Influence of Maternal Prenatal Vitamin D Status on Infant Oral Health

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indicated that they were receiving government assistance. The majority were earning less than $1,000 each month (58.2%) with only 11.9% earning above $1,500 per month. Dental History <strong>of</strong> Mother The majority <strong>of</strong> caregivers (63.3%) reported that they had not visited their dentist during pregnancy, but 53.1% had experienced dental problems during pregnancy or since their infant was born. Dental problems in descending order included cavities (55.4%), extractions (20.0%), dental pain (12.3%), wisdom teeth (9.2%), gum problems (1.5%), and infection (1.5%). Infant Oral Health Pr<strong>of</strong>ile The average age given for the eruption <strong>of</strong> the first primary tooth for infants in this cohort was 5.5 ± 2.3 months <strong>of</strong> age, and ranged from birth to 12 months <strong>of</strong> age with the median age being 5.3 months. When asked, only two caregivers (1.5%) indicated that their child’s teeth did not look healthy when they erupted into the oral cavity and another 30 caregivers (22.2%) believed their child had dental problems. The main types <strong>of</strong> problems identified included decay (46.9%), chipped or discoloured teeth (15.6%), and crooked baby teeth (18.8%). Even though 22.2% <strong>of</strong> caregivers indicated that their child had a dental problem only 15 children (11.1%) had been to the dentist for a first visit. Among those who had already been to the dentist, the main reason was due to cavities and not for a check-up examination (58.3% vs. 41.7%). While 88% <strong>of</strong> caregivers indicated that they had started to clean their child’s teeth and mouth, the age when this needed behaviour was initiated ranged from birth to 30 3-14
months <strong>of</strong> age. The average age when cleaning began was 9.0 ± 5.5 months <strong>of</strong> age while the median age was 8.0 months. Half <strong>of</strong> the caregivers (49.6%) indicated that they used toothpaste to clean their child’s teeth. Mothers were the primary caregiver looking after the child’s oral hygiene (83.6%). None <strong>of</strong> the children had received fluoride drops during infancy. The infant oral examination provided an opportunity to identify whether children exhibited developmental defects <strong>of</strong> enamel (DDEs), including enamel hypoplasia. In accordance with the modified DDE index 2 , normal teeth were given the code 0 while opacities were categorized from 1 to 6. Enamel hypoplasia was rated with codes from 7 to 9 while combinations <strong>of</strong> opacities and hypoplasia were scored as A, B, C or D. Frequencies appear in Tables 3.8 and 3.9. A figure <strong>of</strong> the primary dentition and corresponding tooth numbers appears in Figure 3.1. Those primary maxillary teeth with the highest prevalence <strong>of</strong> DDEs were the primary maxillary central incisors. Similarly, more cases <strong>of</strong> DDEs were observed in the primary maxillary incisors. Primary mandibular teeth that had the greatest number <strong>of</strong> reported cases <strong>of</strong> opacities and hypoplasia were the incisors. The vast majority <strong>of</strong> DDEs were identified on the buccal surfaces <strong>of</strong> primary teeth, particularly the maxillary incisors. Among the children who were examined, 20 had DDEs on the buccal surface <strong>of</strong> tooth #52 (13 opacities, 4 hypoplasia, and 3 combinations <strong>of</strong> opacities and hypoplasia). 45 primary maxillary right central incisors (#51) were found to have DDEs on the buccal surface (35 opacities and 9 hypoplasia). Meanwhile, 25 children had DDEs on the buccal surface <strong>of</strong> tooth #62 (17 opacities, 7 hypoplasia, and 1 combination <strong>of</strong> opacity and hypoplasia), while 47 children had DDEs on the buccal surface <strong>of</strong> tooth #61 (36 opacities 3-15
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Influence
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Abstract Influence
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Acknowledgements This longitudinal
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Table of Contents
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Status and Non-<st
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Table 1.1-1 - Recent studies report
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Table 1.1-2 - Previous used terms f
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The Link Between Enamel Hypoplasia
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If enamel hypoplasia results from n
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malocclusions. 145 Additional human
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Daily intakes of v
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13. Milnes AR, Rubin CW, Karpa M, T
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40. Definition of
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71. Watt RG. From victim blaming to
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97. Fearne JM, Bryan EM, Elliman AM
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124. Burt BA, Pai S. Does low birth
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151. Tinanoff N, D
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Section 2 - Risk Factors for Enamel
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correspond to the timing of
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een published. 3,4,17,19 The intent
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Table 1.2-2 - Risk factors for DDE
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Opacity 51 Implicated Risk Developm
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Implicated Risk Factor Factors asso
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o Metabolic Abnormalities and Healt
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12 months of life.
