Correlation between vitamin D levels in serum and the risk of dental caries in children: a systematic review and meta-analysis
BMC Oral Health . 2023 Oct 19;23(1):768. doi: 10.1186/s12903-023-03422-z.
Zizhan Li 1 2, Xiao Wei 3, Zhongjun Shao 3, Huan Liu 4, Shizhu Bai 5
Background: Vitamin D plays a crucial role in oral health, and its deficiency is associated to significant changes in oral health diseases. We aimed to explore the relationship between levels of 25-hydroxyvitamin D (25(OH) D) and dental caries in children.
Methods: Four electronic databases were searched by two investigators including PubMed, Embase, Web of Science, and Cochrane Library. Dental caries results were presented as either prevalence or based on the index of primary and permanent teeth/surfaces with decaying, missing, and filled areas, while vitamin D levels were determined through laboratory testing. Two researchers independently selected studies, collected information, assessed risk of bias, and evaluated the study quality. Any disagreements were resolved through discussion.
Results: A total of 13 studies were included, comprising 5 cross-sectional studies, 5 cohort studies, 3 case-control studies, all of which had high methodological quality. Our meta-analysis showed that children with vitamin D deficiency had a 22% higher risk of dental caries than those with normal vitamin D levels, with a relative risk (RR) of 1.22 and a 95% confidence interval (CI) of 1.18 to 1. 25. Further subgroup analysis according to the three types of studies showed that the risk of dental caries in children with vitamin D deficiency was higher than that in normal vitamin D level group (cohort studies: 62%; cross-sectional studies, 19%; and case-control studies, 5%). Additionally, according to age, subgroup analysis also showed that the risk of dental caries in children with vitamin D deficiency was higher than that in normal vitamin D level group (permanent teeth studies, 28%; deciduous teeth studies, 68%; and mixed dentition studies 8%).
Conclusions: Levels of 25 (OH) D have been found negatively associated with dental caries in children, indicating that low vitamin D levels may be considered a potential risk factor to this dental disease.
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50 References
- Selwitz RH, Ismail AI, Pitts NB. Dental caries. Lancet. 2007;369(9555):51–9. - PubMed - DOI
- Dudding T, Thomas SJ, Duncan K, Lawlor DA, Timpson NJ. Re-examining the association between vitamin D and childhood caries. PLoS One. 2015;10(12):e0143769. - PubMed - PMC - DOI
- Almoudi MM, Hussein AS, Abu Hassan MI, Schroth RJ. Dental caries and vitamin D status in children in asia. Pediatr Int. 2019;61(4):327–38. - PubMed - DOI
- Foster BL, Hujoel PP. Vitamin D in dentoalveolar and rral health//Feldman D. Vitamin D (Fourth Edition). Volume 1: Biochemistry, Physiology and Diagnostics. ScienceDirect: Academic Press. 2018:497–519.
- Grant WB. A review of the role of solar ultraviolet-B irradiance and vitamin D in reducing risk of dental caries. Dermatoendocrinol. 2011;3(3):193–8. - PubMed - PMC - DOI
- Al-Jubori SH, Al-Murad MA, Al-Mashhadane FA. Effect of oral vitamin D3 on dental caries: an in-vivo and in-vitro study. Cureus. 2022;14(5):e25360. - PubMed - PMC
- Botelho J, Machado V, Proença L, Delgado AS, Mendes JJ. Vitamin D deficiency and oral health: a comprehensive review. Nutrients. 2020;12(5):1471. - PubMed - PMC - DOI
- Hollis BW, Wagner CL, Drezner MK, Binkley NC. Circulating vitamin D3 and 25-hydroxyvitamin D in humans: an important tool to define adequate nutritional vitamin D status. J Steroid Biochem Mol Biol. 2007;103(3–5):631–4. - PubMed - PMC - DOI
- Macdonald HM. Contributions of sunlight and diet to vitamin D status. Calcif Tissue Int. 2013;92(2):163–76. - PubMed - DOI
- Holick MF. The vitamin D deficiency pandemic: approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord. 2017;18(2):153–65. - PubMed - DOI
- Grant WB. Vitamin D, periodontal disease, tooth loss, and cancer risk. Lancet Oncol. 2008;9(7):612–3. - PubMed - DOI
- Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr. 2006;84(1):18–28. - PubMed - DOI
- Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc. 2006;81(3):353–73. - PubMed - DOI
