Associations Between Prenatal, Perinatal, and Early Childhood Vitamin D Status and Risk of Dental Caries at 6 Years

Abstract

Background Previous studies have suggested that insufficient concentrations of vitamin D are associated with dental caries in primary teeth, but evidence remains inconclusive. Objectives We assessed the longitudinal associations between prenatal, perinatal, and early childhood serum 25-hydroxyvitamin D concentrations [25(OH)D] and the risk of dental caries in 6-year-old children. Methods This research was conducted within the Generation R Study, a large, multi-ethnic, prospective cohort study located in Rotterdam, the Netherlands. Dental caries were assessed in children using the decayed-missing-filled-primary teeth index at a mean age of 6.1 years (90% range, 4.8–9.1). We measured serum total 25(OH)D concentrations at 3 time points: prenatally (at 18–24 weeks of gestation), perinatally (at birth), and during early childhood (at age 6 years). We performed logistic regression analyses to determine the longitudinal association of serum 25(OH)D concentrations with caries risks in 5257 children. Additionally, we constructed a Genetic Risk Score (GRS) for the genetic predispositions to serum total 25(OH)D concentrations based on 6 vitamin D–related single nucleotide polymorphisms in a subsample of 3385 children. Results Children with severe prenatal and early childhood serum 25(OH)D deficiencies (<25 nmol/L) were more likely to be diagnosed with caries [OR, 1.56 (95% CI, 1.18–2.06) and 1.58 (95% CI, 1.10–2.25), respectively] than children with optimal concentrations (≥75 nmol/L). After adjustment for residuals of serum 25(OH)D concentrations at other time points, only the early childhood serum 25(OH)D concentration was inversely associated with the caries risk at 6 years (OR, 0.97; 95% CI, 0.95–0.98). However, our GRS analysis showed that children who are genetically predisposed to have lower serum 25(OH)D concentrations do not have a higher risk of developing caries in primary teeth. Conclusions Our study suggests a weak association between serum 25(OH)D concentrations and risks of caries in primary teeth. Based on our results, we do not recommend vitamin D supplementation for the prevention of dental caries in children.

Association between Vitamin D and Dental Caries in a Sample of Canadian and American Preschool-Aged Children

“…Our finding adds to the growing literature pointing to an association between low 25(OH)D and caries in children [4,10,12,21,22]. While most of these studies are crosssectional in design, there is emerging evidence from prospective studies that also indicate an inverse relationship [10,22,23]. A recent vitamin D supplementation study involving a cohort of Canadian children from Winnipeg recently reported a significant inverse relationship between cord 25(OH)D levels and dt (i.e., number of decayed primary teeth) scores in infants [22].…”

“…A recent Chinese study reported that children with optimal 25(OH)D levels had a significantly lower prevalence of ECC [21], while a small study from Iraq reported significantly higher 25(OH)D levels among caries-free preschool children [26]. However, another study revealed a statistically weak relationship between 25(OH)D status in early childhood and caries in primary teeth in children who were 6 years old [23]. A recent Spanish birth cohort study reported that low prenatal and childhood vitamin D levels were associated with caries in the permanent teeth of children [27].…”

Dental Consequences of Vitamin D Deficiency during Pregnancy and Early Infancy—An Observational Study

“…Recently, there have been three dental health studies published (one only as a conference proceeding) with access to prenatal and early life 25OHD data through previous longitudinal studies [ 17 , 27 , 28 ]. Suarez-Calleja et al obtained 25OHD from the INMA-Asturias birth cohort to assess dental caries prevalence in 188 children aged between 6 and 10 [ 27 ].…”

“…The study found that 25OHD insufficiency (<50 nmol/L) in the first trimester of pregnancy and in children at 8 years-of-age were risk factors for dental caries, with odds ratios of 2.51 and 3.45, respectively [ 27 ]. Navarro et al (2021) [ 28 ] utilised 25OHD data from a cohort study in The Netherlands ( n = 5257), with maternal serum levels available from the second trimester and from participants at birth and at age 6. Participants with severe prenatal and early childhood serum 25OHD deficiencies (<25 nmol) were more likely to experience dental caries than those with mild or no deficiency, but this association was weak [ 28 ].…”

Study of Dental Caries and PTH Gene

“…Calcium and 1,25-dihydroxy vitamin D homeostasis are essential for the formation and maintenance of teeth (33). In fact, low levels of calcium were already associated with dental caries in children (26,27,34,35), as well as low levels of 1,25-dihydroxy vitamin D (36). Low calcium levels are detected by extracellular calcium receptors in the parathyroid glands, which increase PTH gene transcription and secretion.…”