Hong Liang, Levy Steven M, Warren John J, Bergus George R, Dawson Deborah V, Wefel James S, Broffitt Barbara
Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, IA 52242-1010, USA.
J Public Health Dent. 2004 Winter;64(1):38-44. doi: 10.1111/j.1752-7325.2004.tb02724.x.
It has been speculated that amoxicillin use could be associated with enamel defects, but there have been few studies of this possible relationship. This study assessed the association between amoxicillin use during the first year of life and primary tooth fluorosis.
Subjects (n = 490) were recruited at birth and followed prospectively with a series of questionnaires to gather information on fluoride intake and amoxicillin use. Primary tooth fluorosis was assessed by calibrated examiners at approximately 5 years of age.
Amoxicillin use for 6 weeks to 3 months and 3 months to 6 months significantly increased the risk for fluorosis of primary second molars in bivariate analyses. However, after controlling for fluoride intake, the adjusted risks of fluorosis were not significant for amoxicillin use. No other antibiotics were significantly associated with fluorosis in the bivariate analyses. In multivariate analyses with logistic regressions, only fluoride intake was statistically significantly related to fluorosis.
Fluoride exposure was the sole predictor of primary tooth fluorosis in a multivariate model. However, bivariate results suggest that amoxicillin could play a contributing role in the development of primary tooth fluorosis, especially for children exposed to lower levels of fluoride. An investigation of the relationship between amoxicillin intake and fluorosis of permanent teeth is warranted.
据推测，使用阿莫西林可能与牙釉质缺陷有关，但关于这种可能关系的研究较少。本研究评估了生命第一年使用阿莫西林与乳牙氟斑牙之间的关联。
研究对象（n = 490）在出生时招募，并通过一系列问卷进行前瞻性随访，以收集氟摄入量和阿莫西林使用情况的信息。大约在5岁时，由经过校准的检查人员评估乳牙氟斑牙情况。
在双变量分析中，使用阿莫西林6周至3个月以及3个月至6个月会显著增加乳磨牙氟斑牙的风险。然而，在控制氟摄入量后，使用阿莫西林导致氟斑牙的校正风险并不显著。在双变量分析中，没有其他抗生素与氟斑牙有显著关联。在采用逻辑回归的多变量分析中，只有氟摄入量与氟斑牙在统计学上有显著关联。
在多变量模型中，氟暴露是乳牙氟斑牙的唯一预测因素。然而，双变量结果表明，阿莫西林可能在乳牙氟斑牙的发生中起一定作用，尤其是对于接触较低水平氟的儿童。有必要对阿莫西林摄入量与恒牙氟斑牙之间的关系进行调查。
