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Hearing and neurologic impairment: insult timing indicated by primary tooth enamel defects
Insights
Early childhood systemic insults can cause both hearing loss and neurologic impairment. Tooth enamel defects indicate the timing of these insults, correlating with the severity of hearing and neurologic deficits in children.
Area of Science:
- Developmental Pediatrics
- Otolaryngology
- Pediatric Neurology
Background:
- Primary tooth enamel defects can indicate timing of prenatal or perinatal insults.
- Hearing loss and neurologic impairment are significant concerns in pediatric care.
- Understanding the relationship between insult timing and developmental outcomes is crucial.
Purpose of the Study:
- To examine the association between hearing loss, neurologic impairment, and primary tooth enamel defects in children.
- To determine if the timing of a systemic insult, indicated by tooth defect location, correlates with hearing and neurologic outcomes.
Main Methods:
- Studied 88 children undergoing hearing evaluations.
- Classified enamel defects based on location (incisal edge, cervical third, middle third).
- Correlated tooth defect timing with audiometric findings and neurologic assessments.
Main Results:
- 41 children had classifiable enamel defects.
- More severe hearing loss was associated with incisal edge defects (early insult) compared to cervical third defects (near term).
- A significant correlation was found between hearing loss severity and estimated insult timing (r = -0.48, p < 0.01).
- Early insults were linked to more frequent moderate/severe neurologic deficits, while later insults correlated with mild/no impairment.
Conclusions:
- Tooth enamel defects serve as reliable indicators of insult timing.
- Auditory and neurologic structures exhibit differential susceptibility to insults based on gestational timing.
- This study supports a link between insult timing and the development of hearing loss and neurologic deficits.
Abstract:
The association between hearing loss, neurologic impairment, and primary tooth enamel defects was examined in a group of 88 children presenting for hearing evaluation at a tertiary care children's hospital. Forty-one had classifiable enamel defects, reflecting the time and duration of prenatal or perinatal insult. Hearing loss was more prevalent and severe in 19 children with enamel defects of the incisal tooth edge (mean = 61 dB) reflecting a systemic insult at 14 to 16 weeks gestation, than in 7 children with cervical third tooth defects (mean = 23 dB) reflecting insult near term (X2 = 4.08; p less than 0.05). Audiometric findings among the 15 children with incisor defects of the middle third varied; 7 had significant hearing loss and 8 were normal. A correlation was observed between severity of hearing loss (in dB) and estimated time of systemic insult (in weeks gestational age) determined by tooth defect site (r = -0.48; p less than 0.01). The neurologic data revealed similar trends. The group with early systemic insults more frequently had moderate or severe neurologic deficits known to originate early in fetal development. The two groups with third trimester or term insults tended to have mild or no neurologic impairment. A differential susceptibility for developing auditory and neurologic structures based on insult timing is supported.