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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) 24160554 | Schroth/2015 | Canadian children 6-11 years old (144 with severe caries, 122 controls) | Cross-sectional study | | Key results | Data 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) 23356636 | Hujoel/2012 | 24 studies/2,827 children | Systematic review of randomized trials | | Key results | Twenty-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: |
04/20/2016 |
| E-mail |
cardchilders@livemail.uthscsa.edu |
| Author |
Olivia Card-Childers |
| Co-author(s) |
|
| Co-author(s) e-mail |
|
| Faculty mentor/Co-author |
Georgiana S. Gross, MPH |
| Faculty mentor/Co-author e-mail |
GROSSG@uthscsa.edu |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
| None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
| None available | |
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