Original articleHigher vitamin D intake during pregnancy is associated with reduced risk of dental caries in young Japanese children
Introduction
Dental caries is a chronic disease that can cause pain, chewing difficulty, and discomfort, thereby impacting the quality of life of the affected individuals [1], [2]. Although its prevalence has declined, dental caries is still the most prevalent childhood disease worldwide. Dental caries is a multifactorial disease. Various etiologic factors, including physical, biological, environmental, and behavioral factors, are involved in dental caries [1].
Human teeth are unique in that they are formed during a limited period [3]. After mineralization, teeth are structurally and metabolically relatively stable [3]. Primary tooth formation and mineralization start during the fetal period [4]. Therefore, the intrauterine environment, which is affected by factors such as smoking and maternal nutrition during pregnancy, might influence the development, formation, and mineralization of children's teeth [5], [6].
Vitamin D plays an essential role in the mineralization of bones and teeth: It maintains the appropriate concentrations of calcium and phosphorus ions in the blood, which ensure the normal mineralization of bones and teeth [7]. Previous studies on the association between vitamin D intake and dental caries have focused mainly on vitamin D deficiency and the protective effects of vitamin D supplementation against dental caries [8]. In addition, these studies were carried out between the First and Second World Wars, and health, nutrition, and lifestyle have undergone significant changes since that time [8]. Recent observational epidemiologic studies on the association between vitamin D and dental caries are limited [9], [10], [11], [12]. It is therefore necessary to accumulate additional evidence to clarify the effect of vitamin D on dental caries. During prenatal development, vitamin D reaches the fetus through the placenta alone [13]. Maternal vitamin D status might affect primary tooth mineralization, and eventually caries susceptibility, in the child. Therefore, the relationship between maternal vitamin D intake during pregnancy and dental caries is worth investigating. In the present prospective study, we assessed the relationship between maternal dietary vitamin D intake during pregnancy and the risk of dental caries among young Japanese children, using the data set of the Kyushu Okinawa Maternal and Child Health Study (KOMCHS).
Section snippets
Study population
The KOMCHS is an ongoing prospective prebirth cohort study that investigates risk and preventive factors for maternal and child health problems such as oral health and allergic disorders. Eligible subjects were those women who became pregnant in one of seven prefectures on Kyushu Island in southern Japan or Okinawa Prefecture, an island chain in the southwest of Japan, between April 2007 and March 2008. At 423 obstetrical hospitals, a set of leaflets explaining the KOMCHS, an application form
Results
Of the 1210 children, 267 (22.1%) had experienced dental caries, and 943 (77.9%) were caries free. The mean numbers of teeth with dental caries for all subjects and for subjects who had experienced caries were 0.71 and 3.2, respectively. Characteristics of the study population are listed in Table 1. The mean maternal age at baseline was 31.6 years. Approximately 46% of mothers and 57% of fathers had received at least 15 years of education. Maternal mean daily total energy intake was 7414.8 kJ,
Discussion
In this prospective study in Japan, we found that higher maternal vitamin D intake during pregnancy was associated with a reduced risk of dental caries in children. Recent studies on the relationship between vitamin D intake or serum levels of 25-hydroxyvitamin D (25[OH]D) and dental caries are scarce [9], [10], [11], [12]. In a case-control study of Canadian preschool children, the subjects with severe early childhood caries were significantly more likely to have low serum levels of 25(OH)D
Conclusions
Our results indicate an association between higher maternal vitamin D intake during pregnancy and a reduced risk of dental caries in young Japanese children. Because of the numerous limitations, these results should be interpreted cautiously and subsequently confirmed in other populations. Further studies are needed to clarify both the mechanisms underlying the association and the long-term consequences.
Acknowledgment
The authors acknowledge the Kyushu Branch of the Japan Allergy Foundation, the Fukuoka Association of Obstetricians & Gynecologists, the Okinawa Association of Obstetricians & Gynecologists, the Miyazaki Association of Obstetricians & Gynecologists, the Oita Association of Obstetricians & Gynecologists, the Kumamoto Association of Obstetricians & Gynecologists, the Nagasaki Association of Obstetricians & Gynecologists, the Kagoshima Association of Obstetricians & Gynecologists, the Saga
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The authors have no conflict of interest to disclose.