Distribution of Enamel Defects and the Association with Respiratory Distress in Very Low Birthweight Infants

Abstract

Although dental defects have long been observed among surviving pre-term infants, only few systematic studies address this problem. In a clinic limited to recall of infants of very low birthweight (<1.5 kg), enamel hypoplasia of primary incisors was found in 14/67 (21%) children, and enamel opacities were found in an additional 31% of the children. In contrast, enamel hypoplasia and opacities were found in 4% and 22%, respectively, of a control group of 46 normal birthweight children. The difference was significant (p < 0.05) for the hypoplasia but not for the opacities. Primary incisor enamel hypoplasia was more commonly noted in maxillary central incisors than in lateral incisors (X² = 28.0, p < 0.01). Furthermore, hypoplasia was more common in maxillary incisors than in mandibular incisors (X² = 48.4, p < 0.01).

In infants with dental defects, there was no significant correlation with pregnancy risk factors, gestational age, birth weight, septicemia, first-week caloric intake, serum bilirubin, or calcium. Infants with enamel hypoplasia were more likely, however, to have severe respiratory distress syndrome (X² = 7.2, p < 0.01), than infants with unaltered enamel.

Central incisor edge involvement may indicate post-natal processes and/or a systemic disturbance extending back to the middle trimester of pregnancy.