Objectives: This study examined the relationship between ear infections, systemic antibiotics in children, and early childhood caries (ECC).

Methods: The study used data from the third National Health and Nutrition Examination Survey (NHANES III, 1988-1994). Children younger than 6 years of age were included in the analysis. Information on children's history of ear infections, their use of systemic antibiotics, and their caries experience was obtained from NHANES III data files. Two statistical models were used to examine the relationship, a logistic regression and a negative binomial regression model.

Results: There were 7805 children (mean age= 3.3 years) included in the analysis, 3857 males (49.42%) and 3948 females (50.58%). Children with a history of at least one ear infection had lower odds of having ECC (OR=0.66, 95%CI=0.47,0.95) than children with no such history. Children with ear tubes had greater odds of having ECC (OR=1.63, 95%CI=0.95, 2.78) compared to those without tubes. Four levels representing the number of ear infections were compared to having no infections: a single episode of ear infection, 2, 3-5 and 6 or more episodes. All of these levels showed lower odds of having ECC (OR=0.80, 95%CI=0.51,1.28; OR=0.93, 95%CI=0.57,1.5; OR=0.49, 95%CI=0.3,0.77; OR=0.57, 95%CI=0.35,0.93, respectively) than did children with no history of ear infections. In the month preceding the survey 13.8% of children in the sample were on some form of systemic antibiotics. The use of such antibiotics was significantly associated with age (X2=58.3, p<0.0001) and race/ethnicity (X2=55.34, p<0.0001), but not with gender (X2=0.04, p<0.85). Use of antibiotics was also associated with lower defs scores (X2=4.94, p<0.03).

Conclusion: The use of systemic antibiotics for ear infections in children may have a protective effect against ECC.

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