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Troubled Teeth: Amoxicillin Used in Infancy Can Cause Problems Later

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Troubled Teeth

Troubled Teeth: Amoxicillin Used in Infancy Can Cause Problems Later

October 31, 2005
By: Jennifer Jope for Dental1

A benign pink liquid used to cure such ailments as childhood ear infections may not be completely harmless after all. A new study has found a link between amoxicillin use during infancy and developmental enamel defects of permanent teeth. But before parents start refusing the antibiotic at the doctor’s office, researchers say further studies are needed.
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Precautions to take when taking amoxicillin (from the U.S. National Library of Medicine):

Tell your doctor and pharmacist if you are allergic to amoxicillin, penicillin, cephalosporins or any other medications.

Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements and herbal products you are taking. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

Tell your doctor if you have or have ever had kidney disease, allergies, asthma, hay fever, hives or phenylketonuria.

Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking amoxicillin, call your doctor.


As part of the Iowa Fluoride Study, a prospective study investigating fluoride exposures, biological and behavioral factors and children’s dental health, data was collected from parents in Iowa in the 1990s. According to the study, which was published in the Archives of Pediatrics & Adolescent Medicine in October, parents completed questionnaires at three and fourth-month intervals, from the child’s birth to 32 months, assessing fluoride intake from sources like antibiotics.

75 percent of the subjects took amoxicillin by 12 months of age and 91 percent by 32 months.

“Overall, 24 percent had fluorosis [a condition resulting for an excessive intake of fluoride during enamel formation],” the study reported. “Amoxicillin use from three to six months significantly increased the risk of fluorosis. The findings from this study suggest a link between amoxicillin use during infancy and developmental enamel defects of permanent teeth; however, further research is needed.”

Dental fluorosis results in porous and stained teeth, usually with white or brown spotting.

According to the U.S. National Library of Medicine, amoxicillin is used to treat infections caused by bacteria, such as pneumonia, bronchitis and infections of the ears, nose and throat. Amoxicillin can be taken as a capsule, tablet, chewable table, liquid or pediatric drops.

Dr. Steven M. Levy, the Wright-Bush-Shreves Endowed professor of research at the University of Iowa College of Dentistry and lead researcher, said it is unlikely that the form of amoxicillin plays a role in the tooth enamel damage. However, in the study, infants were typically given a liquid form of the antibiotic. He suspects that the damage is caused because a child ingests amoxicillin and not because the medication comes in contact with the teeth. If a child is prescribed amoxicillin, parents will know soon enough if enamel defects occurred.

“The appearance of … any possible amoxicillin effect will show at about age seven or eight when the teeth come in,” Levy said. “It will not show later, if not showing when the teeth come in.”

Although the association has been discoverered, Levy quickly points out that the study did not show causation and for now, parents should not be overly concerned. He said, however, that the findings do give the medical and dental fields something new to examine.

“Parents and providers should not worry about this, it is only one study of association and not an experimental study,” Levy said. “It is really just preliminary data that researchers should be thinking about to study more.”

But for those of us who were exposed to amoxicillin as a child, the damage is unfortunately done.

“Once it happens as an infant [or] toddler and shows up when teeth erupt, it is done,” Levy said. “It is more or less life-long, except it sometimes is less noticeable over time, believed [to be] due to some wear of the teeth and post-eruption maturation.”

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