Pediatric asthma medications and symptoms are not associated with an increased risk for dental disease in children at 6 years of age, according to a study in Pediatric Allergy and Immunology.
Researchers evaluated the association between pediatric asthma medication and symptoms and the development of caries (ie, decayed, missing, or filled surfaces) and enamel defects — the main causes of poor pediatric dental health, using data from the COpenhagen Prospective Studies on Asthma in Childhood 2010 mother-child cohort (COPSAC2010).
A total of 700 children from the cohort were invited to a dental examination at age 6 years, and 589 (84%) completed the examination. Of this group, 407 children (69%) had at least 1 fully erupted first permanent molar and were included in the risk factor analysis; 345 children who did not receive high-dose vitamin D supplementation were included in the descriptive analysis.
Among the children who did not receive high-dose vitamin D, caries was observed in the deciduous dentition in 76 children (22%), and 11 (3%) of the 235 children who had permanent dentition had caries in their permanent molars. For the children with caries, the mean number of affected deciduous molars was 2.6 teeth per child. Enamel defects in the deciduous and the permanent dentition occurred in 54 (16%) and 60 (26%) of the 345 children, respectively.
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Use of inhaled corticosteroids, β2-agonists, or asthma symptoms in the first 6 years of life were not associated with the development of caries or enamel defects.
Use of inhaled corticosteroids or β2-agonists during the first 6 years of life was not associated with a higher risk for caries or enamel defects. Asthma and asthma exacerbations during the first 6 years of life also were not associated with the risk for dental diseases.
Notably, up to age 3 years, 61% of the children received inhaled β2-agonists for a mean of 60 days. From ages 3 to 6 years, at least 12 days of inhaled β2-agonists were used in 11% of the children for 1 year, 4% of children for 2 years, and 1% of children for 3 years. In addition, 31% of children received inhaled corticosteroids during the first 3 years of life and 34% in the first 6 years. The median treatment duration in the treated children was 0.8 (interquartile range [IQR], 0.3-1.8) years, with a median cumulative dose of 56.8 (IQR, 20.4-132) mg of fluticasone propionate.
Maternal antibiotic use in pregnancy was associated with an increased risk for enamel defects in the deciduous teeth in the offspring (odds ratio [OR], 1.25; 95% CI, 1.01-1.54) and having a dog at home during first year of life was associated with reduced odds of enamel defects (OR, 0.50; 95% CI, 0.27-0.93). A higher maternal educational level was associated with an increased risk for enamel defects in permanent molars, and a trend of association was observed for a reduced risk for caries. Enamel defects in the deciduous molars were associated with tooth brushing twice per day vs once per day (odds ratio [OR], 2.86; 95% CI, 1.01-8.10) at age 6 years.
A limitation is the assessment of dental hygiene only at 6 years of life.
“Use of inhaled corticosteroids, β2-agonists, or asthma symptoms in the
first 6 years of life were not associated with the development of caries or enamel defects,” the study authors concluded. “Early risk factors for enamel defects are still uncertain, but the possible inducing role of antibiotics in pregnancy and a potential protective effect of having a dog in the household should be addressed in future studies,” the study authors added.
