Influence of Maternal Prenatal Vitamin D Status on Infant Oral Health

A 1958 review on the topic <strong>of</strong> caries prophylaxis even concluded that there is
sufficient work to prove that the quality <strong>of</strong> enamel structure is determined by vitamin D
and mineral salts. 91
Caries
Rickets
As previously mentioned, enamel hypoplasia is the phenotypic presentation <strong>of</strong> children
with rickets. Likewise, caries is also common in these children. The early twentieth
century caries literature reported clear associations between rickets and dental decay. For
instance, longitudinal observations <strong>of</strong> children diagnosed with rickets during early life
revealed that they were more likely to suffer from a higher prevalence <strong>of</strong> caries in their
primary and permanent dentitions than those without rickets. 80,92
Similarly, Lady
Mellanby concluded that caries was more prevalent in those with a history <strong>of</strong> severe
manifestations <strong>of</strong> rickets than healthy children <strong>of</strong> the same socioeconomic class. 36 In fact,
those with rickets as a result <strong>of</strong> vitamin D deficiency had more extensive forms <strong>of</strong>
decay. 36 Likewise, Hess and Abramson provided observational evidence <strong>of</strong> a connection
between rickets and dental caries in the primary dentition. 93 Specifically, dental caries
was more prevalent among those with rickets than children protected from rickets with
cod liver oil during infancy. 93 However, a case control investigation only reported a
slightly higher prevalence <strong>of</strong> caries in the primary and permanent dentitions <strong>of</strong> schoolaged
children with rickets compared to controls without the disease. 82 Similarly, Shelling
and Anderson were unable to demonstrate that rickets predisposed children to a greater
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