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The implication of phenylketonuria on oral health
N M Kilpatrick1, H Awang, B Wilcken
1Royal Children's Hospital, Melbourne, Victoria, Australia.
Insights
Children with phenylketonuria (PKU) show higher tooth wear. Amino acid supplements used in PKU management have high acidity, posing an oral health risk. Dental care is crucial for these children.
Area of Science:
- Pediatric Dentistry
- Metabolic Disorders
- Biochemistry
Background:
- Phenylketonuria (PKU) is a genetic disorder requiring a strict low-phenylalanine diet.
- Dietary management of PKU involves amino acid supplements, whose oral health impact is not fully understood.
Purpose of the Study:
- To evaluate the oral health status of children with PKU.
- To assess the in vitro erosive potential of common amino acid supplements used in PKU management.
Main Methods:
- Dental examinations of 40 children with PKU and a matched control group.
- In vitro assessment of supplement pH and titratable acidity compared to soft drinks.
Main Results:
- No significant difference in caries prevalence between PKU and control groups (over 75% caries-free).
- Significantly higher prevalence of tooth wear in children with PKU (33%) versus controls (24%).
- Flavored amino acid supplements exhibited significantly higher titratable acidity than unflavored versions and Coca Cola.
Conclusions:
- Children with PKU experience more tooth wear, despite similar caries rates.
- Amino acid supplements can have high acidity, contributing to oral health risks.
- Increased dental awareness, advice, and referral are essential for PKU patients.
Purpose:
This study was performed to evaluate the oral health of children with PKU and to assess, in vitro, the erosive potential of 5 amino acid supplements commonly prescribed in the management of these children.
Methods:
Forty children with phenylketonuria underwent a full dental examination and were compared with an age and sex matched control group. The erosive potential of the supplements was assessed by comparing their pH and titratable acidity to those of Coca Cola and orange juice.
Results:
There was no significant difference between the affected and control groups in the level of dental caries, with over 75% of the children examined being caries free. However significantly more (33%) children with phenylketonuria exhibited signs of tooth wear compared with 24% of the controls (P < 0.05). While Coca Cola had the lowest pH (2.46), the titratable acidity of the flavoured supplements (92.86-126.8 mEq/l) was significantly higher than both their unflavored counterparts (4.18-14.0 mEq/l) and Coca Cola (38.56 mEq/l).
Conclusions:
Despite the potentially damaging nature of their diet, significantly less children with PKU had ever seen a dentist. Health professionals involved in the care of these patients should be aware of the implications of management and provide appropriate dental advice and referral.