Influence of Maternal Prenatal Vitamin D Status on Infant Oral Health

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vitamin D status including milk intake, season when the serum sample for vitamin D was collected, and the frequency <strong>of</strong> prenatal vitamin use. Only milk consumption emerged as being significantly associated with ECC. Participants who drank milk <strong>of</strong>ten during pregnancy were significantly less likely to have an infant who developed ECC (p=.024). No other variables in this model were identified as being significantly associated with ECC. Previous models in this study revealed that milk intake was a strong predictor <strong>of</strong> both maternal 25(OH)D and enamel hypoplasia. Another two models were constructed to assess the impact <strong>of</strong> infant feeding methods on caries risk. In addition to infant feeding methods, the other regression model also included the age <strong>of</strong> the child when solids were first introduced along with soother and sippy cup use. However, none <strong>of</strong> the independent variables were found to be significantly associated with ECC in either <strong>of</strong> these two models. Recent reviews <strong>of</strong> the literature have concluded that breastfeeding is not a strong determinant <strong>of</strong> ECC and may instead <strong>of</strong>fer a protective effect. 52,53 Further, results from the analysis <strong>of</strong> the 1999-2002 National Health and Nutrition Examination Survey (NHANES) for a large sample <strong>of</strong> 2-5 year olds concluded that there was no evidence to support the association <strong>of</strong> breastfeeding and its duration as independent risk factors for caries. 54 Since ECC is known to be influenced by SES, a logistic regression model incorporated variables like the participant’s annual income, whether anyone in the household had full-time employment during the mother’s pregnancy, and whether participants were receiving government assistance. Chi square analysis did reveal that there were more infants with ECC from households where someone did not have fulltime employment. The findings from the logistic regression model also support this 6-18
elationship. However, infants belonging to mothers who had an annual income <strong>of</strong> less than $18,000 per annum appeared to be less likely to have ECC, although this was not significant. It is unsure whether annual income is a more reliable indicator <strong>of</strong> each participant’s actual SES as it directly pertained to the mother, while full-time employment status was based on what was reported for the entire household unit. Neither was significantly and independently associated with ECC upon further regression analyses. However, it does indicate that future research must also further examine maternal variables that influence ECC risk, including family finances. Households for many <strong>of</strong> these participants may have <strong>of</strong>ten been in a state <strong>of</strong> flux and what was reported by participants may not have been entirely accurate. Additionally, the results from this investigation revealed that only 34 respondents were from such homes. The dental status and dental behaviours <strong>of</strong> the infant and family were also examined as possible factors associated with ECC. From this regression model, two variables emerged as being significantly associated with ECC. The age <strong>of</strong> children at the time <strong>of</strong> their dental visit was found to be associated with ECC. Specifically, those who were examined at or beyond 14 months <strong>of</strong> age were at increased odds <strong>of</strong> being afflicted by ECC. Age is a recognized predictor <strong>of</strong> ECC; older infants and preschool children are at increased risk for developing caries. 23,55,56 This is due to more teeth being exposed to the oral environment and cariogenic bacteria for longer periods <strong>of</strong> time. The other risk factor identified in this logistic regression model was enamel hypoplasia, which has been shown to be a strong predictor <strong>of</strong> ECC. 30,57,58 Children with enamel hypoplasia were at tremendous odds <strong>of</strong> also having ECC. These enamel defects are preferentially colonized 6-19
Page 1 and 2:
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
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D has an effect on the dentition, p
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14. Utiger RD. The need for more vi
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42. Spiller WF, Jr. A clinical eval
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67. Itota T, Tashiro Y, Torii Y, Ni
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95. Bruszt P. Kariesuntersuchungen
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121. Seow WK, Needleman HL, Holm IA
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Chapter 2 - Methods for a Prospecti
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Each participant also completed an
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Table 2.2 - Recognized case definit
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Population The target population fo
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allowed the project to suffer some
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women of limited m
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involving the surface of</s
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and training cup. In addition, each
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The questionnaire was administered
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statistics including frequencies an
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elationship between the two. Poisso
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References 1. Combs GF. Vit
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27. Seow WK, Amaratunge A, Bennett
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Table 3.2 - Self-declared heritage
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Question Number Valid % Do you take
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Maternal Awareness
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time of recruitmen
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Table 3.6- Prenatal</strong
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A total of 77 care
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indicated that they were receiving
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and 11 hypoplasia). DDEs were also
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Caries rates for children in this p
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Table 3.12 - Frequency of</
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Chapter 4 - Results: Associations <
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II. Relationship Between 25(OH)D Le
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Pregnancy & Health Prof</st
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The frequency of v
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did not (42.9 ± 21.2 nmol/L vs. 49
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Early Childhood Caries (ECC) Pr<str
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likely to have vitamin D levels at
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did not statistically differ from v
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Figure 4.4 - Predicted number <stro
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Table 4.7 - Relationship between ds
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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
Page 200 and 201: Table 5.19(b) - Backwards logistic
Page 202 and 203: Table 5.20(a) - Logistic regression
Page 204 and 205: Table 5.21 - Poisson regression for
Page 206 and 207: If enamel hypoplasia is present and
Page 208 and 209: Since maternal calcium levels were
Page 210 and 211: vitamin D deficiency, and rickets)
Page 212 and 213: to obtain it. Health literacy may b
Page 214 and 215: vitamin D from the diet as dietary
Page 216 and 217: home environment can be determinant
Page 218 and 219: hormone, calcium absorption and bon
Page 220 and 221: important nutrient. For many, this
Page 222 and 223: this potential relationship with ac
Page 224 and 225: genetic conditions, childhood medic
Page 228 and 229: y cariogenic oral flora. 49 Since e
Page 230 and 231: (49.8 ± 26.3 nmol/L vs. 45.1 ± 20
Page 232 and 233: pregnancy, which may have influence
Page 234 and 235: observed and it allowed multiple ou
Page 236 and 237: scientific evidence linking prenata
Page 238 and 239: cognizant that children who undergo
Page 240 and 241: preventive program would need to be
Page 242 and 243: makers in the formative stages. As
Page 244 and 245: Surprisingly, the final regression
Page 246 and 247: 13. First Nations IaMHCCPS. <strong
Page 248 and 249: 38. Hollis BW. Circulating 25-hydro
Page 250 and 251: 65. Li Y, Navia JM, Bian JY. Caries
Page 252 and 253: 91. Brownell MD, Guevremont A, Au W
Page 254 and 255: Chapter 7 - Conclusions This thesis
Page 256 and 257: This study provided an interesting
Page 258: esiding in disadvantaged communitie
Page 271 and 272: If you are taking vitamins during t
Page 273 and 274: Do you Eat? Never Rarely (less than
Page 275 and 276: 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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