- Chapple IL, Bouchard P, Cagetti MG, Campus G, Carra MC, Cocco F, et al. Interaction of lifestyle, behaviour or systemic diseases with dental caries and periodontal diseases: consensus report of group 2 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases. J Clin Periodontol. 2017;44(Suppl 18):S39–51. - PubMed
- Wójcik D, Szalewski L, Pietryka-Michałowska E, Borowicz J, Pels E, Beń-Skowronek I. Vitamin D(3) and dental caries in children with growth hormone deficiency. Int J Endocrinol. 2019;2019:2172137. - PubMed - PMC - DOI
- Pang X, Yang Z, Wang J, Duan Y, Zhao L, Yu D, et al. Relationship between serum 25OH-vitamin D2 level and vitamin D status of children aged 3–5 years in China. Nutrients. 2021;13(11):4135. - PubMed - PMC - DOI
- Schroth RJ, Levi JA, Sellers EA, Friel J, Kliewer E, Moffatt ME. Vitamin D status of children with severe early childhood caries: a case-control study. BMC Pediatr. 2013;13:174. - PubMed - PMC - DOI
- White JH. Vitamin D metabolism and signaling in the immune system. Rev Endocr Metab Disord. 2012;13(1):21–9. - PubMed - DOI
- Schroth RJ, Lavelle C, Tate R, Bruce S, Billings RJ, Moffatt ME. Prenatal vitamin D and dental caries in infants. Pediatrics. 2014;133(5):e1277–84. - PubMed - DOI
- Seminario AL, Jumani K, Velan E, Scott JM, Latimer J, Schroth RJ. Suboptimal serum vitamin D associated with early childhood caries in special health care needs children. J Dent Child (Chic). 2018;85(3):93–101. - PubMed
- Akinkugbe AA, Moreno O, Brickhouse TH. Serum cotinine, vitamin D exposure levels and dental caries experience in U.S. adolescents. Community Dent Oral Epidemiol. 2019;47(2):185–92. - PubMed - DOI
- McInnes MDF, Moher D, Thombs BD, McGrath TA, Bossuyt PM, Clifford T, et al. Preferred reporting items for a systematic review and meta-analysis of diagnostic test accuracy studies: the PRISMA-DTA statement. JAMA. 2018;319(4):388–96. - PubMed - DOI
- Ross AC, Taylor CL, Yaktine AL, Del Valle HB. Dietary reference intakes for calcium and vitamin D//Institute of Medicine Committee to Review Dietary Reference Intakes for Vitamin D, Calcium. In: The National Ccademies Collection: reports funded by National Institutes of Health. Washington (DC): National Academies Press (US); 2011.
- Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25(9):603–5. - PubMed - DOI
- Gupta AA, Kheur S, Varadarajan S, Parveen S, Dewan H, Alhazmi YA, et al. Chronic mechanical irritation and oral squamous cell carcinoma: a systematic review and meta-analysis. Bosn J Basic Med Sci. 2021;21(6):647–58. - PubMed - PMC
- Schroth RJ, Jeal NS, Kliewer E, Sellers EA. The relationship between vitamin D and severe early childhood caries: a pilot study. Int J Vitam Nutr Res. 2012;82(1):53–62. - PubMed - DOI
- Herzog K, Scott JM, Hujoel P, Seminario AL. Association of vitamin D and dental caries in children: findings from the national health and nutrition examination survey, 2005–2006. J Am Dent Assoc. 2016;147(6):413–20. - PubMed - DOI
- Schroth RJ, Rabbani R, Loewen G, Moffatt ME. Vitamin D and dental caries in children. J Dent Res. 2016;95(2):173–9. - PubMed - DOI
- Wagner Y, Heinrich-Weltzien R. Evaluation of an interdisciplinary preventive programme for early childhood caries: findings of a regional German birth cohort study. Clin Oral Investig. 2016;20(8):1943–52. - PubMed - DOI
- Rodd C, Deane S, Schroth RJ, Sharma A. Combined deficiencies of 25-hydroxy vitamin D and anemia in preschool children with severe early childhood caries: a case-control study. Paediatr Child Health. 2017;23(3):e40–5. - PubMed - PMC
- Gyll J, Ridell K, Öhlund I, Karlsland Åkeson P, Johansson I, Lif HP. Vitamin D status and dental caries in healthy swedish children. Nutr J. 2018;17(1):11. - PubMed - PMC - DOI
- Kim IJ, Lee HS, Ju HJ, Na JY, Oh HW. A cross-sectional study on the association between vitamin D levels and caries in the permanent dentition of Korean children. BMC Oral Health. 2018;18(1):43. - PubMed - PMC - DOI
- Carvalho Silva C, Gavinha S, Manso MC, Rodrigues R, Martins S, Guimarães JT, et al. Serum levels of vitamin D and dental caries in 7-year-old children in Porto Metropolitan area. Nutrients. 2021;13(1):166. - PubMed - PMC - DOI
- Navarro CLA, Grgic O, Trajanoska K, van der Tas JT, Rivadeneira F, Wolvius EB, et al. Associations between prenatal, perinatal, and early childhood vitamin D status and risk of dental caries at 6 years. J Nutr. 2021;151(7):1993–2000. - PubMed - PMC - DOI
