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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

Corresponding Author:e001229@u.nus.edu

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Evelyn Loo
Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR),Singapore
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Lynette Shek
National University of Singapore
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Michael Kramer
McGill University Faculty of Medicine
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Carolina Un Lam
Ministry of Health Holdings Pte Ltd
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Bindu Karunakaran
National University of Singapore
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Hugo Van Bever
National University of Singapore
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Anne Goh
KK Women's and Children's Hospital
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Yap Chong
NUHS
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bee wah lee
National University of Singapore
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Kok Hian Tan
Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital (KKH)
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Seang Saw
NUHS
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Keith Godfrey
University of Southampton
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Chin-Ying Hsu
National University of Singapore
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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.