Vitamin D Supplementation, Characteristics of Mastication, and Parent-Supervised Toothbrushing as Crucial Factors in the Prevention of Caries in 12- to 36-Month-Old Children

Abstract

Severe early childhood caries (S-ECC), defined as any sign of smooth-surface caries in a child younger than three years of age, remains a serious health issue. The aim of this study was to indicate oral health behaviours related to S-ECC. The study surveyed parents (socio-economic and medical factors, oral health behaviours) and clinically examined children including non-cavitated d1,2/cavitated d ≥ 3 lesions. %S-ECC, and caries indices (d1,2 d ≥ 3 mft and d1,2 d ≥ 3 mfs) were calculated. Spearman’s correlation and simple and multiple logistic regression were used to assess the relationships between various factors and S-ECC. A total of 496 children were examined. S-ECC occurred in 44.8%: d1,2 d ≥ 3 mft = 2.62 ± 3.88, d1,2 d ≥ 3 mfs = 4.46 ± 8.42. S-ECC was correlated with socio-economic factors, vitamin D supplementation, breastfeeding and using formula after the 18th month, and toothbrushing. Supplementation of vitamin D and toothbrushing tended to decrease the odds of S-ECC (OR = 0.49 (0.27–0.87); p = 0.016, OR = 0.46 (0.24–0.86) p = 0.015, respectively). Feeding exclusively with formula was observed to increase the odds of S-ECC (OR = 2.20 (1.29–3.76); p = 0.004). Consuming > three snacks daily (OR = 1.39 (0.97–1.98); p = 0.072) and the reluctance to eat resilient foods (OR = 1.63 (1.05–2.51); p = 0.028) were nullified by the confounding factors. Vitamin D supplementation, mastication of resilient food, breastfeeding in the first six months of a baby’s life, and parent-supervised toothbrushing are factors in the prevention of caries in toddlers. Breast- and bottle-feeding after the 18th month of life, the reluctance to eat solids, lack of vitamin D supplementation, hygienic neglect, and delay in introducing oral health behaviours may contribute to the development of caries in toddlers.

Maternal Diet Associates with Offspring Bone Mineralization, Fracture Risk and Enamel Defects in Childhood and Influences the Prenatal Effect of High-Dose Vitamin D Supplementation

“…The supplementation effects were more pronounced among certain children for bone outcomes, suggesting the possibility of a targeted prevention approach. More specifically, we Nutrients 2024, 16, 405 2 of 16 found an improved effect on bone outcomes among mothers with low pre-supplementation levels of 25-hydroxyvitamin D (25(OH)D) and among mothers giving birth during winter when sun exposure was low [15]. This trend was also observed in a more recent study [16].…”

“…More specifically, we Nutrients 2024, 16, 405 2 of 16 found an improved effect on bone outcomes among mothers with low pre-supplementation levels of 25-hydroxyvitamin D (25(OH)D) and among mothers giving birth during winter when sun exposure was low [15]. This trend was also observed in a more recent study [16]. However, as 25(OH)D measurements require blood sampling and can fluctuate over time and season, we evaluated a potential targeted non-invasive approach utilizing comprehensive food frequency questionnaires (FFQs) covering a month of dietary intake reflecting early pregnancy dietary patterns.…”

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

“…Their analysis suggested an optimal Vitamin D level ≥ 75 nmol/L for ECC prevention. Sobiech et al, [37] through a detailed survey and clinical examination, found a 44.8% occurrence of S-ECC in their study population, with Vitamin D supplementation and toothbrushing significantly reducing the odds of S-ECC (OR = 0.49 and OR = 0.46, respectively). While Ji et al [36] provide a broad, quantitative analysis emphasizing the systemic relationship between Vitamin D and ECC across different regions, Sobiech et al offer a practical perspective, linking Vitamin D supplementation directly with reduced S-ECC risk alongside other oral health behaviors.…”

“…Ji et al [36] and Sobiech et al [37] delve into the association between Vitamin D levels and severe early childhood caries (S-ECC), yielding insights that underscore Vitamin D's potential role in caries prevention. Ji et al conducted a systematic review and meta-analysis, identifying significantly lower 25(OH)D levels in children with ECC compared to those who were caries-free, with a notable weighted mean difference of −13.96, indicating a strong correlation particularly with S-ECC (mean difference of −18.64).…”

Dental caries in children and vitamin D deficiency: a narrative review

“…Since then, several epidemiologic observational studies, systematic review and meta-analysis of controlled clinical trials have assessed how vitamin D deficiency is highly linked with dental caries in primary and permanent teeth in children (low vitamin D may facilitate demineralizing of teeth, in a similar way to its known action on bone, via reduced concentrations of calcium and phosphate ions), and have suggested that vitamin D exposure in early life may play a role in caries prevention [ 12 , 14 – 26 ]. A recent clinical study has found a significantly lower incidence and severity of caries in children aged < 3 years with continued supplementation with vitamin D at least in the autumn–winter period after the 12th month of life [ 27 ]. Besides, there is evidence that infants born to vitamin D-deficient mothers have higher level of dental caries in their primary teeth compared with infants born from mothers without vitamin D deficiency [ 28 – 31 ], and that a higher maternal vitamin D intake during pregnancy would be associated to a lower risk of dental caries in the offspring [ 32 ].…”