Caries in children with lactose intolerance and cow's milk protein allergy

Abstract

Dental caries in 5-to-8-year-old children with cow's milk protein allergy (CMPA) and lactose intolerance (LI), their treatment needs, and the consumption of milk-based products and milk derivatives by these patients were investigated. A cross-sectional study was undertaken with 200 children in southern Brazil in 2017. The clinical examination was based on the World Health Organization criteria and a questionnaire was sent to parents or legal guardians to collect information on the children's food intake, pre-existing systemic diseases, medication use, and CMPA and LI. Standardization was performed to verify concordance among examiners (kappa = 0.96). Caries prevalence was 67.50% in children with CMPA or LI, but 34.37% in those without these conditions. The mean dmft (decayed, missing, and filled teeth) index in children with CMPA or LI was 1.75 ± 1.84, significantly higher than among non-allergic or lactose-tolerant children (0.83 ± 1.60) (p < 0.001). In children with CMPA or LI, the mean for treatment needs was 1.58 ± 1.50. Lactose-free milk was the most frequently consumed food among allergic/intolerant children (65.00%), with a mean dmft of 2.00 ± 2.08, higher than that obtained for those without CMPA/LI (0.82 ± 0.87), showing no significant difference (p = 0.129). Although dental caries and treatment needs in primary dentition were associated with CMPA or LI, children's intake of replacement foods did not pose any risk for the development of carious lesions. Statistically significant differences were obtained for the prevalence and severity of dental caries. This shows the need for treatment of children with CMPA or LI, who had the worst caries prevalence and severity rates.

Parents´ perception of allergic or food intolerant children in relation to disease

“…Cagetti et al 29 studied the prevalence of caries in children aged six to eight years old and associated the ingestion of lactose-free milk to children with a high caries index. Thus, there are indications that the consumption of baby milk may cause tooth erosion31 demineralisation of deciduous tooth enamel 28 and caries 29,32 . Further studies are recommended to evaluate different risks in children´s mouth diseases and the influence of these factors on quality of life.…”

Avaliação de efetividade de programa de atenção à saúde bucal de 0-36 meses em Salvador-BA, 2017-2018/ Efficacy evaluation of oral health care program from 0 to 36 months in Salvador-BA

“…Embora necessária, a atenção à saúde do bebê não é comum nas Unidades de Saúde da Família (USF). 1 A atenção à saúde bucal do bebê almeja efetividade na manutenção da saúde bucal global, com educação em saúde e medidas de proteção específica direcionadas e acompanhamento de acordo com a faixa etária. A atenção às famílias, inclusive, pode auxiliar na adesão das mesmas e permite um maior conhecimento à respeito dos determinantes sociais e dos hábitos deletérios cultivados.…”