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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