As part of the Iowa Fluoride Study, researchers followed 357 subjects from birth up to 32 months and surveyed every 3 to 4 months to get information on amoxicillin use and fluoride intake. The antibiotic amoxicillin is among the drug of choice for children suffering from upper respiratory tract infection and middle ear infection (otitis media).
By age one, about 75% of the subjects had taken amoxicillin. As they reached 32 months, 91% had already used amoxicillin. Researchers found that amoxicillin use from 3 to 6 months increased the risk of dental fluorosis by twofold.
Researchers found that amoxicillin use could be a risk factor of developing fluorosis on late-erupting permanent teeth such as both permanent maxillary central incisors and first molars. The signs of fluorosis could range from hardly visible white stains to brown discolorations.
Dr. Liang Hong told that even if the effect on dental enamel is minimal, it can have a huge effect on the overall dental health of the public since the use of amoxicillin is widespread.
What is Fluorosis?
Dental Fluorosis is the appearance of white flecks or lines on the teeth. This only occurs when a child took too much fluoride over long duration when the permanent teeth are still developing beneath the gums. It is believed that exposure to excess amounts of fluoride can disrupt the production of ameloblasts, the cells that produce the teeth’s hard protective coating, blocking the natural maturation of dental enamel.
When the teeth already emerge through the gums, you won’t develop fluorosis.
In the case of amoxicillin use, the effect is clinically similar to fluorosis, but are apparently different from tooth staining due to tetracycline use. The enamel defects seem as diffuse opacities, which could be due to enamel hypomineralization.
Keep in mind that fluorosis is not a disease and won’t affect the health and integrity of the teeth. Oftentimes, the discoloration is barely noticeable that only a dentist could see it during an examination.
Use JudiciouslyTo conclude, 24 percent of the subjects had fluorosis on maxillary central incisors. Such finding suggests that the use of amoxicillin during infancy may bring some undocumented risk to the developing teeth. Although the result of this study don’t permit recommendations to stop amoxicillin use, researchers do emphasize the need to prescribe and use antibiotics judiiciously, most particularly on infants.