Influence of Maternal Prenatal Vitamin D Status on Infant Oral Health

Further, amelogenin and enamelin, proteins found in dental matrices are vitamin D-
dependent. 65 In addition to enamel and dentin formation, VDR is strongly expressed in
osteoblasts responsible for alveolar bone formation. 65
Studies involving human embryonic and fetal tissue to demonstrate the role <strong>of</strong>
1,25(OH) 2 D 3 on enamel and dentin formation reveal that 1,25-dihydroxyvitamin D 3
membrane-associated rapid-response steroid binding protein is expressed during human
tooth mineralization in ameloblasts and odontoblasts. 66
In addition to its role in the initial production <strong>of</strong> dentin, Calbindin D-28k, the
vitamin D-dependent calcium-binding protein, is important in the synthesis <strong>of</strong> tertiary
dentin under caries lesions. 67
Enamel Hypoplasia
Deficiencies <strong>of</strong> vitamin D during periods <strong>of</strong> tooth development are believed to result in
developmental defects <strong>of</strong> enamel (DDE), which includes both enamel opacities and
enamel hypoplasia. 68 A 1973 report in the Lancet reported that a considerable number <strong>of</strong>
infants with neonatal tetany, resulting from maternal vitamin D deficiency, had
noticeable enamel hypoplasia in the primary teeth when examined at a mean <strong>of</strong> 42.4
months (range 24 – 80 months) <strong>of</strong> age. 69
Overall, 56% had pronounced enamel
hypoplasia in their primary teeth. 69
Histological examination <strong>of</strong> a subset number <strong>of</strong>
exfoliated primary incisors revealed that much <strong>of</strong> the enamel hypoplasia coincided with
enamel formation during the third trimester <strong>of</strong> pregnancy. 69
There are also documented case reports <strong>of</strong> children who developed enamel
hypoplasia as a result <strong>of</strong> inadequate vitamin D during periods <strong>of</strong> dental development.
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