The implication of phenylketonuria on oral health.

PURPOSE This study was performed to evaluate the oral health of children with PKU and to assess, in vitro, the erosive potential of 5 amino acid supplements commonly prescribed in the management of these children. METHODS Forty children with phenylketonuria underwent a full dental examination and were compared with an age and sex matched control group. The erosive potential of the supplements was assessed by comparing their pH and titratable acidity to those of Coca Cola and orange juice. RESULTS There was no significant difference between the affected and control groups in the level of dental caries, with over 75% of the children examined being caries free. However significantly more (33%) children with phenylketonuria exhibited signs of tooth wear compared with 24% of the controls (P < 0.05). While Coca Cola had the lowest pH (2.46), the titratable acidity of the flavoured supplements (92.86-126.8 mEq/l) was significantly higher than both their unflavored counterparts (4.18-14.0 mEq/l) and Coca Cola (38.56 mEq/l). CONCLUSIONS Despite the potentially damaging nature of their diet, significantly less children with PKU had ever seen a dentist. Health professionals involved in the care of these patients should be aware of the implications of management and provide appropriate dental advice and referral.

[1]  N. Kilpatrick,et al.  Oral health implications in children with inborn errors of intermediary metabolism: a review. , 2003, International journal of paediatric dentistry.

[2]  D. Zero,et al.  Etiology of dental erosion--extrinsic factors. , 1996, European journal of oral sciences.

[3]  P Scheutzel,et al.  Etiology of dental erosion--intrinsic factors. , 1996, European journal of oral sciences.

[4]  J. T. ten Cate,et al.  Pathogenesis and modifying factors of dental erosion. , 1996, European journal of oral sciences.

[5]  G. Slade,et al.  Caries prevalence in Australasia. , 1994, International dental journal.

[6]  S. Grobler,et al.  In vitro demineralization of enamel by orange juice, apple juice, Pepsi Cola and Diet Pepsi Cola. , 1990, Clinical preventive dentistry.

[7]  M. Mistry,et al.  Laboratory studies of the dental properties of soft drinks , 1989, British Journal of Nutrition.

[8]  B G Smith,et al.  An index for measuring the wear of teeth , 1984, British Dental Journal.

[9]  G. Roberts,et al.  Relation between medicines sweetened with sucrose and dental disease. , 1979, British medical journal.

[10]  J. Murray.  Fluorides and dental caries , 1973 .

[11]  R. Gardner,et al.  Phenylketonuria--oral manifestations. , 1970, ASDC journal of dentistry for children.

[12]  H. Myers,et al.  Dental manifestations of phenylketonuria. , 1968, Journal of the American Dental Association.

[13]  H. Löe,et al.  PERIODONTAL DISEASE IN PREGNANCY. II. CORRELATION BETWEEN ORAL HYGIENE AND PERIODONTAL CONDTION. , 1964, Acta odontologica Scandinavica.

[14]  H. Löe,et al.  PERIODONTAL DISEASE IN PREGNANCY. I. PREVALENCE AND SEVERITY. , 1963, Acta odontologica Scandinavica.

[15]  F. J. Mcclure,et al.  Salivary Citrate and Dental Erosion , 1949, Journal of dental research.

[16]  L Shaw,et al.  Continuous monitoring of salivary flow rate and pH at the surface of the dentition following consumption of acidic beverages. , 1997, Caries research.

[17]  L. Silverstone.  Diet and dental caries, part 2. , 1977, Dental update.

[18]  B. G. Bibby.  The cariogenicity of snack foods and confections. , 1975, Journal of the American Dental Association.

[19]  G. B. Winter,et al.  Prevalence of dental caries in phenylketonuric children. , 1974, Caries research.

[20]  P. Schmid,et al.  An apparatus for frequency-controlled feeding of small rodents and its use in dental caries experiments. , 1968, Archives of oral biology.