Influence of Maternal Prenatal Vitamin D Status on Infant Oral Health

A study <strong>of</strong> Australian infants who were premature and diagnosed, both clinically
and radiographically, with rickets in the neonatal period reported that all children
exhibited developmental defects <strong>of</strong> enamel in the primary dentition, with 47% having
enamel opacities and hypoplasia, 20% with only opacities, and the remainder with
enamel hypoplasia (33%). 77 Meanwhile, an early case-controlled study provided evidence
that children with rickets were more likely to have enamel hypoplasia in both primary
and permanent dentitions than children without rickets who received vitamin D
prophylaxis (viosterol) during the early childhood period. 78
Specifically, those with
rickets were more likely to have both marked hypoplasia and slight hypoplasia than
ricket-free controls who received vitamin D prophylaxis in the form <strong>of</strong> viosterol. 78 There
were further case reports <strong>of</strong> children with acute rickets having enamel hypoplasia in their
dentitions. 79
There is long-standing longitudinal evidence too, showing that children who
experienced rickets during the early childhood period were more likely to have enamel
defects in their permanent dentitions. 80,81 In fact, the more severe the case <strong>of</strong> rickets, the
greater the prevalence and the more severe the enamel defects. 80,81
Another study
contrasted dental findings <strong>of</strong> children with rickets and controls. 82 This case-control study
revealed that children with rickets were nine times more likely to have hypoplasia in the
permanent dentition than healthy controls. 82
There are several classifications <strong>of</strong> rickets, including dietary, transport, matrix
defect and metabolic. 77 One type <strong>of</strong> metabolic rickets is VDDR, where the synthesis <strong>of</strong>
1,25(OH) 2 D is impaired. 83 Case study reports have confirmed that children with VDDR
are highly prone to enamel hypoplasia. 38,83,84
Even those who were diagnosed with
1.3-16