loading page

Clinical severity of atopic dermatitis is associated with dental caries risk in 3-year old children
  • +11
  • Tosha Ashish Kalhan,
  • Evelyn Loo,
  • Lynette Shek,
  • Michael Kramer,
  • Carolina Un Lam,
  • Bindu Karunakaran,
  • Hugo Van Bever,
  • Anne Goh,
  • Yap Chong,
  • bee wah lee,
  • Kok Hian Tan,
  • Seang Saw,
  • Keith Godfrey,
  • Chin-Ying Hsu
Tosha Ashish Kalhan
National University of Singapore
Author Profile
Evelyn Loo
Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR),Singapore
Author Profile
Lynette Shek
National University of Singapore
Author Profile
Michael Kramer
McGill University Faculty of Medicine
Author Profile
Carolina Un Lam
Ministry of Health Holdings Pte Ltd
Author Profile
Bindu Karunakaran
National University of Singapore
Author Profile
Hugo Van Bever
National University of Singapore
Author Profile
Anne Goh
KK Women's and Children's Hospital
Author Profile
Yap Chong
NUHS
Author Profile
bee wah lee
National University of Singapore
Author Profile
Kok Hian Tan
Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital (KKH)
Author Profile
Seang Saw
NUHS
Author Profile
Keith Godfrey
University of Southampton
Author Profile
Chin-Ying Hsu
National University of Singapore
Author Profile

Abstract

Background: Infants with atopic dermatitis (AD) are reported to be at higher risk of early childhood caries (ECC) at 3-years, but the clinical validity of the reported link remains unknown. We investigated if clinical severity of AD in young children is associated with increased ECC risk at 3-years. Methods: In Growing Up in Singapore Towards healthy Outcomes (GUSTO) mother-offspring cohort, AD was diagnosed by trained physicians using Hanifin and Rajka criteria at 18-month and 3-year clinic visits (n=837). Of the children diagnosed with AD, disease severity was assessed using SCORAD (SCORing Atopic Dermatitis) index and categorized into moderate-to-severe AD (SCORAD≥25), and mild AD (SCORAD<25), with children without AD (non-AD) as a reference group. Oral examinations for ECC detection was performed by calibrated dentists in 656 children at age 3-years. Negative binomial regression was used to calculate the adjusted incidence risk ratio (aIRR; adjusted for socio-demographic factors and prenatal tobacco smoke exposure). Results: Atopic dermatitis was diagnosed in 7.3% (61/837) children; amongst which 23% had moderate-to-severe AD and 77% had mild AD. ECC was observed in 85.7%, 36.8% and 42.8% of the children in moderate-to-severe, mild and non-AD groups, respectively. Children with moderate-to-severe AD were at higher risk of ECC (aIRR 2.30 [95% confidence interval (CI) 1.04-5.06]; p=0.03) at 3 years compared to non-AD, while no association was seen between mild AD and ECC. Conclusions: Children with moderate-to-severe atopic dermatitis were at higher risk of ECC compared to those without AD and may benefit from early dental referral.