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.
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.
Authors: Marlies E C Elfrink; Henriette A Moll; Jessica C Kiefte-de Jong; Hanan El Marroun; Vincent W V Jaddoe; Albert Hofman; Bruno H Stricker; Jacob M ten Cate; Jaap S J Veerkamp Journal: Drug Saf Date: 2013-08 Impact factor: 5.606
Authors: Steven M Levy; Julie Eichenberger-Gilmore; John J Warren; Elena Letuchy; Barbara Broffitt; Teresa A Marshall; Trudy Burns; Marcia Willing; Kathleen Janz; James C Torner Journal: Community Dent Oral Epidemiol Date: 2009-10 Impact factor: 3.383