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Overview
Online articles from Reuters  , HealthDay News , WedMD , The New York Times , and the BBC are reporting that amoxicillin, a common antibiotic prescribed to infants and children, may affect tooth enamel. These reports are based on the findings of a study published in the October 2005 Archives of Pediatrics and Adolescent Medicine.
The new study assessed the association between dental fluorosis and amoxicillin use during early childhood, based on data gathered as part of the Iowa Fluoride Study. The study monitored 592 subjects from birth to 32 months to assess amoxicillin use and fluoride intake or exposure. At approximately 9 years of age, the subjects’ maxillary central incisors were assessed for dental fluorosis using the Fluorosis Risk Index.
The authors concluded that their "results suggest a link between amoxicillin use and fluorosis-like enamel defects, but the findings are not conclusive because of the substantial limitations of the study. There is a need for further research, such as animal studies, histopathologic studies and well-designed cohort studies [to confirm the results].” 1 Some study limitations cited by the authors included the “use of a convenience sample, relatively high socioeconomic status [of the subjects], and use of self-administered questionnaires without direct verification.”1 The study also found that children who took amoxicillin tended to have higher fluoride intake. Given these limitations, the authors noted that the study results do not warrant discontinuation of amoxicillin use in infants and young children, but do underscore the need for judicious use of antibiotics.
It is essential for all health care providers to use medications, including amoxicillin, according to manufacturers’ recommendations. Consistent with the authors’ conclusions, currently there is insufficient information to recommend a change in the administration of amoxicillin to infants and young children. Further research on this topic is encouraged.
Footnote
1 Hong L, Levy SM, Warren JJ, Dawson DV, Bergus GR, Wefel JS. Association of amoxicillin use during early childhood with developmental tooth enamel defects . Arch Pediatr Adolesc Med. 2005 Oct;159(10):943-8.
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A–Z Topic: Fluoride and Fluoridation
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Science in the News is a service by the American Dental Association (ADA) to present current information about science topics in the news. The ADA is a professional association of dentists committed to the public's oral health, ethics, science and professional advancement; leading a unified profession through initiatives in advocacy, education, research and the development of standards. As a science-based organization, the ADA's evaluation of the scientific evidence may change as more information becomes available. Your thoughts would be greatly appreciated.
Document Posted October 2005
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