Top

BMC Pediatrics

Published in:

01-12-2021 | Caries | Research

Vitamin D, pregnancy and caries in children in the INMA-Asturias birth cohort

Authors: Claudia Suárez-Calleja, Jaime Aza-Morera, Tania Iglesias-Cabo, Adonina Tardón

Published in: BMC Pediatrics | Issue 1/2021

Abstract

Background

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, 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.

Methods

The 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.

Results

The 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 (OR_gest = 2.51(1.01–6.36) and OR_8years = 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.

Conclusions

Although 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.

Holick MF. The vitamin D deficiency pandemic: approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord. 2017;18(2):153–65.PubMedCrossRef

Cashman KD, Dowling KG, Škrabáková Z, Gonzalez-Gross M, Valtueña J, De Henauw S, et al. Vitamin D deficiency in Europe: pandemic? Am J Clin Nutr. 2016;103(4):1033–44.PubMedPubMedCentralCrossRef

Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr. 2008;87(4):1080–6.CrossRef

Nikiforuk G, Fraser D. The etiology of enamel hypoplasia: A unifying concept. J Pediatr. 1981;98:888–93.PubMedCrossRef

Schroth RJ, Lavelle C, Tate R, Bruce S, Billings RJ, Moffatt MEK. Prenatal vitamin D and dental caries in infants. Pediatr Int. 2014;133(5):e1277–84 Available from: http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2013-2215.

Schroth RJ, Levi JA, Sellers EA, Friel J, Kliewer E, Moffatt ME. Vitamin D status of children with severe early childhood caries: a case–control study. BMC Pediatr [Internet]. 2013;13(1):174 Available from: http://bmcpediatr.biomedcentral.com/articles/10.1186/1471-2431-13-174.CrossRef

Needleman HL, Allred E, Bellinger D, Leviton A, Rabinowitz M, Iverson K. Antecedents and correlates of hypoplastic enamel defects of primary incisors. Pediatr Dent. 1992;14(3):158–66.PubMed

Casamassimo PS. Maternal Oral Health; 2001. p. 469–78.

Barbero JG. Patología y Terapéutica Dental; 2000. p. 137–45.

10.

Tanaka K, Hitsumoto S, Miyake Y, Okubo H, Sasaki S, Miyatake N, et al. Higher vitamin D intake during pregnancy is associated with reduced risk of dental caries in young Japanese children. Ann Epidemiol. 2015;25(8):620–5.PubMedCrossRef

11.

Dudding T, Thomas SJ, Duncan K, Lawlor DA, Timpson NJ. Re-Examining the Association between Vitamin D and Childhood Caries. PLoS One. 2015;10(12):e0143769. https://doi.org/10.1371/journal.pone.0143769.

12.

Seow WK. Early childhood caries. Pediatr Clin North Am [internet]. 2018;65(5):941–54 Available from: https://doi.org/10.1016/j.pcl.2018.05.004.CrossRef

13.

Blinkhorn A, Bartold PM, Cullinan MP, Madden TE, Marshall RI, Raphael SL, et al. Is there a role for triclosan/copolymer toothpaste in the management of periodontal disease? Br Dent J. 2009;207(3):117–25.PubMedCrossRef

14.

Uwitonze AM, Rahman S, Ojeh N, Grant WB, Kaur H, Haq A, et al. Oral manifestations of magnesium and vitamin D inadequacy. J steroid Biochem Mol Biol [internet]. 2020;200(April 2019):105636 Available from: https://doi.org/10.1016/j.jsbmb.2020.105636.CrossRef

15.

Petersen PE. Continuous improvement of oral health in the 21st century: the approach of the WHO global Oral health Programme. Zhonghua Kou Qiang Yi Xue Za Zhi. 2004;39(6):441–4.PubMed

16.

Hara AT. The Caries E n v i ro n m e n t : Saliva , Pellicle , D i e t , an d H a rd T i s s u e U l t r a s t r u c t u re. Dent Clin. 2010;54:455–67.

17.

Chapple ILC, Bouchard P, Cagetti MG, Campus G, Carra MC, Cocco F, et al. Interaction of lifestyle, behaviour or systemic diseases with dental caries and periodontal diseases: consensus report of group 2 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases. J Clin Periodontol. 2017;44:S39–51.PubMedCrossRef

18.

