Review suggests increased risk of enamel defects in children born pre-term


Enamel defects and other oral abnormalities have been reported in premature children. The aim of this review was to assess whether there is any association between premature birth and enamel opacities or hypoplasia.

A search was conducted in PubMed  and Embase for follow-up, case control or cross sectional studies  published in English German, Danish, Swedish or Norwegian. . Studies were only included if they had a control group of children born ≥37 wks of gestation (non-exposed) or an exposed group with at least two levels of exposure.  Outcomes in both the primary and the permanent dentition were included.  Study selection was carried out independently by 3 reviewers and data extraction by two reviewers. Quality assessment was performed using the Newcastle–Ottawa Quality Assessment Scale.

  • 23 studies were included  (19 follow-up studies, 2 case-control studies, 2cross-sectional surveys).
  • 10 of the studies were assessed as being of high quality.
  • 17 studies reported on enamel hypoplasia of the primary teeth with 13 studies reporting an association.
  • 7 studies considered enamel disturbances of the permanent teeth, four of which suggested an increased risk of enamel opacities.

The authors concluded

This systematic review suggests an increased risk of enamel hypoplasia in primary teeth of children born preterm and enamel opacities in very-low birth-weight children. A larger number of well-designed studies are, however, needed in order to increase the validity of the studies.


The included studies covered a 40-year period and there was variation in the definition of pre-term delivery and also the diagnostic criteria for the enamel defects.  In the follow-up studies included in the review it is not clearly reported whether the data collection was prospective or retrospective, although it is noted that some relied on parental recall of gestational age.  The authors highlighted that only 4 of the studies had the outcome assessor blinded, which would also impact on validity. To confirm the suggested link high quality studies are needed.



Jacobsen PE, Haubek D, Henriksen TB, Ostergaard JR, Poulsen S. Developmental enamel defects in children born preterm: a systematic review. Eur J Oral Sci. 2014 Feb;122(1):7-14. doi: 10.1111/eos.12094. Epub 2013 Oct 24. PubMed PMID: 24164573.







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