The importance of vitamin D for development of teeth and caries in the primary dentition – a cohort study of children born 2011 and 2012 in Umeå.
A prospective cohort study of 100 women and their newborn children. The children are followed up at 5 and 7 years of age and caries and signs of enamel hypoplasia are registered. Dental data are analysed in relation to vitamin D of the mother soon after delivery, feeding and health of the child during the first year of life and present level of vitamin D of the child.
Vitamin D plays an important role in the mineralization of the body's hard tissues such as skeleton and teeth. The development of primary teeth occurs gradually during pregnancy and at birth, all primary teeth are under development and partially calcified. Prenatal levels of vitamin D are believed to be important for dental development. The first permanent molar begins to mineralize at birth.
In infants low levels of vitamin D have been associated with increased risk for dental caries and enamel hypoplasia (Schroth et al., 2014). School-children with low levels have an increased risk for molar-incisor hypomineralization (MIH) and those with higher levels have less dental caries (Kuhnisch et al., 2015). The impact of maternal vitamin D-levels for hard tissue development are not fully understood.
The aims of the study are: i) to investigate the importance of mothers vitamin D levels on enamel hypoplasias and caries in primary teeth and in the permanent teeth that are mineralized just before or after birth. ii) to examine caries in relation to the current vitamin D level of the child.
The study is a cohort study with prospective study design. In the original study (Stecksén-Blicks et al., 2015; Hasslöf et al. 2017; Gustavsson et al. 2018) during 2011-2012, 100 healthy mothers and their newborn children (4 weeks old) were examined. The female level of 25-hydroxy vitamin D (25 (OH) D) was analyzed in blood samples. In addition, iron status and antisecretory factor in plasma and breast milk were investigated. Dietary habits and infections during pregnancy were recorded.
The children were followed during one year with samplings for oral candida and with questionnaires about feeding, diseases, use of antibiotics and probiotics, and living conditions. In the present study the children are examined for caries and enamel hypoplasia at 5 years old (first examination) and at 7 years old (second examination). Exfoliated primary teeth are collected for analysis of enamel. A blood-sample is collected for analysis of vitamin D. Dental data from 5 and 7 years of the child are analyzed together with earlier collected data from the mother-child pairs and present D-vitamin status of the child. It is expected that the results from this study will contribute to knowledge about the association between maternal vitamin D status and tooth development, risk of dental caries and enamel hypoplasia (MIH). Further, the association between the child's feeding and health during the first year of life, present vitamin D-status and dental health will be explored.