Link found between amoxicillin and enamel defects
Amoxicillin use during infancy has been linked to the development of
enamel defects in permanent teeth, according to research published
this week (Archives of Paediatrics and Adolescent Medicine 2005;159:943).
Liang Hong, University of Iowa, and colleagues explain that some antibiotics,
such as tetracycline, clearly influence the development of the tooth,
however little is known about the effects of most other antibiotics.
Subjects in the Iowa Fluoride Study (n=579) were followed from birth
to 32 months using questionnaires every three to four months to ascertain
fluoride intake and amoxicillin use. Teeth were assessed for fluorosis
(an enamel defect that can lead to white flecks, pits and dark brown
stains) at nine years. By 32 months, 91 per cent of subjects had been
exposed to amoxicillin.
Results show that amoxicillin use from three to six months increased
the risk of fluorosis on maxillary central incisors (relative risk 2.04;
95 per cent confidence interval 1.49–2.78). After adjusting for
fluoride intake and otitis media the association was still significant
(1.85; 1.20–2.78, P=0.005). Similar results were obtained for the
association between amoxicillin and fluorosis of molars.
The researchers say that the study findings are not conclusive due to
substantial limitations, including the use of a convenience sample, relatively
high socioeconomic status and the use of self-administered questionnaires. “There
is a need for further research, such as animal studies, histopathologic
studies and well-designed cohort studies,” they conclude. However,
they believe that their results highlight the need to use antibiotics
judiciously. |
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