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Absence of breastfeeding may predispose children to enamel defects

By Dental Tribune International
May 27, 2013

DIAMANTINA, Brazil: New research from Brazil has suggested that perinatal factors, such as breastfeeding, are closely associated with the development of tooth enamel defects in children. A study of over 200 preschool children found a significantly higher prevalence of such defects among those who had not been breastfed and whose mothers were under 24 at the birth of the child.

In order to determine the prevalence of developmental defects of enamel (DDE) and to identify risk factors associated with DDE in primary dentition, researchers from Universidade Federal dos Vales do Jequitinhonha e Mucuri in Brazil examined the oral cavities of 104 children with at least one dental surface affected by DDE and 105 healthy controls. The children were aged between 3 and 5, and lived in Diamantina, a city in southeastern Brazil. In addition, the researchers conducted interviews with the children's parents or guardians.

The most common types of DDE were diffuse and demarcated opacity (54 percent) and hypoplasia (7 percent). In the case of enamel opacities, the matrix is secreted to normal thickness but parts fail to mature or mineralize properly, leaving regions with deficient mineral content, shown in yellowish and brown coloration, the researchers explained. Enamel hypoplasia is associated with a reduction in enamel thickness. DDE render teeth more susceptible to caries and can affect the esthetics of the maxillary incisors.

In addition, they found that the absence of breastfeeding was significantly associated with DDE. Children who had not been breastfed had more enamel defects compared with those who had been. According to the researchers, this is may be due to a reduced amount of nutrients during tooth formation, such as calcium, which are normally transmitted through breast milk.

Moreover, the age of the mother seemed to affect the development of DDE. In the study, children of mothers under 24 at the time of birth had a greater frequency of enamel defects. The mother's age was also associated with monthly household income. DDE were mostly found in children of mothers who earned less than twice the minimum wage (R$622 per month; US$303).

The researchers suggested that young mothers with lower socioeconomic status are more susceptible to complications during pregnancy owing to poorer access to health care services, resulting in premature birth and low birth weight. Both factors have been associated with DDE in primary teeth in prior studies.

The study was published online in the Brazilian Oral Research journal ahead of print.

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