Prenatal, neonatal and postnatal factors and the developmental defects of dental enamel

Lunardelli, Sandra Espíndola; Lunardelli, Abelardo Nunes; Martins, Luiz Gustavo Teixeira; Traebert, Eliane; Traebert, Jefferson

doi:10.1590/1984-0462/2024/42/2022226

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Brasil

Revista Paulista de Pediatria

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Brasil

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Original Article • Rev. paul. pediatr. 42 • 2024 • https://doi.org/10.1590/1984-0462/2024/42/2022226 copy

Prenatal, neonatal and postnatal factors and the developmental defects of dental enamel

Fatores pré-natais, neonatais e pós-natais e defeitos de desenvolvimento do esmalte dentário

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To estimate the prevalence of developmental defects in dental enamel and its possible association with prenatal, neonatal and postnatal conditions in six-year-old schoolchildren in a southern Brazilian municipality.

Methods:

A cross-sectional study was conducted involving 655 six-year-old schoolchildren. Sociodemographic and health data were collected through interviews with mothers and children’s oral examinations at schools. Multivariate analyses were performed using Poisson regression with robust estimator.

Results:

The prevalence of developmental defects of enamel was 44.0%. Demarcated opacities were the most prevalent, followed by diffuse opacities. Late pregnancy, maternal schooling less than eight years, female gender and child’s white skin color were independently associated with the prevalence of demarcated opacities.

Conclusions:

The prevalence of developmental defects in dental enamel was 44.0%. Late pregnancy, maternal schooling less than eight years, female gender and child’s white skin color were associated with the prevalences.

Keywords:
Enamel defects; Epidemiology; Children

		PR	95%CI	p-value
Child gender
	Male	1.00		0.036
	Female	1.35	1.02–1.78	0.036
Child skin color
	Not white	1.00		0.060
	White	1.57	0.98–2.51	0.060
Mother schooling when child was born (years)
	≥8	1.00		0.050
	<8	1.35	1.00–1.82	0.050
Father schooling when child was born (years)
	≥8	1.00		0.700
	<8	1.06	0.77–1.46	0.700
Late pregnancy
	No	1.00		0.003
	Yes	1.72	1.20–2.46	0.003
Teenage pregnancy
	No	1.00		0.124
	Yes	0.76	0.53–1.00	0.124
Number of prenatal consultations
	6 or more	1.00		0.223
	Up to 5	0.71	0.41–1.23	0.223
Use of alcohol while pregnant
	No	1.00		0.710
	Yes	0.88	0.45–1.72	0.710
Smoking while pregnant
	No	1.00		0.269
	Yes	1.36	0.94–1.98	0.269
Use of drugs while pregnant
	No	1.00		0.325
	Yes	1.56	0.64–3.80	0.325
Infectious diseases while pregnant
	No	1.00		0.300
	Yes	1.46	0.72–2.96	0.300
Pneumonia while pregnant
	No	1.00		0.773
	Yes	0.82	0.20–3.28	0.773
Vaginal discharge while pregnant
	No	1.00		0.421
	Yes	0.87	0.61–1.23	0.421
Urinary infection while pregnant
	No	1.00		0.354
	Yes	1.16	0.85–1.57	0.354
Diabetes while pregnant
	No	1.00		0.614
	Yes	0.84	0.43–1.64	0.614
Hypertension while pregnant
	No	1.00		0.238
	Yes	1.25	0.86–1.82	0.238
Heart diseases while pregnant
	No	1.00		0.230
	Yes	0.50	0.16–1.55	0.230

