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Diagnosis of FASD is crucial in obtaining appropriate care, but it is not always possible when PAE cannot be documented.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Deciduous teeth from a child with known PAE and a child with known absence of PAE were analyzed using liquid chromatography\u2010isotope dilution tandem mass spectrometry (LC\u2010IDMS\/MS) in a multiple\u2010reaction monitoring mode for direct markers and LC\u2010high resolution MS in positive and negative mode with hydrophilic interaction liquid chromatography and reverse\u2010phase chromatography, respectively, for indirect markers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Direct markers of PAE (ethyl glucuronide and ethyl sulfate) were detected in prenatal and postnatal dentine from a case tooth but not from a control tooth. Indirect biomarker analysis indicated a dysregulation of amino acids and an increase in cholesterol sulfate in the case compared to the control tooth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This proof\u2010of\u2010concept study demonstrates for the first time that direct biomarkers of PAE are detectable and measurable in deciduous teeth which begin forming in utero and are typically naturally shed between 5 and 12\u2009years of age. Further examination of these novel biomarkers may allow diagnosis of FASD where documentation of PAE is otherwise unavailable. Furthermore, because teeth grow incrementally, defined growth zones can be sampled allowing for identification of gestational timing of PAE to help better understand mechanisms underlying alcohol's disruption of perinatal development.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.2054","type":"journal-article","created":{"date-parts":[[2022,6,10]],"date-time":"2022-06-10T10:51:35Z","timestamp":1654858295000},"page":"797-804","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Prenatal alcohol exposure can be determined from baby teeth: Proof of concept"],"prefix":"10.1002","volume":"114","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9675-1260","authenticated-orcid":false,"given":"Annika C.","family":"Montag","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of California San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina 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