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Antibiotic could be associated with enamel defects

An antibiotic commonly used for treating childhood ear infections may be linked to tooth enamel defects.

There is some evidence that amoxicillin—often used among pediatric patients for treatment of otitis media (infection and inflammation of the inner ear)—could be associated with dental enamel defects.

According to recently published research in the Archives of Pediatrics and Adolescent Medicine, even a small effect on dental enamel could have a significant effect on public dental health due to amoxicillin’s widespread use.

"The results show that amoxicillin use during early infancy seems to be linked to dental fluorosis on both permanent first molars and maxillary central incisors," reported a team of University of Iowa researchers led by Dr. Liang Hong.

The signs of fluorosis range from barely noticeable white flecks to brown stains.

Dr. Hong and colleagues assessed the association between dental fluorosis and amoxicillin use during childhood based on data from the Iowa Fluoride Study, a prospective study investigating fluoride exposures, biological and behavioral factors, and children's dental health.

"Duration of amoxicillin use was related to the number of early-erupting permanent teeth with fluorosis," they wrote. By age 1, three-quarters of the subjects had used amoxicillin, and by 32 months, 91 percent of participants had used the antibiotic.

"Overall, 24 percent had fluorosis on both maxillary central incisors," the authors wrote. Amoxicillin use from three to six months doubled the risk of dental fluorosis, they added.

"The findings suggest that amoxicillin use in infancy could carry some heretofore undocumented risk to the developing teeth," the researchers wrote. "While the results of this one study do not warrant recommendations to cease use of amoxicillin early in life, they do further highlight the need to use antibiotics judiciously, particularly during infancy."

Additional laboratory and clinical studies with specified amoxicillin dosages and well-designed epidemiological studies are needed to confirm the results, added the study’s authors.

Please contact the ADA if you have questions about this article.

©2010 American Dental Association. All rights reserved. Reproduction or republication is strictly prohibited without the prior written permission from the American Dental Association.

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