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

Abstract

Dental caries in 5-to-8-year-old children with cow’s milk proteinallergy (CMPA) and lactose intolerance (LI), their treatment needs, and theconsumption of milk-based products and milk derivatives by these patientswere investigated. A cross-sectional study was undertaken with 200 childrenin southern Brazil in 2017. The clinical examination was based on the WorldHealth Organization criteria and a questionnaire was sent to parents or legalguardians to collect information on the children’s food intake, pre-existingsystemic diseases, medication use, and CMPA and LI. Standardization wasperformed to verify concordance among examiners (kappa = 0.96). Cariesprevalence was 67.50% in children with CMPA or LI, but 34.37% in thosewithout these conditions. The mean dmft (decayed, missing, and filledteeth) index in children with CMPA or LI was 1.75 ± 1.84, significantlyhigher 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 was1.58 ± 1.50. Lactose-free milk was the most frequently consumed food amongallergic/intolerant children (65.00%), with a mean dmft of 2.00 ± 2.08, higherthan that obtained for those without CMPA/LI (0.82 ± 0.87), showing nosignificant difference (p = 0.129). Although dental caries and treatment needsin primary dentition were associated with CMPA or LI, children’s intakeof replacement foods did not pose any risk for the development of cariouslesions. Statistically significant differences were obtained for the prevalenceand severity of dental caries. This shows the need for treatment of childrenwith CMPA or LI, who had the worst caries prevalence and severity rates