Dental erosion following clopidogrel administration in a dog: A case-based study

A 10-year-old neutered male Chihuahua presented with unilateral dental erosion that occurred after several months of oral medications mixed with honey. A pH test was performed on all oral medications administered to the dogs to determine the cause of enamel erosion. Among the medications, the only acidic medication was clopidogrel (pH 2.65). To evaluate the effect of clopidogrel on the tooth surface under the same conditions as in the present patient, an additional preliminary study was designed in which two extracted teeth of another dog were immersed in a clopidogrel-honey mixture or only in honey. After a 3-week soaking of the extracted tooth in the clopidogrel-honey mixture, field-emission scanning electron microscope analysis revealed a rougher surface, whereas energy-dispersive X-ray spectroscopy analysis showed a reduced Ca/C ratio compared to the control tooth. In this case, prolonged exposure of the tooth surface to clopidogrel may be a cause of dental erosion. A 10-year-old neutered male Chihuahua was presented with unilateral dental erosion that occurred after several months of oral medications mixed with honey. Among the medications, the only acidic medication was clopidogrel (pH 2.65). Additionally, it was demonstrated in an independent experiment that a clopidogrel-honey mixture could cause dental erosion when administered to a patient with low salivation. This result suggested prolonged exposure of the tooth surface to clopidogrel may cause dental erosion in dogs.Figure legendsMacroscopic and microscopic features of tooth surface that immersed into clopidogrel-honey mixture (left) vs. honey alone (right). image