A study conducted shows that anti-inflammatory drugs commonly taken by children may be associated with dental enamel defects (DEDs) currently seen in about 20% of children worldwide.
The authors investigated the effects of celecoxib and indomethacin, non-steroidal anti-inflammatory drugs (NSAIDs), alongside paracetamol.
Dentists have observed a sharp rise in the number of children seeking treatment for pain, white or yellow tooth spots, dental sensitivity and fragility.
Dental decay in the form of carious lesions appears sooner and more frequently in these patients, whose restorations are less adhesive and tend to fail more. Studies have shown they may have to replace restorations ten times more often over a lifetime than people with healthy teeth.
A specific coincidence aroused the researchers' curiosity most of all: the patients' ages. The first years of life, when DEDs form, are a period in which sickness is frequent, often with high fever.
"These diseases are typically treated with NSAIDs, which inhibit the activity of cyclooxygenase [COX, a key inflammatory enzyme] and reduce production of prostaglandin [which promotes inflammation]," said Francisco de Paula-Silva.
The researchers used rats to study the problem, as these animals have incisors that grow continuously. The rats were treated with celecoxib and indomethacin for 28 days, after which practically no differences in their teeth were visible to the naked eye. However, when the researchers began extracting, they found that the teeth fractured more easily.
Analysis based on imaging and chemical composition suggested that dental mineralization had been affected. The teeth contained below-normal levels of calcium and phosphate, which are important to dental enamel formation, and mineral density was low.
When the researchers looked for the reasons for this, they found alterations in proteins required for mineralization and cellular differentiation, showing that the drugs had indeed affected the composition of the dental enamel.
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