Hajishengallis E, Parsaei Y, Klein MI, Koo H. Advances in the microbial etiology and pathogenesis of early childhood caries. Mol Oral Microbiol. 2017;32(1):24–34.PubMedCrossRef

19.

Broadbent JM, Thomson WM. For debate: problems with the DMF index pertinent to dental caries data analysis. Community Dent Oral Epidemiol [Internet]. 2005;33(6):400–9 Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1388190/pdf/nihms6255.pdf.CrossRef

20.

Nadanovsky P, Sheiham A. Relative contribution of dental services to the changes in caries levels of 12-year-old children in 18 industrialized countries in the 1970s and early 1980s. Community Dent Oral Epidemiol. 1995;23(6):331–9.PubMedCrossRef

21.

Norris J. Can the sunshine vitamin shed light on type 1 diabetes? Lancet. 2001;358(9292):1476–8.PubMedCrossRef

22.

Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatr Int. 2008;122(2):398–417 Available from: http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2007-1894.

23.

Holick MF. Vitamin D: The underappreciated D-lightful hormone that is important for skeletal and cellular health. Curr Opin Endocrinol Diabetes. 2002;9(1):87–98.CrossRef

24.

Ross AC. The 2011 report on dietary reference intakes for calcium and vitamin D. Public Health Nutr. 2010;14(5):938–9.CrossRef

25.

Robert J, Schroth, Nathan S. Jeal, Eleonore Kliewer and EACS. The relationship between vitamin D and severe early childhood caries: a pilot study. Int J Vitam Nutr Res [internet]. 2012;82(1):53–62 Available from: http://www.ncbi.nlm.nih.gov/pubmed/22419202.CrossRef

26.

Hollis BW. Assessment of vitamin D nutritional and hormonal status: what to measure and how to do it. Calcif Tissue Int. 1996;58(1):4–5.PubMedCrossRef

27.

Pereira Souza A, Kobayashi TY, Neto NL, Moura S, Silva B, Andrade MA, et al. Dental manifestations of patient with vitamin D-resistant rickets. J Appl Oral Sci. 2013;21(6):601–6.CrossRef

28.

Kulie T, Groff A, Redmer J, Hounshell J, Schrager S. Vitamin D: An evidence-based review. J Am Board Fam Med [Internet] 2009;22(6):698–706. Available from: http://www.jabfm.org/cgi/doi/10.3122/jabfm.2009.06.090037

29.

Wolf M, Shah A, Gutierrez O, Ankers E, Monroy M, Tamez H, et al. Vitamin D levels and early mortality among incident hemodialysis patients. Kidney Int. 2007;72(8):1004–13.PubMedCrossRef

30.

Inaguma D, Nagaya H, Hara K, Tatematsu M, Shinjo H, Suzuki S, et al. Relationship between serum 1,25-dihydroxyvitamin D and mortality in patients with pre-dialysis chronic kidney disease. Clin Exp Nephrol. 2008;12(2):126–31.PubMedCrossRef

31.

Danescu LG, Levy S, Levy J. Vitamin D and diabetes mellitus. Endocrine. 2009;35(1):11–7.PubMedCrossRef

32.

Osborne JE, Hutchinson PE. Vitamin D and systemic cancer: is this relevant to malignant melanoma? Br J Dermatol. 2002;147(2):197–213.PubMedCrossRef

33.

Bikle DD, Teichert A, Arnold LA, Uchida Y, Elias PM, Oda Y. Differential regulation of epidermal function by VDR coactivators. J Steroid Biochem Mol Biol. 2010;121(1-2):308-13. https://doi.org/10.1016/j.jsbmb.2010.03.027.

34.

Rodríguez-Dehli AC, Riaño-Galán I, Fernández-Somoano A, Navarrete-Muñoz EM, Espada M, Vioque J, et al. Hipovitaminosis D y factores asociados a los 4 años en el norte de España. An Pediatría [Internet]. 2017;86(4):188–96 Available from: http://linkinghub.elsevier.com/retrieve/pii/S1695403316000412.CrossRef

35.

Rodríguez-Dehli AC, Galán IR, Fernández-Somoano A, Navarrete-Muñoz EM, Espada M, Vioque J, et al. Prevalencia de deficiencia e insuficiencia de vitamina D y factores asociados en mujeres embarazadas del norte de España PREVALENCE OF VITAMIN D DEFICIENCY AND INSUFFIENCY AND ASSOCIATED FACTORS IN PREGNANT WOMEN OF NORTHERN SPAIN. Nutr Hosp. 2015;31(4):1633–40.PubMed

36.

