Suboptimal Vitamin D Associated with Dental Caries at an Urban Pediatric Hospital

Abstract

Purpose: Inadequate vitamin D levels in children are associated with impaired calcification of hard tissues, including teeth. This study seeks to investigate associations between serum vitamin D levels and dental caries among children who receive care at a major northwest urban hospital. Study design: This cross-sectional study examined data from Seattle Children’s Hospital between 1999 and 2014. Inclusion criteria were children aged 1-6 years with primary dentition, American Society of Anesthesiologists (ASA) health status of I-IV, serum vitamin D levels, and dental data. Vitamin D levels were categorized as optimal (≥ 75 nmol/L) or suboptimal (< 75 nmol/L). Associations between vitamin D and caries were assessed using bivariate and multivariate (modified) Poisson regression models. Multivariate models were adjusted for age, race, ASA classification, season of vitamin D collection, and G-tube feeding status. Critical value was established at 5%. Results: A total of 824 children were assessed of which 276 (33.5%) met the inclusion criteria. On average, children were 3.4 years old, 50.4% female, 48.9% white, 81.5% ASA III, 36.2% G-tube fed, and 33.3% had tooth decay experience. Children with suboptimal vitamin D levels were 2 times more likely to have dental caries than children with optimal vitamin D levels (RR 2.16; 95% CI = (1.46,3.19); p=<0.001) Conclusions: Children with suboptimal levels of vitamin D had an associated increased dental caries risk. Since children seeking care at hospitals are more vulnerable and interventions beyond the realm of the mouth are of relevance, awareness of their vitamin D status should be considered.