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Vitamin D deficiency in children with dental caries - a prevalence study
  1. T Brown1,2,
  2. S Creed1,
  3. S Alexander1,
  4. K Barnard1,3,
  5. N Bridges1,
  6. M Hancock1,4
  1. 1Paediatric Department, Chelsea and Westminster NHS Foundation Trust, London, UK
  2. 2Institute of Child Health, University College London, London, UK
  3. 3Dental Department, Chelsea and Westminster NHS Foundation Trust, London, UK
  4. 4Biochemistry Department, Chelsea and Westminster NHS Foundation Trust, London, UK

Abstract

Background Vitamin D deficiency is a re-emerging public health concern, despite being preventable with supplementation. Dental caries also remain a significant chronic disease of childhood, affecting up to 41% of 5 year olds in England. There is a known association between dental caries and vitamin D deficiency, but this has not been investigated since the 1940's.

Aims To determine the prevalence of vitamin D deficiency in children aged 1-5 years, with dental caries.

Methods Children aged 1-5 years, attending an inner city Dental Hospital, requiring dental caries treatment, were recruited between August 2010 and May 2011. A 2 ml blood sample was taken from each child, following parental consent, for measurement of 25-hydroxy-Vitamin D (25 OHD), bone profile and parathyroid hormone levels. Further data was collected via a questionnaire regarding ethnicity, breastfeeding and vitamin D supplementation. The primary outcome was serum 25 OHD (<50 nmol/L = deficient, 51-75 = insufficient, >76 = replete). Results were analysed using SPSS and appropriate tests of significance.

Results 102 children were recruited, 25 OHD levels were available for 68. 66% were vitamin D deficient, 27% insufficient, and only 7% of children were replete. Mean Vitamin D levels were significantly lower in children of Black and mixed race or Asian backgrounds, compared to white children by 28 nmol/L (95% confidence interval −44.4, −12.2) and 20.9 nmol/L (−32.9, 8.9) respectively. Importantly, 50% of Caucasian children were also noted to be Vitamin D deficient. No children were hypocalcaemic. Compliance with the Department of Health's Guidelines was poor: only 34% of mothers took vitamins during their pregnancy, and 33% of children were taking vitamin supplements.

Conclusions This study confirms that a high proportion of children below 5 years, presenting with dental caries, are deficient in vitamin D. An increased awareness of vitamin D deficiency, and its association with dental caries amongst professionals is imperative. We propose that all children with significant dental caries are tested for vitamin D deficiency, so that they can be treated appropriately. Prevention however, should remain the primary goal, and existing recommendations regarding vitamin D supplementation require implementing.

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