López-Vicente M, Sunyer J, Lertxundi N, González L, Rodríguez-Dehli C, Espada Sáenz-Torre M, et al. Maternal circulating vitamin D3 levels during pregnancy and behaviour across childhood. Sci Rep. 2019;9(1):1–8.CrossRef

37.

Guxens M, Ballester F, Espada M, Fernández MF, Grimalt JO, Ibarluzea J, et al. Cohort profile: the INMA-INfancia y Medio Ambiente-(environment and childhood) project. Int J Epidemiol. 2012;41(4):930–40.PubMedCrossRef

38.

Hujoel PP, Lingström P. Nutrition, dental caries and periodontal disease: a narrative review. J Clin Periodontol. 2017;44:S79–84.PubMedCrossRef

39.

Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911–30.PubMedCrossRef

40.

Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Guidelines for preventing and treating vitamin D deficiency and insufficiency revisited. J Clin Endocrinol Metab. 2012;97(4):1153–8.PubMedCrossRef

41.

Institute of Medicine (IOM). Dietary Reference Intakes for Calcium and Vitamin D and Calcium [Internet]. Dietary Reference Intakes for Calcium and Vitamin D. National Academies Press (US); 2011 [Cited 2018 Jun 5]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21796828.

42.

Grigalauskienė R, Slabšinskienė E, Vasiliauskienė I. Biological approach of dental caries management. Stomatologija. 2015;17(4):107–12.PubMed

43.

Plonka KA, Pukallus ML, Barnett AG, Holcombe TF, Walsh LJ, Seow WK. A longitudinal case-control study of caries development from birth to 36 months. Caries Res. 2013;47(2):117–27.PubMedCrossRef

44.

ten Cate JM, Zaura E. The numerous microbial species in oral biofilms: how could antibacterial therapy be effective? Adv Dent Res. 2012;24(2):108–11.PubMedCrossRef

45.

Philip N, Suneja B, Walsh LJ. Ecological approaches to dental caries prevention: paradigm shift or shibboleth? Caries Res. 2018;52(1–2):153–65.PubMedCrossRef

46.

Riley P, Lamont T. Triclosan / copolymer containing toothpastes for oral health ( review ). Cochrane Libr. 2013;12:1–135.

47.

Dang MH, Jung JE, Lee DW, Song KY, Jeon JG. Recovery of acid production in Streptococcus mutans biofilms after short-term fluoride treatment. Caries Res. 2016;50(4):363–71.PubMedCrossRef

48.

Palmer CA, Kent R, Loo CY, Hughes CV, Stutius E, Pradhan N, et al. Diet and caries-associated bacteria in severe early childhood caries. J Dent Res. 2010;89(11):1224–9.PubMedPubMedCentralCrossRef

49.

Gyll J, Ridell K, Öhlund I, Karlsland Åkeson P, Johansson I, Lif HP. Vitamin D status and dental caries in healthy Swedish children. Nutr J. 2018;17(1):1–10.CrossRef

50.

Hujoel PP. Vitamin D and dental caries in controlled clinical trials: Systematic review and meta-analysis. Nutr Rev. 2013;71(2):88–97.PubMedCrossRef

51.

Seminario AL, Velan E. Vitamin D and dental caries in primary dentition. J Dent Child. 2016;83(3):114–9.

52.

Ślebioda Z, Szponar E, Dorocka-Bobkowska B. Vitamin D and its relevance in the Etiopathogenesis of Oral cavity diseases. Arch Immunol Ther Exp. 2016;64(5):385–97.CrossRef

53.

Fatturi AL, Menoncin BL, Reyes MT, Meger M, Scariot R, Brancher JA, et al. The relationship between molar incisor hypomineralization, dental caries, socioeconomic factors, and polymorphisms in the vitamin D receptor gene: a population-based study. Clin Oral Investig. 2020;24:3971–80.PubMedCrossRef

54.

Singleton R, Day G, Thomas T, Schroth R, Klejka J, Lenaker D, et al. Association of Maternal Vitamin D Deficiency with early childhood caries. J Dent Res. 2019;98(5):549–55.PubMedPubMedCentralCrossRef

55.

Schroth RJ, Christensen J, Morris M, Gregory P, Mittermuller BA, Rockman-Greenberg C. The influence of prenatal vitamin D supplementation on dental caries in infants. J Can Dent Assoc. 2020;86(C):k13.PubMed

56.

