Caries in children with lactose intolerance and cow's milk protein allergy.

Suzely Adas Saliba Moimaz,Cléa Adas Saliba Garbin,Marcelo Augusto Amaral,Orlando Saliba,Tânia Adas Saliba

doi:10.1590/1807-3107bor-2018.vol32.0091

Suzely Adas Saliba Moimaz, Cléa Adas Saliba Garbin + Show 3 more

Open Access

https://doi.org/10.1590/1807-3107bor-2018.vol32.0091

Copy DOI

Abstract

Dental caries in 5-to-8-year-old children with cow's milk protein allergy (CMPA) and lactose intolerance (LI), their treatment needs, and the consumption of milk-based products and milk derivatives by these patients were investigated. A cross-sectional study was undertaken with 200 children in southern Brazil in 2017. The clinical examination was based on the World Health Organization criteria and a questionnaire was sent to parents or legal guardians to collect information on the children's food intake, pre-existing systemic diseases, medication use, and CMPA and LI. Standardization was performed to verify concordance among examiners (kappa = 0.96). Caries prevalence was 67.50% in children with CMPA or LI, but 34.37% in those without these conditions. The mean dmft (decayed, missing, and filled teeth) index in children with CMPA or LI was 1.75 ± 1.84, significantly higher than among non-allergic or lactose-tolerant children (0.83 ± 1.60) (p < 0.001). In children with CMPA or LI, the mean for treatment needs was 1.58 ± 1.50. Lactose-free milk was the most frequently consumed food among allergic/intolerant children (65.00%), with a mean dmft of 2.00 ± 2.08, higher than that obtained for those without CMPA/LI (0.82 ± 0.87), showing no significant difference (p = 0.129). Although dental caries and treatment needs in primary dentition were associated with CMPA or LI, children's intake of replacement foods did not pose any risk for the development of carious lesions. Statistically significant differences were obtained for the prevalence and severity of dental caries. This shows the need for treatment of children with CMPA or LI, who had the worst caries prevalence and severity rates.

Highlights

Food allergy is a public health concern since it affects 6 to 8% of children and 2% of adults worldwide.[1,2] Its self-reported prevalence in adults and children in European populations hovers around 5.9% and 6.9%, respectively.[3]
Drug treatment of lactose malabsorption was identified in seven children (17.50%) with Cow’s milk protein allergy (CMPA) or lactose intolerance (LI) (Table 1)
Results show that seven children (17.50%) with CMPA/LI and caries had a dmft index ≥ 4. These children make up a representative group which needs dental treatment, or rather, they constitute an epidemiological polarization group. These findings reveal that children with CMPA/LI need prevention programs for caries and more dental care

Summary

Introduction

Food allergy is a public health concern since it affects 6 to 8% of children and 2% of adults worldwide.[1,2] Its self-reported prevalence in adults and children in European populations hovers around 5.9% and 6.9%, respectively.[3] Cow’s milk protein allergy (CMPA) is the most common allergy in children.[4,5] rare, there have been reports in recent decades on an increase in CMPA prevalence. CMPA may be defined as an adverse immunological reaction to one or more cow’s milk proteins.[7] The reaction involves immunoglobulin E (IgE), lymphocytes T, or both, affecting 2-3% of children.[4] There is no consensus among patients and physicians about lactose intolerance (LI) and CMPA

Methods

Results

Conclusion