Nutrient intake and oral health outcomes in children with cow's milk allergy

Oral health is essential to child health, yet the impact of cow's milk allergy (CMA) is poorly defined. This study aimed to compare oral health outcomes between children with CMA and healthy controls and to identify dietary, clinical, and behavioral factors associated with these outcomes.

Patients with CMA and healthy controls were examined for dental caries, gingival health, dietary habits, and oral health risk factors. A three-day food diary was used to calculate intake and cariogenic food exposure, and laboratory parameters were documented.

Sixty-six patients with CMA aged 2-12 years [56.1% male, median age 39.3 months, 39.4% with multiple food allergies] and 44 healthy controls [61.4% male, median age 42.5 months] were included. Dietary fat, lactose, calcium, fluoride and phosphorus intakes were lower in the CMA group, while dietary iron, vitamin D, glucose and fiber intakes were higher (p < .05). The prevalence of early childhood caries (ECC) and the presence of dmft (decayed, missing, filled primary teeth ≥ 1) were similar between the CMA and control groups (p > .05). The mean gingival index scores were elevated in the CMA group compared to the control group (0.8 ± 0.3 vs. 0.7 ± 0.4, p = .03) whereas mean plaque index scores were comparable. In the CMA group, low serum 25(OH) vitamin D was independently associated with the presence of dmft in a penalized multivariable model [aOR 4.64 (95% CI 1.29-20.59; p = .018)].

While no differences were observed in ECC or dmft between children with CMA and healthy controls, children with CMA had slightly higher gingival index scores. Within the CMA group, low serum 25(OH) vitamin D levels were independently associated with the presence of dmft. Oral and periodontal health monitoring may be considered as part of comprehensive, personalized care for children with CMA.