The neonatal intubation causes defects in primary teeth of premature infants

Abstract

Aim. This study aimed to evaluate the relationship between intubation during the neonatal period and enamel defects in primary teeth of preterm infants. It was an observational, prospective, analytical and sampling of convenience. We selected 157 children who had average birth weight of 1656.3 ± 627.8 g, gestational age of 31.7 ± 2.7 weeks and the examination of chronological age 2.2 ± 0.6 years old. Methods. Clinical examination of the oral cavity showed that the frequency of enamel defects was higher (86.3%) among children intubated when compared to non-intubated children (13.7%). The enamel defects was found to be inversely proportional to gestational age. The intubation time was related to the probability of occurrence of DDE (P<0.001), in other words, the greater the number of days intubated, the greater the chance of DDE. In children intubated, hypoplasia mainly affected the upper teeth on the left side of the mouth. Conclusion. Tracheal intubation in the neonatal period is the main cause of enamel defects in primary teeth of children born preterm. The longer the duration of intubation, the greater the chance of developing dental enamel defect. The area of action during movement of the laryngoscope toggle corresponds to the region most affected by tooth enamel hypoplasia in children intubated, upper right central incisor, lateral incisor and upper left.

Effects of maternal, gestational, and perinatal variables on neonatal line width observed in a modern UK birth cohort

“…A number of pathologies and stress events are known to disrupt enamel formation. These include genetic or inherited conditions such as amelogenesis imperfecta (Alt & Türp, ; Bhat & Nelson, ; Flanagan et al, ; Garn, Lewis, & Blizzard, ; Klingberg, Oskarsdottir, Johannesson, & Noren, ; Pindborg, ; Witkop, ); maternal disturbances including maternal diabetes, hypothyroidism and hypertension in pregnancy (Dolphin & Goodman, ; Grahnen & Edlund, ; Gregg, ; Guggenheimer, Nowak, & Michaels, ; Kreshover, Clough, & Hancock, ; Norén, ; Silva‐Sousa, Peres, & Foss, ; Vucic et al, ); variables reflecting prenatal experience such as gestational age, very low birth weight, and perinatal Vitamin Deficiency (Fearne, Bryan, Elliman, Brook, & Williams, ; Franco, Line, & de Moura‐Ribeiro, ; Grahnen & Larsson, ; Norén, ; Pimlott, Howley, Nikiforuk, & Fitzhardinge, ; Priya, Jaiprabhu, & Priya, ; Rythen et al, ; Seow, ; Seow, Brown, Tudehope, & O'Callaghan, ; Seow, Brown, Tudehope, & O'Callaghan, ); or subsequent conditions associated with birth and early neonatal life including trauma such as intubation (de Oliveira Melo, da Silva, & de Lima, ; Eli, Sarnat, & Talmi, ; Johnsen, Krejci, Hack, & Fanaroff, ; Schour & Kronfeld, ) as well as stress events or systemic disturbances to health occurring while the deciduous dentition is being formed. In many populations EH and IAS in early forming deciduous teeth are likely to result from the combined effect of several conditions such as malnutrition, parasitic load, and infectious diseases, and fevers (Hillson, ).…”

Developmental defects of enamel in the deciduous incisors of infants born preterm: Prospective cohort

“…and result from complications during the pre-, peri-and postnatal periods, which coincide with the timing of the mineralization of deciduous teeth (Sabel, 2012;Wagner & Heinrich-Weltzien, 2017). Knowledge of the aetiology of DDE has been obtained primarily from cross-sectional studies with retrospective collection of perinatal data (Chaves, Rosenblatt, & Oliveira, 2007;Corrêa-Faria et al, 2013;Falcao et al, 2014;Massoni, Chaves, Rosenblatt, Sampaio, & Oliveira, 2009;Seow, Humphrys, & Tudehope, 1987;Velló et al, 2010). Most of these studies demonstrated an association between prematurity, very low birthweight and the occurrence of DDE.…”

Defeitos de esmalte não fluoróticos em crianças: aspectos clínicos e epidemiológicos

“…Essas relações podem ser explicadas porque doenças maternas durante a gestação podem levar à prematuridade no nascimento, fator que leva ao baixo peso ao nascer, que é um grande determinante da presença de DDE 33 . De Oliveira Melo et al 34 (2012) encontraram que aspectos relacionados à saúde materna durante a etapa gestacional não estiveram associados à presença de DDE em crianças, embora tenham encontrado associação entre DDE e prematuridade. As doenças analisadas no estudo que não foram associadas ao DDE foram icterícia, apneia, RDS, sepse, PCA, HPIV, enterocolitenecrosante, osteopenia da prematuridade, doença bronco--pulmonar leve/grave, hipoglicemia e gastrosquise 34 .…”

“…Crianças nascidas antes de 37 semanas de gestação foram 2,6 vezes mais suscetíveis a serem afetadas por algum tipo de DDE quando comparadas a crianças maturas 5 . Crianças nascidas a pré-termo, que precisaram de intubação orotraqueal e de ventilação mecânica após o parto, apresentaram maior prevalência de DDE 16,25,34 . A intubação pode promover algum efeito traumático sobre o esmalte do dente em formação 16,25,34 .…”

“…Crianças nascidas a pré-termo, que precisaram de intubação orotraqueal e de ventilação mecânica após o parto, apresentaram maior prevalência de DDE 16,25,34 . A intubação pode promover algum efeito traumático sobre o esmalte do dente em formação 16,25,34 . Nas crianças com histórico de intubação, o defeito mais encontrado foi a hipoplasia, no incisivo central superior direito e incisivo lateral superior esquerdo, fato que pode ocorrer devido ao atrito do laringoscópio com a gengiva 34 .…”