Abstract
BackgroundVitamin D is traditionally associated with the metabolism of calcium and phosphorus, a process essential for the mineralization of hard tissue such as bone or tooth. Deficiency of this vitamin is a problem worldwide, however. Given the possibly significant role of Vitamin D in odontogenesis in children, the objective of our study was to determine the influence of vitamin D levels in the blood on dental anomalies in children between 6 and 10 years of age, by means of 25-hydroxy vitamin D tests performed during pregnancy and the first years of life.MethodsThe data analyzed were sourced from data belonging to the INMA-Asturias birth cohort, a prospective cohort study initiated in 2004 as part of the INMA Project. The 25-hydroxy vitamin D (25(OH)D) test was performed with samples from 188 children in the INMA-Asturias birth cohort with a dental examination performed between 6 and 10 years of age. The samples were taken at three stages: in the mother at 12 weeks of gestation, and subsequently in the child at 4 and 8 years of age. Diet, nutritional and oro-dental hygiene habits were also analyzed by means of questionnaires.ResultsThe results indicate a significant association between caries and correct or incorrect brushing technique. With incorrect brushing technique, the prevalence of caries was 48.89%, but this dropped to 22.38% with correct brushing technique. An association was also found between tooth decay and frequency of sugar intake. The prevalence of caries was 24.54% with occasional sugar intake, but this rose to 56% with regular sugar intake. On the other hand, levels < 20 ng/ml in both mother and child at 8 years of age would also be risk factors (ORgest = 2.51(1.01–6.36) and OR8years = 3.45(1.14–11.01)) for the presence of caries in children. The risk of caries practically tripled where 25(OH) D values were < 20 ng/ml.ConclusionsAlthough incorrect brushing technique and regular sugar consumption was found to be the main cause of caries in the children, the low concentrations of vitamin D in the blood of the pregnant mothers may have magnified this correlation, indicating that the monitoring of vitamin D levels during pregnancy should be included in antenatal programmes. It is particularly striking that 50% of the children were deficient in vitamin D at the age of 4, and that dental floss was practically absent from regular cleaning routines.
Highlights
Vitamin D is traditionally associated with the metabolism of calcium and phosphorus, a process essential for the mineralization of hard tissue such as bone or tooth
There is evidence that increased intake of vitamin D in children may decrease the risk of the development of type 1 diabetes mellitus [31], and some observational studies in human and animals support the argument that vitamin D has a positive function in cancer prevention and survival. This may be related to its role in the regulation of cell growth and differentiation [32, 33]. For all these reasons and given the possibly significant role of vitamin D in the development of dentition in children, we proposed to study the influence of vitamin D levels during pregnancy and the first years of life on dental anomalies in children between 6 and 10 years of age
We analyzed the following variables related to oro-dental hygiene and eating habits: frequency of brushing; type of toothpaste according to fluoride content; use of dental floss; correct or incorrect brushing technique; frequency of sugar intake; six-monthly fluoride tray application; use of mouthwash. (Table 2)
Summary
Vitamin D is traditionally associated with the metabolism of calcium and phosphorus, a process essential for the mineralization of hard tissue such as bone or tooth. Deficiency of this vitamin is a problem worldwide, . Vitamin D is a fat-soluble vitamin involved in calcium and phosphorus metabolism, an essential process for the calcification of hard tissue and the mineralization of teeth and bones [4,5,6]. Dental caries is a complex infectious disease arising from tooth-adherent bacteria that metabolize sugars to produce acid which attacks dental tissue, resulting in pain, discomfort and problems chewing, and adversely affecting quality of life [9,10,11]. Some authors argue that the most important factor for the development of caries is the dental biofilm composed of the community of bacteria that live in the oral cavity, and that the role of the other factors is merely to interact and modify the pathogenicity of these bacteria [16]
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