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Title Vitamin D Intake Less Than 50 nmol/L May Result in Increased Susceptibility to Dental Caries in School-Age Children
Clinical Question In children, does 25-Hydroxyvitamin D intake between 50-75 nmol/L, compared to intake <50 nmol/L, result in lower incidence of dental caries?
Clinical Bottom Line Vitamin D intake less than 50-75 nmol/L is associated with increased rates of dental caries. A Canadian cross-sectional study and a systematic review of 24 controlled clinical trials revealed that increased 25(OH)D intake results in decreased incidence of dental caries in children. Vitamin D supplementation is an easily implementable method for reducing caries risk in children.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 24160554Schroth/2015Canadian children 6-11 years old (144 with severe caries, 122 controls)Cross-sectional study
Key resultsData from Canadian children ranging in age from 6-11 years were analyzed. Results showed that caries were present in 56.4% of children with daily 25(OH)D intake < 75 nmol/L (95% CI: 48.5%-64%), compared to 43.6% in children with intake > 75 nmol/L (95% CI: 36.1%-51.5%). Correlation analyses revealed that children with higher 25 (OH)D levels had lower caries scores (P = 0.05).
#2) 23356636Hujoel/201224 studies/2,827 children Systematic review of randomized trials
Key resultsTwenty-four clinical trials were conducted in 2,827 children between the ages of 2 and 16. Results indicate with low certainty that supplemental Vitamin D during childhood is associated with a 47% decrease in caries risk. Analysis showed the pooled relative rate (RR) of dental caries with Vitamin D supplementation was 0.53 (95% confidence interval [CI], 0.43–0.65). Additionally, meta-regression analysis evaluated whether the outcomes of the clinical trials were due to the effect of the vitamin D vehicle (such as cod liver oil) rather than directly due to nutritional supplementation. Results of this meta-regression suggest that alternative explanations are not significant enough to account for the consistent caries-prevention effects observed across trials.
Evidence Search "Dental Caries"[Mesh] AND "Vitamin D"[Mesh]
Comments on
The Evidence
Meta-regression analysis in the systematic review showed several features of study design that significantly decreased the effectiveness of Vitamin D supplementation. These factors include: low study quality, biased assignment of groups, studies conducted prior to 1950. Overall results may have been more robust had these variables been controlled. Schroth et al. included a large sample size, and trained dentists performed the dental exams. Additionally, they validated their findings by comparing their patient population (56.4% caries experience) to that of the Canadian Health Measures Survey (CHMS) oral health report (56.8% caries experience). Their overall total caries scores (dmft) also matched that of the CHMS study.
Applicability When looking at these results one should recognize that most of the data from Hujoel et. al. applies to populations growing up between World War I and II. In light of this, we should be careful generalizing this data to modern populations. That being said, these results are important and applicable. Both studies included data from a large number of patients and controlled for other covariates that could have biased the results. These results suggest that adequate Vitamin D supplementation may be an important preventative consideration in reducing caries risk in children.
Specialty/Discipline (General Dentistry) (Pediatric Dentistry)
Keywords Dental caries; Vitamin D; Children
ID# 3077
Date of submission: 04/20/2016spacer
E-mail cardchilders@livemail.uthscsa.edu
Author Olivia Card-Childers
Co-author(s) e-mail
Faculty mentor/Co-author Georgiana Gross, MPH
Faculty mentor/Co-author e-mail GROSSG@uthscsa.edu
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