title: Developmental enamel defects in children prenatally exposed to anti-epileptic drugs.
abstract: OBJECTIVE
  Some anti-epileptic drugs (AED) have well-known teratogenic effects. The aim of the present study was to elucidate the effect of prenatal exposure to AED and the risk of enamel defects in the primary and permanent dentition.
  
  
  METHODS
  A total of 38 exposed and 129 non-exposed children, 6-10 years of age, were recruited from the Aarhus Birth Cohort and the Department of Neurology, Viborg Regional Hospital, Denmark. Medication during pregnancy was confirmed by the Danish Prescription Database. All children had their teeth examined and outcomes in terms of enamel opacities and enamel hypoplasia were recorded.
  
  
  RESULTS
  Children prenatally exposed to AED have an increased prevalence of enamel hypoplasia (11% vs. 4%, odds ratio (OR) = 3.6 [95% confidence interval (CI): 0.9 to 15.4]), diffuse opacities (18% vs. 7%, OR = 3.0; [95% CI: 1.0 to 8.7, p<0.05]), and numerous (>3) white opacities (18% vs. 10%, OR = 2.2; [95% CI: 0.8 to 6.1]) in the primary dentition. In the permanent dentition, an increased risk of numerous (>3) white opacities (34% vs. 12%, OR = 3.3; [95% CI: 1.3 to 8.4]) was found.
  
  
  CONCLUSIONS
  The present study shows that children prenatally exposed to AED have an increased risk of developing numerous teeth with white opacities in their primary and permanent dentition. In addition, they also have an increased risk of developing diffuse opacities and enamel hypoplasia in their primary teeth.
authors.affiliation: Section of Pediatric Dentistry, Department of Dentistry, Health, Aarhus University, Aarhus, Denmark. pej@odontologi.au.dk
authors.forename: Pernille E
authors.initials: PE
authors.lastname: Jacobsen
authors.forename: Tine B
authors.initials: TB
authors.lastname: Henriksen
authors.forename: Dorte
authors.initials: D
authors.lastname: Haubek
authors.forename: John R
authors.initials: JR
authors.lastname: Ostergaard
mesh_terms: D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D015331:Cohort Studies; D003718:Denmark; D003743:Dental Enamel / Q000378:metabolism*; D003744:Dental Enamel Hypoplasia / Q000139:chemically induced / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000453:epidemiology / Q000473:pathology; D015995:Prevalence; D012307:Risk Factors
chemical_list: D000927:Anticonvulsants