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Parenteral nutrition in childhood and consequences for dentition and gingivae
Pubblication date: /1/2017
Authors: D. Olczak-Kowalczyk*, M. Danko**, E. Banaś**, D. Gozdowski***, K. Popińska**, E. Krasuska-Sławińska****, J. Książyk**
Institution: *Medical University of Warsaw, Department of Paediatric Dentistry, 18 Miodowa St, Warsaw, Poland
**Department of Paediatrics and Nutrition, Children’s Memorial Health Institute, Warsaw, Poland
***Department of Experimental Statistics and Bioinformatics, Warsaw University of Life Science, Warsaw, Poland
****Dental Outpatient Clinic, Children’s Memorial Health Institute, Warsaw, Poland
Publication: European Journal of Paediatic Dentistry
Title: Parenteral nutrition in childhood and consequences for dentition and gingivae
Abstract: Aim Assessment of dentition in children under parenteral nutrition, risk factors for caries, and dental developmental abnormalities.
Material and method The study involved 63 patients (aged 2.25–16.6 years), i.e. 32 subjects receiving parenteral nutrition for a mean period of 5.6±2.94 years, and 31 healthy control subjects. Oral hygiene (OHI-S, PL-I), gingival (GI), and dentition status (caries, DMFT/dmft, enamel defects, shape alterations), frequency of oral meals and frequency of cariogenic snacks consumption were evaluated. Medical records provided information on parenteral meals per week, age parenteral nutrition started, birth body mass, Apgar score, weight deficiency, and antibiotic therapy until aged 1 year. The Mann-Whitney test, chi-squared test, and Spearman rank correlation coefficient were used (p≤0.05).
Results Dental developmental abnormalities occurred more often in PN subjects (71.87% vs. 25.80%). The prevalence of caries in PN (56.25% vs. 90.32%) and dmft (2.00±3.30 vs. 4.21±3.33) and DMFT (2.47±4.08 vs. 3.33±3.50) were lower. Positive caries Spearman’s rank correlation coefficients: frequency of oral meals and frequency of cariogenic snacks consumption, and GI. Negative correlation coefficients: low birth body mass, antibiotic therapy, and low body mass in the first year of life. Positive dental developmental abnormality Spearman’s coefficients: low birth body mass, Apgar score < 7, parenteral nutrition duration, low body mass and antibiotic therapy in the first year of life. Beta-lactam, aminoglycoside, glycopeptide and nitroimidazole treatments were related to enamel hypoplasia.
Conclusion Parenteral nutrition in childhood is related to the risk of dental developmental abnormalities, promoted by malnutrition and antibiotic therapy in infancy. Limiting the number of meals and cariogenic snacks, and most probably administration of antibiotics, decreases the risk of caries.