Association of amoxicillin use during early childhood with developmental tooth enamel defects

Liang Hong, Steven M. Levy, John J. Warren, Deborah V. Dawson, George R. Bergus, James S. Wefel

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background: It has been speculated that amoxicillin use could be associated with dental enamel defects. Objective: To assess the association between dental fluorosis, one of the most common developmental tooth enamel defects, and amoxicillin use during early childhood. Design, Setting, and Participants: As participants in the Iowa Fluoride Study, subjects were followed up from birth to 32 months using questionnaires every 3 to 4 months to gather information on fluoride intake and amoxicillin use. Methods: Early-erupting permanent teeth of 579 subjects were assessed for fluorosis using the Fluorosis Risk Index at approximately the age of 9 years. Relationships between fluorosis and amoxicillin use were assessed using relative risk (RR), Mantel-Haenszel stratified analyses, and multivariable logistic regression. Results: Amoxicillin use was reported by 75% of subjects by 12 months and 91% by 32 months. Overall, 24% had fluorosis on both maxillary central incisors. Amoxicillin use from 3 to 6 months significantly increased the risk of fluorosis on the maxillary central incisors (RR=2.04; 95% confidence interval [CI], 1.49-2.78). After adjusting for fluoride intake and otitis media, the risk of fluorosis on the maxillary central incisors from amoxicillin use during 3 to 6 months (Mantel-Haenszel RR=1.85; 95% CI, 1.20-2.78) was still statistically significant. Multivariable logistic regression analyses confirmed the increased risk of fluorosis from amoxicillin use during 3 to 6 months (odds ratio=2.50; 95% CI, 1.21-5.15); fluoride intake was also statistically significant. Conclusion: The findings from this study suggest a link between amoxicillin use during infancy and developmental enamel defects of permanent teeth; however, further research is needed.

Original languageEnglish (US)
Pages (from-to)943-948
Number of pages6
JournalArchives of Pediatrics and Adolescent Medicine
Volume159
Issue number10
DOIs
StatePublished - Oct 1 2005

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Amoxicillin
Dental Enamel
Tooth
Fluorides
Incisor
Confidence Intervals
Logistic Models
Dental Fluorosis
Otitis Media
Odds Ratio
Regression Analysis
Parturition

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Association of amoxicillin use during early childhood with developmental tooth enamel defects. / Hong, Liang; Levy, Steven M.; Warren, John J.; Dawson, Deborah V.; Bergus, George R.; Wefel, James S.

In: Archives of Pediatrics and Adolescent Medicine, Vol. 159, No. 10, 01.10.2005, p. 943-948.

Research output: Contribution to journalArticle

Hong, Liang ; Levy, Steven M. ; Warren, John J. ; Dawson, Deborah V. ; Bergus, George R. ; Wefel, James S. / Association of amoxicillin use during early childhood with developmental tooth enamel defects. In: Archives of Pediatrics and Adolescent Medicine. 2005 ; Vol. 159, No. 10. pp. 943-948.
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abstract = "Background: It has been speculated that amoxicillin use could be associated with dental enamel defects. Objective: To assess the association between dental fluorosis, one of the most common developmental tooth enamel defects, and amoxicillin use during early childhood. Design, Setting, and Participants: As participants in the Iowa Fluoride Study, subjects were followed up from birth to 32 months using questionnaires every 3 to 4 months to gather information on fluoride intake and amoxicillin use. Methods: Early-erupting permanent teeth of 579 subjects were assessed for fluorosis using the Fluorosis Risk Index at approximately the age of 9 years. Relationships between fluorosis and amoxicillin use were assessed using relative risk (RR), Mantel-Haenszel stratified analyses, and multivariable logistic regression. Results: Amoxicillin use was reported by 75{\%} of subjects by 12 months and 91{\%} by 32 months. Overall, 24{\%} had fluorosis on both maxillary central incisors. Amoxicillin use from 3 to 6 months significantly increased the risk of fluorosis on the maxillary central incisors (RR=2.04; 95{\%} confidence interval [CI], 1.49-2.78). After adjusting for fluoride intake and otitis media, the risk of fluorosis on the maxillary central incisors from amoxicillin use during 3 to 6 months (Mantel-Haenszel RR=1.85; 95{\%} CI, 1.20-2.78) was still statistically significant. Multivariable logistic regression analyses confirmed the increased risk of fluorosis from amoxicillin use during 3 to 6 months (odds ratio=2.50; 95{\%} CI, 1.21-5.15); fluoride intake was also statistically significant. Conclusion: The findings from this study suggest a link between amoxicillin use during infancy and developmental enamel defects of permanent teeth; however, further research is needed.",
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