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Published on: March 29, 2018
Amoxicillin use during early childhood and fluorosis of later developing tooth zones
Liang Hong1, Steven M Levy, John J Warren
1Department of Pediatric Dentistry and Community Oral Health, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
Objectives:
Amoxicillin use has been reported to be associated with developmental defects on enamel surfaces. This analysis assessed the association between amoxicillin use and fluorosis on late-erupting permanent teeth.
Methods:
As part of the Iowa Fluoride Study, subjects were followed from birth to 32 months with questionnaires every 3-4 months to gather information on fluoride intake and amoxicillin use (n = 357 subjects for this analysis). Permanent tooth fluorosis on late-erupting zones was assessed by three trained dentists using the fluorosis risk index (FRI) at approximately age 13. A case was defined as fluorosis if a subject had at least two FRI classification II zone scores of 2 or 3. Chi-square tests and logistic regression were used, and relative risks (RRs) and odds ratios (ORs) were calculated.
Results:
There were 113 cases and 244 controls. In bivariate analyses, amoxicillin use from 20 to 24 months significantly increased the risk of fluorosis on FRI classification II zones [44.2 percent versus 30.4 percent, [RR = 1.45, 95 percent confidence interval (CI) 1.05-2.04], but other individual time periods did not. Multivariable logistic regression confirmed the increased risk of fluorosis for amoxicillin use from 20 to 24 months (OR = 2.92, 95 percent CI = 1.34-6.40), after controlling for otitis media, breast-feeding, and fluoride intake.
Conclusions:
Amoxicillin use during early childhood could be a risk factor in the etiology of fluorosis on late-erupting permanent tooth zones, but further research is needed.
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