420 - Investigating a Correlation between Hyperbilirubinemia in Infancy and Caries Risk

Purpose: High serum levels of bilirubin have been implicated in causing developmental tooth defects, and it is known that developmental tooth defects are associated with elevated caries risk. The purpose of the present study was to investigate whether a diagnosis of early childhood caries or severe early childhood caries in children under the age of 6 was associated with a.) increased frequency of diagnosis of hyperbilirubinemia, and b.) increased frequency of treatment for hyperbilirubinemia with phototherapy, when compared to the general pediatric population.

Methods: Two retrospective chart reviews were done on children that were treated for caries at the Medical University of South Carolina (MUSC) whose birth records were available for review. The first retrospective chart review analyzed data between the years of 2017 and 2023 for patients who had a diagnosis of early childhood caries, receiving dental treatment under general anesthesia. The second retrospective chart review analyzed data between the years of 2013 and 2023 for all patients under the age of 6 who were treated in the Pediatric Dentistry Clinic at the Medical University of South Carolina. The bilirubinometry index, transcutaneous bilirubin levels, peak total serum bilirubin levels, peak direct serum bilirubin levels, a diagnosis of hyperbilirubinemia (yes or no), phototherapy treatment (yes or no), and gestational age at birth were recorded. Statistical analyses were performed.

Results: The first retrospective chart review analyzed 1000 total charts, and 314 fit the criteria for inclusion. The second retrospective chart review was performed to include more patients and more criteria to investigate a relationship between a diagnosis of hyperbilirubinemia and a diagnosis of early childhood caries. Out of roughly 6000 total charts reviewed, 769 fit the criteria for inclusion. Of the 242 patients who were diagnosed with hyperbilirubinemia, 105 patients were diagnosed with early childhood caries (43.39%). The Chi-squared test revealed a p-value of 0.03, so the null hypothesis is rejected, and the conclusion is there is a relationship between a diagnosis of hyperbilirubinemia and a diagnosis of early childhood caries. The phi coefficient represents a very weak association between these two variables.

Conclusion: In the patient population evaluated in this study, there is a very weak association between hyperbilirubinemia in infancy and a diagnosis of early childhood caries under 6 years of age.