Influence of Maternal Prenatal Vitamin D Status on Infant Oral Health

observed and it allowed multiple outcomes to be assessed for a single exposure (i.e.
vitamin D status). Additionally, a temporal sequence was established spanning pregnancy
through infancy. Cohort studies also have the advantage <strong>of</strong> reduced bias.
Another notable strength <strong>of</strong> this study was that the infant dental assessments were
made while being blinded to maternal 25(OH)D levels. This was a unique aspect <strong>of</strong> this
study design ensuring that the dental examiner was not biased by prenatal vitamin D
concentrations <strong>of</strong> mothers when performing the infant dental examination for enamel
hypoplasia and caries.
Findings from this study may have implications for early childhood oral health
policy. Health policy is loosely defined as the actions <strong>of</strong> key players such as decisionmakers,
the public, and various levels <strong>of</strong> government that are concentrated on improving
the overall health <strong>of</strong> the population. 63 Policy development is not a static process. It is
continually changing and subjected to several factors including social and political
influences, technological advancements, changes in the general population, the overall
importance <strong>of</strong> a health issue and the population at-risk, and the ongoing debate between a
preventive view <strong>of</strong> health (i.e. promoting wellness) versus a fixation with treatment (i.e.
disease based approach). 64 Undoubtedly, these forces are at play with oral health policy
for infants and preschool aged children.
Assuming that low maternal calcium and vitamin D concentrations during
pregnancy predispose enamel hypoplasia and caries in <strong>of</strong>fspring, translating this
knowledge in an effective manner may assist in shaping needed oral health policy for
young children. Research evidence already links these DDEs with ECC. 30,65-69 6-26