Background: Vitamin D (25OHD) is important for mineral balance in early childhood, optimizing absorption of minerals such as calcium and phosphorus. Deficiency during pregnancy is common in New Zealand and correlated with foetal and new-born 25OHD. Late pregnancy and birth are critical periods for dental development. Severe 25OHD deficiency can result in bone and tooth mineralisation defects. The effects of milder 25OHD deficiency on oral health are unclear.
Aim: To investigate dental consequences of vitamin-D deficiency during pregnancy and infancy.
Methods: Dental examinations were conducted, and exfoliated primary teeth analysed for mineral and protein content using Micro-Computed-Tomography (Micro-CT), Energy-Dispersive-X-ray analysis (EDX) and Raman Spectroscopy. Pregnancy and birth data, including 25OHD status, were available for participants and their mothers through a previous study. Enamel structure, dental caries and developmental enamel defects, and associations with 25OHD were investigated.
Results: 81 children participated, and 64 provided an exfoliated primary tooth for analysis. The mean age was 6.6 years, 52% were male, and 80% resided in areas of low or medium deprivation. Two thirds of participants had at least one tooth affected by an enamel defect, and half had experienced dental caries. 25OHD insufficiency was not associated with hypomineralisation, but an increased caries risk (IRR of 3.55) was observed by age six. EDX and Micro CT analysis found no differences in mineral or protein content by 25OHD status, however, Raman spectroscopic data revealed subtle structural differences between those with sufficient, insufficient, and deficient levels of 25OHD.
Conclusions: Enamel defect and dental caries prevalence in this sample was high relative to national and international data. Maternal 25OHD insufficiency during third-trimester was associated with greater caries experience in the primary dentition. No association was found between early life 25OHD and enamel defect prevalence. Subtle differences in enamel quality according to 25OHD categorisation were identified.