Pregnancy Vitamin D levels less than 40 ng probably results in poor fetal tooth mineralization

Created May 2018

Foetal, neonatal and child vitamin D status and enamel hypomineralization

Community Dentistry and Oral Epidemiology 01 March 2018, https://doi.org/10.1111/cdoe.12372

Justin T. van der Tas Marlies E.C. Elfrink Annemieke C. Heijboer Fernando Rivadeneira Vincent W.V. Jaddoe Henning Tiemeier

* This study only considered Vitamin D Levels during pregnancy of slightly above 20 ng * Tooth mineralization is assumed to happen during pregnancy * The many benefits of vitamin D during pregnancy typically occur above 40 ng * It is rare to find a woman living much of her life indoors with no supplementation with even 30 ng of vitamin D * We anticipate that > 40 ng of Vitamin D during pregnancy will result in good tooth mineralization * > 40 ng of vitamin D is typical for women living outdoors a lot: * native Africans, gardeners, life guards * > 40 ng of vitamin D is also achieved by taking 6,400 IU of Vitamin D during pregnancy * Unfortunately current trials do not start adding vitamin D until the 10 week * And those trials do not get > 40 ng until weeks 18-22 (12th week if use loading doses) * Tooth development starts at 6 weeks * Need good Vitamin D level before mineralization – need to find out when that happens --- 1. See also VitaminDWiki * 3X fewer infant dental caries if good level of vitamin D while pregnant – April 2014 * Pregnant women 2X more dental problems when vitamin D less than 30ng – Feb 2011 * A good vitamin D level is good for the teeth of both the pregnant woman and child Healthy pregnancies need lots of vitamin D has the following summary {include}

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Objectives

Recent literature suggested that higher vitamin D concentrations in childhood are associated with a lower prevalence of molar incisor hypomineralization (MIH). As tooth development already starts in utero, we aimed to study whether vitamin D status during foetal, postnatal and childhood periods is associated with the presence of hypomineralized second primary molars (HSPMs) and/or MIH at the age of six.

Methods

Our study was embedded in the Generation R Study, a population‐based, prospective cohort from foetal life onwards in Rotterdam, the Netherlands. HSPMs and MIH were scored from intraoral photographs of the children at their age of six. Serum 25(OH)D concentrations were measured at three points in time, which resulted in three different samples; mid‐gestational in mothers’ blood (n = 4750), in umbilical cord blood (n = 3406) and in children's blood at the age of 6 years (n = 3983).

Results

The children had a mean (±SD) age of 6.2 (±0.5) years at the moment of taking the intraoral photographs. After adjustment for confounders, no association was found between foetal 25(OH)D concentrations and the presence of HSPMs (OR 1.02 per 10 nmol/L higher 25(OH)D, 95% CI: 0.98‐1.07) or MIH (OR 1.05 per 10 nmol/L increase, 95% CI: 0.98‐1.12) in 6‐year‐olds. A higher 25(OH)D concentration in umbilical cord blood resulted in neither lower odds of having HSPM (OR 1.05, 95% CI: 0.98‐1.13) nor lower odds of having MIH (OR 0.95, 95% CI: 0.84‐1.07) by the age of six. Finally, we did not find higher 25(OH)D concentrations at the age of six to be associated with a significant change in the odds of having HSPM (OR 0.97, 95% CI: 0.92‐1.02) or MIH (OR 1.07, 95% CI: 0.98‐1.16).

Conclusions

25(OH)D concentrations in prenatal, early postnatal and later postnatal life are not associated with the presence of HPSMs or with MIH at the age of six. Future observational research is required to replicate our findings. Furthermore, it is encouraged to focus on identifying other modifiable risk factors, because prevention of hypomineralization is possible only if the causes are known.

Tags: Dental Pregnancy