Association between Vitamin D Levels and Dental Caries: A Systematic Review and Dose-Response Meta-Analysis of Cross-Sectional Studies

Abstract

Background and Aims: Previous observational studies found inconsistent associations between serum vitamin D levels and dental caries risk. A dose-response meta-analysis of cross-sectional studies was performed to investigate the association. Methods: To April 2023, the ISI Web of Science, PubMed, Scopus, and Google Scholar databases were searched for published papers. Finally, 13 cross-sectional studies were considered that provided odds ratios (ORs) with 95% confidence intervals (CIs) for dental caries in relation to serum vitamin D levels across all age groups. Two reviewers conducted a thorough screening of the studies, data extraction, bias risk assessment, and evidence quality. A random-effect model was used to assess the pooled estimated odd ratios (with 95% confidence intervals). A weighted mixed-effects dose-response meta-analysis in one stage was carried out. Results: Dental caries was significantly more likely to occur when serum vitamin D levels were low compared to high (OR: 1.41; 95% CI: 1.18, 1.68; GRADE = poor confidence). With a 10 nmol/L increase in serum vitamin D level, linear dose-response analysis showed a significant 3% (OR: 0.97; 95% CI: 0.96, 0.99) decrease in the likelihood of dental caries. Serum vitamin D levels and dental caries were found to be inversely correlated, with a significant dose-response relationship at levels greater than 78 nmol/L. Conclusion: This meta-analysis showed that vitamin D insufficiency was strongly associated with dental caries, and that a 10 nmol/L increase in blood 25(OH)D levels was linked to a 3% decrease in dental caries. However, the findings may have less clinical significance due to the uncertainty of the evidence.

Association between prenatal vitamin D deficiency with dental caries in infants and children: a systematic review and meta-analysis

“…Our study also observed that prenatal vitamin D levels had an inverse linear relationship with the risk of DC in children; however, we could not perform a dose-response analysis. Our study and MK Mahmood et al [ 41 ] show that vitamin D deficiency was associated with an increased risk of DCs during pregnancy in mothers and after birth in children.…”

“…PVDD in the last weeks of pregnancy (> 24 weeks) or the third trimester of pregnancy may be associated with a further increase in the risk of DC in children. In a review study in 2023, MK Mahmood et al [ 41 ] showed that the risk of DCs in children with low and poor serum vitamin D levels was significantly higher than in children with high serum vitamin D levels. Based on a dose-response analysis, their study showed an inverse linear relationship between serum vitamin D levels and the risk of DC.…”

“…Vitamin D is one of the essential micronutrients that play a critical role in bone and tooth mineralization. A deficiency in vitamin D can lead to “rickets teeth,” making them more prone to fracture and decay [ 41 – 43 ]. Several mechanisms have been reported for the effect of vitamin D deficiency on tooth mineralization [ 43 – 45 ].…”

The Potential Systemic Role of Diet in Dental Caries Development and Arrest: A Narrative Review

“…Research shows that deficiencies in vitamin A and vitamin D can disrupt salivary flow or interfere with protective qualities of saliva, thereby increasing the risk of caries. Furthermore, severe vitamin D deficiencies have been shown to contribute to tooth hypo-mineralization and enamel hypoplasia [34,35]. Lower levels of vitamins A and/or D have been associated with higher prevalence of dental caries among adults and/or children in some epidemiological studies [36][37][38][39][40][41][42] but not others [43].…”

A Systematic Review of the Relationship between Serum Vitamin D Levels and Caries in the Permanent Teeth of Children and Adolescents

“…Another meta-analysis by Mahmood et al [34] and the observational study by Chhonkar's [35] both underline the significant association between Vitamin D deficiency and the risk of dental caries in children, although through different research lenses. Mahmood et al analyzed 13 cross-sectional studies, finding that low serum Vitamin D levels increased the likelihood of dental caries (OR: 1.41), with each 10 nmol/L increase in serum Vitamin D reducing caries risk by 3% (OR: 0.97), although with no distinction between permanent and decidual dentition.…”