Lower vitamin D levels in the second and third trimesters are associated with an increased risk of early childhood caries in children

1. In this cohort of maternal-child pairs, lower maternal vitamin D levels, especially in the second and third trimesters, are associated with an increased risk of early childhood caries (ECC). 

Evidence Rating Level: 1 (Excellent)

Early childhood caries (ECC) is a common and serious public health issue, affecting more than half of young children worldwide and up to 70%of Chinese preschoolers. ECC can impair chewing, appearance, learning, and overall health, creating significant burdens for families and society. Since tooth mineralization begins in mid-pregnancy and continues through late pregnancy, maternal vitamin D plays a crucial role in the development of healthy enamel. Low vitamin D levels in pregnancy can lead to enamel defects and increase a child’s risk of cavities, yet past studies have shown mixed results. This cohort study aims to clarify the relationship between maternal vitamin D levels in each trimester and the incidence of dental caries in children. Plasma levels of 25 (OH)D2 and 25 (OD)D3 were measured using liquid chromatography-tandem mass spectrometry, and vitamin D deficiency was defined as a total 25 (OH)D level below 20 ng/mL. The study included 4109 mother-child pairs (median [IQR] maternal age, 29 [27.0-32.0] years; 39-week median gestation; 51.6% male), and by their last dental exam, 960 children (23.4%) aged 1-6 years had ECC. Higher maternal 25(OH)D levels were associated with lower odds of ECC across all trimesters (first trimester odds ratio [OR], 0.98 [95% CI, 0.97-0.99]; second trimester OR, 0.98 [95% CI, 0.97-0.99]; third trimester OR, 0.99 [95% CI, 0.98-1.00]). When vitamin D was assessed categorically, maternal vitamin D insufficiency, deficiency, and severe deficiency were generally associated with an increased risk of ECC compared to sufficient maternal vitamin D levels; however, some associations weakened after correction for the false discovery rate (FDR). In summary, an inverse relationship between maternal vitamin D levels and ECC was demonstrated, suggesting that routine vitamin D screening and supplementation in pregnancy may help prevent cavities in children.

Click here to read this study in JAMA Network Open

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