childhood caries). There are sugar substitutes that do not contribute to dental caries.

The Canadian Dental Association’s position is as follows:

1. Health care providers, especially physicians, dentists and pharmacists, should be made aware of the high sugar content of oral elixers, suspensions and chewable medications and should be advised to try to prescribe/dispense drugs utilizing sugar substitutes whenever possible.
2. The Pharmaceutical Manufacturers Association and Proprietary Drug Association should be made aware of the high risk of decay associated with prescription and over-thecounter drugs containing sugar and should be encouraged to employ sugar substitutes in medications.
3. Special needs patients and/or parents/caregivers of children should be advised of the increased risk of tooth decay associated with the chronic use of sugar-sweetened medications. They should also be counseled regarding oral hygiene and other preventive measures.
4. Labeling of medication should indicate sugar content to assist the choice of alternatives.
   High sugar content medications such as oral elixers, suspensions and chewable medications should include warnings regarding the increased risk of dental caries from chronic use on labels or/and in drug monographs.

Approved
CDA Board of Directors
February 2005