Factors associated with first molar dental enamel defects: a multivariate epidemiological approach.

Purpose: The purpose of this study was to ascertain factors linked to developmental defects of tooth enamel (DDE) in first permanent molars. Methods: A retrospective epidemiological case-control study was conducted with 48 cases and 149 controls. Dental examinations were performed on 8-year-old children in accordance with World Health Organization (WHO) guidelines. DDE were defined according to FDI World Dental Federation criteria (DDE index). The various study variables were measured and compared during the first 3 years of life, using dental and health records. These variables included gender, pediatric care, hospital admission, certain specific diseases (urinary tract infections, upper and lower respiratory tract infections, varicella, gastroenteritis, otitis) and drug therapies. A multivariate analysis was performed using multiple logistic regression techniques. Results: The multivariate analysis indicated that: girls had at least a two-fold risk of DDE; frequent pediatric care showed a strong association with DDE, which had an odds ratio (OR) of 3.40 to 4.16 according to year of life; urinary tract infection (UTI) registered a strong association in the second and third years of life with DDE, showing an OR of 32.4 in the second year of life and 6.33 in the third year of life; and mucolytics acted as a protective factor for DDE with an OR range of 0.53 to 0.23 according to year of life. Conclusions: Female gender, UTI, and high frequency of pediatric care registered a strong association with DDE. Treatment with mucolytics exerted a protective effect against DDE.