Silva CC, Gavinha S, Manso MC, Rodrigues R, Martins S, Guimarães JT, et al. Serum levels of vitamin d and dental caries in 7-year-old children in Porto metropolitan area. Nutrients. 2021;13(1):1–16.

57.

Thorne-Lyman, A; W. Fawzi W. Display Settings : Vitamin D during pregnancy and maternal , neonatal and infant health outcomes : a systematic review and meta-analysis. 2013;26(0 1):2–3.

58.

Schroth RJ, Jeal NS, Kliewer E, Sellers EAC. The relationship between vitamin D and severe early childhood caries: a pilot study. Int J Vitam Nutr Res Int J Vitam Nutr Res. 2012;82(821):53–62.PubMedCrossRef

59.

Marshall TA, Levy SM, Broffitt B, Warren JJ, Eichenberger-Gilmore JM, Burns TL, et al. Dental caries and beverage consumption in young children. Pediatr Int. 2003;112(3):184–91 Available from: http://pediatrics.aappublications.org/content/112/3/e184.full.html.

60.

Aribam V, Aswath N, Ramanathan A. Single-nucleotide polymorphism in Vitamin D receptor gene and its association with dental caries in children. J Indian Soc Pedod Prev Dent [Internet]. 2020;38(1):–8 Available from: http://www.jisppd.com/text.asp?2020/38/1/8/280513.

61.

Cockburn F, Belton NR, Purvis RJ, Giles MM, Brown JK, Turner TL, et al. Maternal vitamin D intake and mineral metabolism in mothers and their newborn infants. Br Med J [Internet]. 1980;281(6232):11–4 Available from: http://www.ncbi.nlm.nih.gov/pubmed/7407476%5Cnhttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC1713762.CrossRef

62.

Roh YE, Kim BR, Choi WB, Kim YM, Cho MJ, Kim HY, et al. Vitamin D deficiency in children aged 6 to 12 years: single center’s experience in busan. Ann Pediatr Endocrinol Metab. 2016;21(3):149–54.PubMedPubMedCentralCrossRef

63.

Alonso A, Rodríguez J, Carvajal I, Prieto ML, Rodríguez RM, Pérez AM, et al. Prophylactic vitamin D in healthy infants: assessing the need. Metabolism [Internet]. 2011;60(12):1719–25 Available from: http://dx.doi.org/10.1016/j.metabol.2011.04.011.CrossRef

64.

Girish M, Subramaniam G. Rickets in exclusively breast fed babies. Indian J Pediatr. 2008;75(6):641–3.PubMedCrossRef

65.

Kim MJ, Na B, No SJ, Han HS, Jeong EH, Lee W, et al. Nutritional status of vitamin D and the effect of vitamin D supplementation in Korean breast-fed infants. J Korean Med Sci. 2010;25(1):83–9.PubMedCrossRef

66.

Abulmeaty MMA. Sunlight exposure vs. vitamin D supplementation on bone homeostasis of vitamin D deficient rats. Clin Nutr Exp [Internet]. 2017;11:1–9 Available from: http://dx.doi.org/10.1016/j.yclnex.2016.10.003.CrossRef

Title: Vitamin D, pregnancy and caries in children in the INMA-Asturias birth cohort
Authors: Claudia Suárez-Calleja
Jaime Aza-Morera
Tania Iglesias-Cabo
Adonina Tardón
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Caries
Published in: BMC Pediatrics / Issue 1/2021
Electronic ISSN: 1471-2431
DOI: https://doi.org/10.1186/s12887-021-02857-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Vitamin D, pregnancy and caries in children in the INMA-Asturias birth cohort

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2021

Concentration levels of serum 25-Hydroxyvitamin-D and vitamin D deficiency among children and adolescents of India: a descriptive cross-sectional study

Reference intervals for hemoglobin and mean corpuscular volume in an ethnically diverse community sample of Canadian children 2 to 36 months

Effect of maternal education and encouragement on newborn care utilization: a health system intervention

Prediction of arrhythmia after intervention in children with atrial septal defect based on random forest

Patent ductus arteriosus, systemic NT-proBNP concentrations and development of bronchopulmonary dysplasia in very preterm infants: retrospective data analysis from a randomized controlled trial

Neonatal rebound hyperkalemia associated with ritodrine alone: a case report