		PR	95%CI	p-value
Gestational age (weeks)
	37 to 42	1.00		0.895
	<37	0.89	0.49–1.88	0.895
Route of delivery
	Vaginal	1.00		0.272
	Cesarean	1.20	0.87–1.65	0.272
Birth weight
	≥2500 g	1.00		0.562
	<2500 g	0.81	0.40–1.65	0.562
Congenital anomaly
	No	1.00		0.222
	Yes	1.61	0.75–3.43	0.222
1st minute Apgar
	≥8	1.00		0.821
	<8	0.93	0.50–1.73	0.821
5th minute Apgar
	≥8	1.00		0.947
	<8	0.90	0.23–3.87	0.947
Need for medical care intervention during the first 28 days
	No	1.00		0.518
	Yes	0.81	0.42–1.54	0.518
Respiratory problems during the first 28 days
	No	1.00		0.288
	Yes	1.40	0.75–2.60	0.288
Need for intubation
	No	1.00		0.403
	Yes	0.74	0.36–1.50	0.403
Neonatal jaundice
	No	1.00		0.888
	Yes	1.02	0.72–1.45	0.888

		PR	95%CI	p-value
Breastfeeding
	No	1.00		0.671
	Yes	0.90		0.671
Time of breastfeeding (months)
	≥6	1.00		0.086
	<6	1.33	0.96–1.84	0.086
Need for medical care intervention for more than 2 days
	No	1.00		0.769
	Yes	0.94	0.64–1.39	0.769
Use of medication for more than 30 consecutive days
	No	1.00		0.064
	Yes	0.69	0.47–1.02	0.064
Use of antibiotics
	No	1.00		0.701
	Yes	0.94	0.71–1.26	0.701
Occurrence of varicella
	No	1.00		0.352
	Yes	0.86	0.62–1.18	0.352
Occurrence of rubella
	No	1.00		0.933
	Yes	0.95	0.30–2.99	0.933
Occurrence of pneumonia
	No	1.00		0.373
	Yes	0.99	0.71–1.39	0.373
Occurrence of diarrhea
	No	1.00		0.403
	Yes	0.89	0.67–1.17	0.403
Occurrence of verminosis
	No	1.00		0.434
	Yes	1.14	0.82–1.59	0.434
Occurrence of tonsillitis
	No	1.00		0.280
	Yes	0.86	0.65–1.13	0.280
Occurrence of skin infection
	No	1.00		0.665
	Yes	0.92	0.64–1.32
Occurrence of ear infection
	No	1.00		0.404
	Yes	0.88	0.66–1.18	0.404
Occurrence of diabetes
	No	1.00		0.312
	Yes	1.07	0.34–3.34	0.312
Occurrence of heart diseases
	No	1.00		0.092
	Yes	0.43	0.16–1.15	0.092
Occurrence of acid reflux
	No	1.00		0.125
	Yes	0.72	0.47–1.09	0.125
Occurrence of anemia
	No	1.00		0.738
	Yes	1.07	0.71–1.63	0.738

		PR_c	95%CI	p-value	PR_a	95%CI	p-value
Late pregnancy
	No	1.00		0.003	1.00		0.004
	Yes	1.72	1.20–2.46	0.003	1.96	1.23–3.11	0.004
Child’s gender
	Male	1.00		0.036	1.00		0.042
	Female	1.35	1.02–1.78	0.036	1.44	1.01–2.05	0.042
Mother’s schooling when the child was born
	≥8 years	1.00		0.053	1.00		0.026
	<8 years	1.35	1.00–1.82	0.053	1.53	1.05–2.22	0.026
Time of breastfeeding (months)
	≥6	1.00		0.086	1.00		0.236
	<6	1.33	0.96–1.84	0.086	1.29	0.85–1.95	0.236
Child’s skin color
	Not white	1.00		0.060	1.00		0.028
	White	1.57	0.98–2.51	0.060	1.84	1.07–3.17	0.028
Use of medication for more than 30 consecutive days
	No	1.00		0.064	1.00		0.758
	Yes	0.69	0.47–1.02	0.064	1.08	0.68–1.71	0.758
Occurrence of acid reflux
	No	1.00		0.125	1.00		0.535
	Yes	0.72	0.47–1.09	0.125	0.85	0.51–1.42	0.535

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[1] Corresponding author. E-mail: jefferson.traebert@gmail.com (J. Traebert)