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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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Table 1.2-1 – Modified DDE Index for use in epidemiological studies 12<br />

Code<br />

Normal 0<br />

Demarcated opacities:<br />

White/cream<br />

Yellow/brown<br />

Diffuse opacities:<br />

Lines<br />

Patchy<br />

C<strong>on</strong>fluent<br />

C<strong>on</strong>fluent/patchy + staining + loss <str<strong>on</strong>g>of</str<strong>on</strong>g> enamel<br />

Hypoplasia:<br />

Pits<br />

Missing Enamel<br />

Any other defect<br />

Combinati<strong>on</strong>s:<br />

Demarcated and Diffuse<br />

Demarcated and hypoplasia<br />

Diffuse and hypoplasia<br />

All 3 defects<br />

1<br />

2<br />

3<br />

4<br />

5<br />

6<br />

7<br />

8<br />

9<br />

A<br />

B<br />

C<br />

D<br />

Several indices have been proposed for standardizing DDE, including enamel<br />

hypoplasia. 12,13,15,16,18<br />

Currently, <strong>on</strong>e index is preferred for recording and reporting<br />

enamel opacities and hypoplasia for epidemiological purposes although several others<br />

have also been proposed. 12 Clarks<strong>on</strong> and O’Mullane proposed two versi<strong>on</strong>s <str<strong>on</strong>g>of</str<strong>on</strong>g> their<br />

index, a simplified <strong>on</strong>e for screening purposes and a more comprehensive tool for dental<br />

surveys. 16<br />

Likewise, the World <strong>Health</strong> Organizati<strong>on</strong> also has an index for<br />

epidemiological surveys. 15 Unfortunately, it <strong>on</strong>ly records enamel defects for specific teeth<br />

in the mouth 15 and thereby underestimates the true prevalence <str<strong>on</strong>g>of</str<strong>on</strong>g> DDE. Finally, another<br />

proposed index for DDE does not account for qualitative changes in the translucency <str<strong>on</strong>g>of</str<strong>on</strong>g><br />

enamel (i.e. opacities), and instead <strong>on</strong>ly focuses <strong>on</strong> enamel hypoplasia. 18<br />

The literature c<strong>on</strong>tains numerous studies reporting the prevalence and risk factors<br />

for enamel hypoplasia. Expert reviews <strong>on</strong> the subject <str<strong>on</strong>g>of</str<strong>on</strong>g> enamel hypoplasia have also<br />

1.2-4

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