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Other Factors Some uncommon risk fa
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devastating problem of</str
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13. An epidemiological index <stron
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54. Seow WK, Perham S. Enamel hypop
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82. Berdal A, Papagerakis P, Hotton
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Vitamin D may be d
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have been used to prof</str
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health’. In addition, articles we
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36 month trial had ended. 45 The nu
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Recently, a cross-sectional study <
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andomized, placebo-controlled study
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Further, amelogenin and enamelin, p
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A study of Austral
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Both dietary interventions and supp
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incidence of carie
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important nutrient. However, many <
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caries, and more hardening
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controls. 106 Interestingly, childr
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A few years later, additional resea
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Delayed Tooth Eruption Vita
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Description of Pop
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Influence
Page 96 and 97: D has an effect on the dentition, p
Page 98 and 99: 14. Utiger RD. The need for more vi
Page 100 and 101: 42. Spiller WF, Jr. A clinical eval
Page 102 and 103: 67. Itota T, Tashiro Y, Torii Y, Ni
Page 104 and 105: 95. Bruszt P. Kariesuntersuchungen
Page 106 and 107: 121. Seow WK, Needleman HL, Holm IA
Page 108 and 109: Chapter 2 - Methods for a Prospecti
Page 110 and 111: Each participant also completed an
Page 112 and 113: Table 2.2 - Recognized case definit
Page 114 and 115: Population The target population fo
Page 116 and 117: allowed the project to suffer some
Page 118 and 119: women of limited m
Page 120 and 121: involving the surface of</s
Page 122 and 123: and training cup. In addition, each
Page 124 and 125: The questionnaire was administered
Page 126 and 127: statistics including frequencies an
Page 128 and 129: elationship between the two. Poisso
Page 130 and 131: References 1. Combs GF. Vit
Page 132 and 133: 27. Seow WK, Amaratunge A, Bennett
Page 134 and 135: Table 3.2 - Self-declared heritage
Page 136 and 137: Question Number Valid % Do you take
Page 138 and 139: Maternal Awareness
Page 140 and 141: time of recruitmen
Page 142 and 143: Table 3.6- Prenatal</strong
Page 144 and 145: A total of 77 care
Page 148 and 149: and 11 hypoplasia). DDEs were also
Page 150 and 151: Caries rates for children in this p
Page 152 and 153: Table 3.12 - Frequency of</
Page 154 and 155: Chapter 4 - Results: Associations <
Page 156 and 157: II. Relationship Between 25(OH)D Le
Page 158 and 159: Pregnancy & Health Prof</st
Page 160 and 161: The frequency of v
Page 162 and 163: did not (42.9 ± 21.2 nmol/L vs. 49
Page 164 and 165: Early Childhood Caries (ECC) Pr<str
Page 166 and 167: likely to have vitamin D levels at
Page 168 and 169: did not statistically differ from v
Page 170 and 171: Figure 4.4 - Predicted number <stro
Page 172 and 173: Table 4.7 - Relationship between ds
Page 174 and 175: frequently, and less likely to have
Page 176 and 177: health as average or poor, and more
Page 178 and 179: tail (p=.034) suggesting that early
Page 180 and 181: The next series of
Page 182 and 183: Results from the second model appea
Page 184 and 185: Table 5.6 - Multiple regression sta
Page 186 and 187: vitamin D. However, it did suggest
Page 188 and 189: significant at the bivariate level
Page 190 and 191: Table 5.12(a) - Logistic regression
Page 192 and 193: III. Multivariate Regression Analys
Page 194 and 195: Table 5.14 - Logistic regression fo
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Table 5.16 - Logistic regression fo
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Table 5.18 - Logistic regression fo
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Table 5.19(b) - Backwards logistic
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Table 5.20(a) - Logistic regression
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Table 5.21 - Poisson regression for
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If enamel hypoplasia is present and
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Since maternal calcium levels were
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vitamin D deficiency, and rickets)
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to obtain it. Health literacy may b
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vitamin D from the diet as dietary
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home environment can be determinant
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hormone, calcium absorption and bon
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important nutrient. For many, this
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this potential relationship with ac
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genetic conditions, childhood medic
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vitamin D status including milk int
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y cariogenic oral flora. 49 Since e
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(49.8 ± 26.3 nmol/L vs. 45.1 ± 20
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pregnancy, which may have influence
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observed and it allowed multiple ou
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scientific evidence linking prenata
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cognizant that children who undergo
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preventive program would need to be
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makers in the formative stages. As
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Surprisingly, the final regression
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13. First Nations IaMHCCPS. <strong
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38. Hollis BW. Circulating 25-hydro
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65. Li Y, Navia JM, Bian JY. Caries
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91. Brownell MD, Guevremont A, Au W
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Chapter 7 - Conclusions This thesis
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This study provided an interesting
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esiding in disadvantaged communitie
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If you are taking vitamins during t
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Do you Eat? Never Rarely (less than
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What problems can early childhood c
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Prenatal Nutrition
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Did you ever add sugar to the bottl
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Enamel Hypoplasia Enamel Hypoplasia
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Influence of Maternal Prenatal Vitamin D Status on Infant Oral Health

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