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ObjectivesWe investigated the relationship between early childhood malnutrition‐related measures and subsequent enamel defects in the permanent dentition.Materials and MethodsThis cohort study included 349 Amerindian adolescents (10–17 years, 52% male) from the Bolivian Amazon. Exposures included: stunted growth (height‐for‐age z‐scores), underweight (weight‐for‐age z‐scores), anemia (hemoglobin), acute inflammation (C‐reactive protein) and parasitic infection (hookworm). We measured the occurrence (no/yes) and extent (2/3) of enamel defects. We estimated associations between childhood exposures and enamel defect measures using log‐binomial and multinomial logistic regression.ResultsThe prevalence of an enamel defect characterized by an orange peel texture on a large central depression on the labial surface of the central maxillary incisors was 92.3%. During childhood (1–4 years), participants had a high prevalence of stunted growth (75.2%), anemia (56.9%), acute inflammation (39.1%), and hookworm infection (49.6%). We observed associations between childhood height‐for‐age (OR = 0.65; P = 0.028 for >2/3 extent vs. no EH) and gastrointestinal hookworm infection (OR = 3.43; P = 0.035 for >2/3 extent vs. no defects or <1/3 extent) with enamel defects.DiscussionThe study describes a possibly novel form of enamel hypoplasia and provides evidence for associations of malnutrition‐related measures in early childhood, including stunted growth and parasitic helminth infection, with the observed enamel defects.

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