26.12.2013 Views

Influence of Maternal Prenatal Vitamin D Status on Infant Oral Health

Influence of Maternal Prenatal Vitamin D Status on Infant Oral Health

Influence of Maternal Prenatal Vitamin D Status on Infant Oral Health

SHOW MORE
SHOW LESS

Create successful ePaper yourself

Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.

Chapter 6 – Discussi<strong>on</strong><br />

There is no doubt that optimal vitamin levels are associated with improved health<br />

outcomes. It also appears that oral health is influenced by vitamin D c<strong>on</strong>centrati<strong>on</strong>s (as<br />

reviewed in Chapter 1, Secti<strong>on</strong> 3). For instance, we know that vitamin D regulates the<br />

body’s use <str<strong>on</strong>g>of</str<strong>on</strong>g> calcium and plays a key role in crani<str<strong>on</strong>g>of</str<strong>on</strong>g>acial development and the<br />

maintenance <str<strong>on</strong>g>of</str<strong>on</strong>g> good oral health. <str<strong>on</strong>g>Vitamin</str<strong>on</strong>g> D has a role in enamel and dentin formati<strong>on</strong><br />

and also is associated with period<strong>on</strong>tal and oral b<strong>on</strong>e health. 1,2 Higher serum levels <str<strong>on</strong>g>of</str<strong>on</strong>g><br />

25(OH)D are generally associated with improved period<strong>on</strong>tal health outcomes for adults.<br />

Several early studies identified a c<strong>on</strong>necti<strong>on</strong> between vitamin D fortified diets and<br />

caries and enamel hypoplasia in school aged children. As reviewed in Chapter 1, Secti<strong>on</strong><br />

3, research from the first half <str<strong>on</strong>g>of</str<strong>on</strong>g> the twentieth century suggested that school-aged children<br />

receiving cod liver oil <strong>on</strong> a daily basis had a lower incidence <str<strong>on</strong>g>of</str<strong>on</strong>g> caries in both their<br />

primary and permanent dentiti<strong>on</strong> after two years. 3<br />

In additi<strong>on</strong>, children receiving<br />

radiostol (vitamin D) had significantly lower incidence and extent <str<strong>on</strong>g>of</str<strong>on</strong>g> caries in the<br />

permanent dentiti<strong>on</strong> than c<strong>on</strong>trols. 3 Further, cod liver oil and sunbathing during infancy<br />

and early childhood was shown to be effective in decreasing the incidence <str<strong>on</strong>g>of</str<strong>on</strong>g> enamel<br />

hypoplasia in the permanent dentiti<strong>on</strong>. 4<br />

Unfortunately, most <str<strong>on</strong>g>of</str<strong>on</strong>g> these studies were not c<strong>on</strong>trolled trials and did not involve<br />

large samples <str<strong>on</strong>g>of</str<strong>on</strong>g> children needed for statistical power. They also did not correlate actual<br />

25(OH)D levels with caries or developmental defects <str<strong>on</strong>g>of</str<strong>on</strong>g> enamel (DDE) like enamel<br />

hypoplasia. Few studies have reported associati<strong>on</strong>s between vitamin D status (e.g.<br />

ne<strong>on</strong>atal tetany as a result <str<strong>on</strong>g>of</str<strong>on</strong>g> maternal vitamin D deficiency, chr<strong>on</strong>ic disorders <str<strong>on</strong>g>of</str<strong>on</strong>g> calcium<br />

and phosphate homeostasis like <str<strong>on</strong>g>Vitamin</str<strong>on</strong>g> D Dependent Rickets (VDDR), privati<strong>on</strong>al<br />

6-1

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!