- Foster BL, Nociti FH Jr, Somerman MJ. The rachitic tooth. Endocr Rev. 2014;35(1):1–34. - PubMed - DOI
- D’Ortenzio L, Kahlon B, Peacock T, Salahuddin H, Brickley M. The rachitic tooth: refining the use of interglobular dentine in diagnosing vitamin D deficiency. Int J Paleopathol. 2018;22:101–8. - PubMed - DOI
- Davideau JL, Lezot F, Kato S, Bailleul-Forestier I, Berdal A. Dental alveolar bone defects related to vitamin D and calcium status. J Steroid Biochem Mol Biol. 2004;89–90(1–5):615–8. - PubMed - DOI
- Svensson D, Nebel D, Nilsson BO. Vitamin D3 modulates the innate immune response through regulation of the hCAP-18/LL-37 gene expression and cytokine production. Inflamm Res. 2016;65(1):25–32. - PubMed - DOI
- Reichrath J, Saternus R, Vogt T. Challenge and perspective: The relevance of ultraviolet (UV) radiation and the vitamin D endocrine system (VDES) for psoriasis and other inflammatory skin diseases. Photochem Photobiol Sci. 2017;16(3):433–44. - PubMed - DOI
- Skaaby T, Husemoen LL, Pisinger C, Jørgensen T, Thuesen BH, Fenger M, et al. Vitamin D status and incident cardiovascular disease and all-cause mortality: a general population study. Endocrine. 2013;43(3):618–25. - PubMed - DOI
- Abhimanyu, Coussens AK. The role of UV radiation and vitamin D in the seasonality and outcomes of infectious disease. Photochem Photobiol Sci. 2017;16(3):314–38.
- Gombart AF. The vitamin D-antimicrobial peptide pathway and its role in protection against infection. Future Microbiol. 2009;4(9):1151–65. - PubMed - DOI
- Youssef DA, Miller CW, El-Abbassi AM, Cutchins DC, Cutchins C, Grant WB, et al. Antimicrobial implications of vitamin D. Dermatoendocrinol. 2011;3(4):220–9. - PubMed - PMC - DOI
- Hewison M. Vitamin D and the immune system: new perspectives on an old theme. Endocrinol Metab Clin North Am. 2010;39(2):365–79. - PubMed - PMC - DOI
- Doğusal G, Sönmez I, Ünüvar T. Evaluation of serum 25(OH)D levels in obese and normal-weight children with carious and hypomineralized teeth. J Clin Pediatr Dent. 2021;45(1):35–40. - PubMed - DOI
- Silva MJ, Kilpatrick NM, Craig JM, Manton DJ, Leong P, Burgner DP, et al. Genetic and early-life environmental influences on dental caries risk: a twin study. Pediatrics. 2019;143(5):e20183499. - PubMed - DOI
- Chhonkar A, Gupta A, Arya V. Comparison of vitamin D level of children with severe early childhood caries and children with no caries. Int J Clin Pediatr Dent. 2018;11(3):199–204. - PubMed - PMC - DOI
- Kühnisch J, Thiering E, Kratzsch J, Heinrich-Weltzien R, Hickel R, Heinrich J. Elevated serum 25(OH)-vitamin D levels are negatively correlated with molar-incisor hypomineralization. J Dent Res. 2015;94(2):381–7. - PubMed - PMC - DOI
- Hujoel PP. Vitamin D and dental caries in controlled clinical trials: systematic review and meta-analysis. Nutr Rev. 2013;71(2):88–97. - PubMed - DOI
- Nørrisgaard PE, Haubek D, Kühnisch J, Chawes BL, Stokholm J, Bønnelykke K, et al. Association of high-dose vitamin D supplementation during pregnancy with the risk of enamel defects in offspring: a 6-year follow-up of a randomized clinical trial. JAMA Pediatr. 2019;173(10):924–30. - PubMed - PMC - DOI
21+ VitaminDWiki pages with CARIES or DECAY in the title
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VitaminDWiki – Dental category contains
Some Dental studies
- Vitamin D cut dental caries in half 80 years ago – meta-analysis 2013 80 years ago
- Caries (tooth decay) and Vitamin D - 23+ studies
- Periodontitis reduced by Vitamin D - many studies
- Risk of Oral Surgery reduced by Vitamin D – scoping review Nov 2021
- Some Dental Malocclusions 5X more likely if low vitamin D – June 2021
- Grinding teeth while sleeping (sleep bruxism) 6 X more likely if low vitamin D – Jan 2021
- Early tooth decay 1.9 X more likely if a poor Vitamin D receptor – July 2017
7 Intervention AND Dental studies 19 items listed in BOTH Dental and Infant or Child 7 listed in BOTH Dental and Vitamin D Receptor Dental caries 1.22 X more likely if Vitamin D Deficient – meta-analysis Oct 20231146 visitors, last modified 20 Oct, 2023, This page is in the following categories (# of items in each category)