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Prenatal and Early Childhood Determinants of Enamel Hypoplasia in Infants

Author(s): Schroth RJ, Dhalla S, Tate R, Moffatt MEK

Objective: Enamel hypoplasia (EH) is a recognized risk factor for dental caries. The purpose was to investigate the relationship between prenatal and early life risk factors, including prenatal nutritional status, and EH among infants.

Methods: Pregnant mothers from an at-risk urban population in Manitoba, Canada were recruited during the second or early third trimester into a prospective cohort study. At baseline participants completed a questionnaire and provided a serum sample to analysze calcium and 25-hydroxyvitamin D [25(OH)D]. Dental examinations were completed at one year of age by an examiner blinded to mothers’ serum nutrient levels and parents completed a questionnaire by interview. Enamel defects were determined using the DDE index. Data were analyzed using descriptive techniques and regression analysis. A p value < 0.05 was significant.

Results: Overall, 22% of infants had EH. Although mothers of infants with EH had lower mean concentrations of 25(OH)D, they did not statistically differ from values associated with children without EH (p=0.072). Infants with EH were significantly more likely to have early childhood caries (73% vs. 27%, p<.001). Four factors were significantly and independently associated with EH: prenatal maternal calcium levels (p=.030), not having heard of vitamin D (p=.033), not drinking milk frequently during pregnancy (p=.034), and not consuming margarine daily (p=.023).

Conclusions: Several prenatal and early childhood determinants were identified to be associated with EH in infants and, due to the strong association with early childhood caries, the management of EH risk factors is critical to reducing oral health disparities in at-risk children.

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