Pediatr Infect Vaccine.  2024 Apr;31(1):25-36. 10.14776/piv.2024.31.e1.

Incidence of Dental Discoloration After Tetracycline Exposure in Korean Children: A Nationwide PopulationBased Study

• Lee JY
• Kim EH
• Lee M
• Shin J
• Lim SM
• Baek JY
• Kim M
• Ahn JG
• Kang CM
• Jung I
• Kang JM

• KMID: 2555423
• DOI: http://doi.org/10.14776/piv.2024.31.e1

Abstract

Purpose
Tetracycline is not recommended for children under 12 by guideline due to the risk of tooth discoloration. We aimed to assess the incidence of dental discoloration in Korean children prescribed tetracyclines and investigate whether its risk was greater in tetracyclineexposed children than in the general population.
Methods
This population-based cohort study using the Health Insurance Review and Assessment service database included children aged 0–12 years exposed to tetracyclines for at least 1 day between January 2008 and December 2020. The primary outcome was the incidence rate of dental discoloration ≥6 months after prescription, and the standardized incidence ratio (SIR) was evaluated as secondary outcome.
Results
56,990 children were included—1,735 and 55,255 aged <8 and 8–12 years, respectively. 61% children were prescribed tetracycline for <14 days with mostly secondgeneration tetracyclines, doxycycline (61%) and minocycline (35%). The 5- and 10-year cumulative incidence rates of dental discoloration were 4.1% (95% confidence interval [CI], 3.0–5.7%) and 5.7% (95% CI, 4.1% to 7.8%), respectively, in the 0–7 years age group and 0.8% (95% CI, 0.7% to 0.9%) and 1.3 (95% CI, 1.1% to 1.4%), respectively, in the 8–12 years age group. Tetracycline exposure did not increase such risk compared to that in the general population (SIR, 1.08; 95% CI, 0.69 to 1.60).
Conclusions
The incidence of dental discoloration was lower than previously suggested. Relieving the age restriction for prescribing tetracyclines may be considered.

Keyword

Tetracycline; Tooth discoloration; Doxycycline; Minocycline; Korea