Vitamin D is key to the musculoskeletal system. Its deficiency can arise from lack of exposure to sunlight and through dietary insufficiency. This can have an impact upon the oral health of an individual, including resulting in chronological hypoplasia enamel defects. Enamel hypoplasia is a quantitative defect in the enamel, presenting as pits, grooves, missing enamel or smaller teeth. The management of these defects can present a challenge to the dentist. This paper outlines the oral manifestations of vitamin D deficiency in the permanent dentition and the treatment modalities used in their management.
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Girgis C, Clifton-Bligh R, Hamrick M, Holick M, Gunton J. The Roles of Vitamin D in Skeletal Muscle: Form, Function, and Metabolism. Endocr Rev 2013; 34: 33-83.
Scientific Advisory Committee on Nutrition. Vitamin D and Health. 2016. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/537616/SACN_Vitamin_D_and_Health_report.pdf (accessed September 2019).
NHS. How to get vitamin D from sunlight. 2018. Available at https://www.nhs.uk/live-well/healthy-body/how-to-get-vitamin-d-from-sunlight/ (accessed September 2019).
Munns C, Shaw N, Kiely M et al. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets. J Clin Endocrinol Metab 2016; 101: 394-415.
Braegger C, Campoy C, Colomb V et al. Vitamin D in the Healthy European Paediatric Population. J Pediatr Gastroenterol Nutr 2013; 56: 692-701.
Linglart A, Biosse-Duplan M, Briot K et al. Therapeutic management of hypophosphatemic rickets from infancy to adulthood. Endocr Connect 2014; DOI: 10.1530/EC-13-0103.
Lips P. Vitamin D physiology. Prog Biophys Mol Biol 2006; 92: 4-8.
Bahrami A, Sadeghnia H, Tabatabaeizadeh S et al. Genetic and epigenetic factors influencing vitamin D status. J Cell Physiol 2017; 233: 4033-4043.
van der Pligt P, Willcox J, Szymlek-Gay E, Murray E, Worsley A, Daly R. Associations of Maternal Vitamin D Deficiency with Pregnancy and Neonatal Complications in Developing Countries: A Systematic Review. Nutrients 2018; 10: 640.
Dovnik A, Mujezinović F. The Association of Vitamin D Levels with Common Pregnancy Complications. Nutrients 2018; 10: 867.
Goldacre M, Hall N, Yeates D. Hospitalisation for children with rickets in England: a historical perspective. Lancet 2014; 383: 597-598.
Cashman K, Dowling K, Škrabáková Zet al. Vitamin D deficiency in Europe: pandemic? Am J Clin Nutr 2016; 104: 1033-1044.
Zerofsky M, Ryder M, Bhatia S, Stephensen C, King J, Fung E. Effects of early vitamin D deficiency rickets on bone and dental health, growth and immunity. Matern Child Nutr 2015; 12: 898-907.
Ford D, Seow W, Kazoullis S, Holcombe T, Newman B. A controlled study of risk factors for enamel hypoplasia in the permanent dentition. Pediatr Dent 2009; 31: 382-388.
Reed S, Voronca D, Wingate J et al. Prenatal vitamin D and enamel hypoplasia in human primary maxillary central incisors: A pilot study. Pediatr Dent J 2017; 27: 21-28.
Watts A, Addy M. Tooth discolouration and staining: a review of the literature. Br Dent J 2001; 190: 309-316.
Kühnisch J, Thiering E, Kratzsch J, Heinrich-Weltzien R, Hickel R, Heinrich J. Elevated serum 25(OH)-vitamin D levels are negatively correlated with molar-incisor hypomineralization. J Dent Res 2015; 94: 381-387.
van der Tas J, Elfrink M, Heijboer A et al. Fetal, neonatal and child vitamin D status and enamel hypomineralization. Community Dentist Oral Epidemiol 2018; 46: 343-351.
Schroth R, Lavelle C, Tate R, Bruce S, Billings R, Moffatt M. Prenatal Vitamin D, Dental Caries in Infants. Pediatrics 2014; 133: 1277-1284.
Schroth R, Levi J, Sellers E, Friel J, Kliewer E, Moffatt M. Vitamin D status of children with severe early childhood caries: a case-control study. BMC Paediatr 2013; 13: 174.
Schroth R, Rabbani R, Loewen G, Moffatt M. Vitamin D, Dental Caries in Children. J Dent Res 2015; 95: 173-179.
Gupta A, Chhonkar A, Arya V. Comparison of Vitamin D Level of Children with Severe Early Childhood Caries and Children with No Caries. Int J Clin Pediatr Dent 2018; 11: 199-204.
Kim I, Lee H, Ju H, Na J, Oh H. A cross-sectional study on the association between vitamin D levels and caries in the permanent dentition of Korean children. BMC Oral Health 2018; 18: 43.
Alshouibi E, Kaye E, Cabral H, Leone C, Garcia R. Vitamin D, Periodontal Health in Older Men. J Dent Res 2013; 92: 689-693.
Jagelavičienė E, Vaitkevičienė I, Šilingaitė D, Šinkūnaitė E, Daugėlaitė G. The Relationship between Vitamin D, Periodontal Pathology. Medicina (Kaunas) 2018; DOI: 10.3390/medicina54030045.
Younessian F, Tehranchi A, Sadighnia A, Abdi A, Shirvani A. Correlation of vitamin D status and orthodontic-induced external apical root resorption. Dent Res J 2017; 14: 403.
Foulds H. Developmental defects of enamel and caries in primary teeth. Evid Based Dent 2017; 18: 72-73.
Adair S. Evidence-based use of fluoride in contemporary paediatric dental practice. Pediatr Dent 2006; 28: 133-142.
Tao S, Zhu Y, Yuan H et al. Efficacy of fluorides and CPP-ACP vs fluorides monotherapy on early caries lesions: A systematic review and meta-analysis. PLoS One 2018; DOI: 10.1371/journal.pone.0196660.
Salanitri S, Seow W. Developmental enamel defects in the primary dentition: aetiology and clinical management. Aust Dent J 2013; 58: 133-140.
Reston E, Corba D, Ruschel K, Tovo M, Barbosa A. Conservative Approach for Esthetic Treatment of Enamel Hypoplasia. Oper Dent 2011; 36: 340-343.
Pini N. Enamel microabrasion: An overview of clinical and scientific considerations. World J Clin Cases 2015; 3: 34-41.
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Fulton, A., Amlani, M. & Parekh, S. Oral manifestations of vitamin D deficiency in children. Br Dent J 228, 515–518 (2020). https://doi.org/10.1038/s41415-020-1424-y
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