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
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corresp<strong>on</strong>d to the timing <str<strong>on</strong>g>of</str<strong>on</strong>g> tooth development. This may assist in narrowing down the<br />
potential c<strong>on</strong>tributing agents or c<strong>on</strong>diti<strong>on</strong>s that may predispose such enamel defects.<br />
Electr<strong>on</strong> microscopy <str<strong>on</strong>g>of</str<strong>on</strong>g> exfoliated teeth may serve as a unique method to detect<br />
DDE at the microscopic level. 14 Current epidemiological survey techniques do not allow<br />
for further microscopic examinati<strong>on</strong> <str<strong>on</strong>g>of</str<strong>on</strong>g> the enamel surface <str<strong>on</strong>g>of</str<strong>on</strong>g> primary teeth. Therefore,<br />
minute areas <str<strong>on</strong>g>of</str<strong>on</strong>g> enamel hypoplasia may not be visible without magnificati<strong>on</strong>.<br />
The introducti<strong>on</strong> <str<strong>on</strong>g>of</str<strong>on</strong>g> several indices for DDE has helped propel this area forward<br />
to the stage where established criteria are used for research purposes. Having<br />
standardized indices improves the reliability <str<strong>on</strong>g>of</str<strong>on</strong>g> studies and assists in the comparis<strong>on</strong> <str<strong>on</strong>g>of</str<strong>on</strong>g><br />
prevalence and risk factors for DDE am<strong>on</strong>g published reports.<br />
By definiti<strong>on</strong>, demarcated opacities are alterati<strong>on</strong>s in the normal translucency <str<strong>on</strong>g>of</str<strong>on</strong>g><br />
enamel, but the thickness <str<strong>on</strong>g>of</str<strong>on</strong>g> enamel is not altered. 12,13,15 The defect has clear margins and<br />
may be white, cream, yellow, or brown in colour. Diffuse opacities are also changes in<br />
the translucency <str<strong>on</strong>g>of</str<strong>on</strong>g> enamel but these defects lack clear boundaries and can be patchy,<br />
c<strong>on</strong>fluent, or even linear. 12,13,15<br />
As dental fluorosis primarily manisfests as diffuse<br />
opacities, it too is recognized to be an enamel defect. Separate indices for fluorosis exist,<br />
but their discussi<strong>on</strong> is bey<strong>on</strong>d the scope <str<strong>on</strong>g>of</str<strong>on</strong>g> this review.<br />
While opacities are qualitative changes, enamel hypoplasia involves quantitative<br />
changes to enamel. 12,13,15,16 Hypoplastic lesi<strong>on</strong>s may typically appear as pits, grooves, or<br />
missing enamel <str<strong>on</strong>g>of</str<strong>on</strong>g> varying size. 12,17 Table 1.2-1 highlights the classificati<strong>on</strong>s <str<strong>on</strong>g>of</str<strong>on</strong>g> DDE<br />
according to the modified DDE Index. 12 In some instances, both enamel hypoplasia and<br />
opacities can exist simultaneously and current DDE indices account for this possibility. 12<br />
1.2-3