Eruption of Permanent Teeth As Risk Factor for Allergic Reactions During Oral Immunotherapy

Oral immunotherapy (OIT) increases the threshold of reaction in children older than 4 years with food allergy. The risk for severe allergic reactions (ARs) during OIT has been reported in several studies, often in the presence of concomitant cofactors such as physical exercise, empty stomach, medications, poorly controlled asthma, menses, and alcohol consumption. We describe a case series of 5 scholar age patients undergoing OIT who showed ARs to a known, previously tolerated dose of allergen during permanent tooth eruption, in which other known cofactors were excluded. Patients may be exposed to cofactors due to behavioral habits not only in the second and third decades of life, but also in the first decade of life, due to the timing of mixed dentition. More studies are needed to estimate the frequency and entity of tooth eruption as cofactor, as well as to know the correct management of children undergoing dentition during OIT.