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Prenatal Vitamin D, Dental Development, and Childhood Caries

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Dental research has a new area of investigation: the role of Vitamin D in the development of prenatal teeth, and how that development might be a factor in preventing Early Childhood Caries (ECC). While the studies showing the positive role of Vitamin D in the dental condition of older children and adults is fairly well known, those studies cannot directly translate to the development and condition of prenatal teeth, not least because the Vitamin D a prenatal child receives comes entirely through its mother. At the same time, the prenatal infant is in a very early phase of dental development, starting teeth months before birth that will typically not come into view until perhaps six months after the infant is born.

Vitamin D essential in regulating body’s absorption of calcium and phosphorus. Those elements are key to the process of tooth mineralization — the building up of the tooth’s structure. Strongly mineralized teeth have greater structural integrity and greater resistance to dental caries (cavities).

A deficiency in Vitamin D is connected to, among other things, weakened tooth calcification. Whether a similar deficiency in tooth calcification occurs for infants in utero when their mothers have a Vitamin D deficiency is not yet established, but it is the case that tooth calcification begins in the prenatal infant in the second and third trimesters. Weakened tooth calcification manifests as deficient, pitted, or irregular tooth enamel that can in turn lead to an increased prevalence of dental caries (cavities).

How and when Vitamin D strengthens teeth

Vitamin D strengthens teeth by assisting the incorporation of calcium and phosphorus into the tooth structure. In the case of the formation of primary teeth, the essential start to tooth formation happens before the child is born, when the ameloblasts (enamel-forming cells) and odontoblasts (dentin-forming cells) are initially developing.

Ultra-Sound of Identical Twin

While it is recognized that Vitamin D is useful at all ages, study tends to overlook prenatal benefits, even though that is the time when important tooth development is occurring between the second and third trimesters of pregnancy.

What amounts of Vitamin D are ideal?

The recommended daily intake of Vitamin D is 400 to 600 International Units (IU) per day for children and adults, according to the National Academy of Medicine in the United States, a recommendation adopted in Canada by Health Canada. This is the standard dosage in vitamin pills.

When looking at the amount of Vitamin D in the body the best measure is the presence 25-hydroxyvitamin D (25(OH)D), the active metabolite of Vitamin D. This measure takes into account all possible sources of Vitamin D. The table below shows the adequacy of various levels of 25(OH)D.

How does one get enough Vitamin D?

The body obtains Vitamin D through food sources, sunlight, and vitamin supplements. In the case of the unborn, the sole source of Vitamin D is through mother; consequently it is important that adequate Vitamin D is a part of maternal diet.

Conclusions

The role of Vitamin D in preventing cavities is already established with a reasonable degree of confidence, although the role of prenatal Vitamin D is somewhat less well established. The connections between Vitamin D and tooth development in children might well translate into similar benefits for infants before birth, through prenatal access to Vitamin D in the maternal diet.

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