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Suboptimal Serum Vitamin D Associated with Early Childhood Caries in Special Health Care Needs Children

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Purpose: To investigate the association between suboptimal serum vitamin D and early childhood caries (ECC) among children who received care at Seattle Children's Hospital (SCH) between 1999 and 2014.

Methods: This cross-sectional study examined one- to six-year-old children in their primary dentition, with an American Society of Anesthesiologists (ASA) health status of II to IV, serum vitamin D, and dental data. Serum vitamin D was categorized as optimal (at least 75 nanomoles per liter) or suboptimal (less than 75 nanomoles per liter). Associations between serum vitamin D and caries were assessed using bivariate and multivariable (modified) Poisson regression models. Multivariable models were adjusted for age, race, ASA classification, season of vitamin D collection, and gastrostomy tube (G-tube) feeding status.

Results: The mean age of 276 subjects was 3.4±1.5 years; 50.4 percent was female, 48.9 percent was Caucasian, 81.5 percent was ASA III status, 36.2 percent was G-tube fed, and 33.3 percent had ECC. Children with suboptimal 25-hydroxy vitamin D status were twice as likely to have ECC than children with optimal levels (relative risk = 2.14; 95 percent confidence interval = 1.45 to 3.16). The association between serum vitamin D and ECC was observed among children with neurologic (P<0.001) and genetic (P<0.001) conditions.

Conclusions: Suboptimal 25-hydroxy vitamin D status was associated with increased risk for ECC in children with special health care needs. Interventions beyond the realm of the mouth are relevant for this highly vulnerable population and awareness of their vitamin D status should be considered.
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Keywords: CHILDREN; EARLY CHILDHOOD CARIES; MEDICALLY COMPROMISED/DISABILITY; VITAMIN D

Document Type: Research Article

Affiliations: 1: Director, Timothy A. DeRouen Center for Global Oral Health, and associate professor, in the Department of Pediatric Dentistry, in the School of Dentistry, Uni\versity of Washington, Seattle, Wash., USA;, Email: [email protected] 2: Affiliate assistant professor, in the Department of Pediatric Dentistry, in the School of Dentistry, Uni\versity of Washington, Seattle, Wash., USA 3: Assistant professor, Department of Research and Graduate Programs, School of Dentistry, University of Missouri at Kansas City, Kansas City, Mo., USA 4: Dental student, in the School of Dentistry, University of Washington, Seattle, Wash., USA 5: Associate professor, Department of Community Health Sciences and Department of Pediatrics and Child Health, Max Rady College of Medicine, and Department of Preventive Dental Science and Department of Oral Biology, Dr. Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, Manitoba, Canada

Publication date: September 1, 2018

More about this publication?
  • Acquired after the merger between the American Society of Dentistry for Children and the American Academy of Pediatric Dentistry in 2002, the Journal of Dentistry for Children (JDC) is an internationally renowned journal whose publishing dates back to 1934. Published three times a year, JDC promotes the practice, education and research specifically related to the specialty of pediatric dentistry. It covers a wide range of topics related to the clinical care of children, from clinical techniques of daily importance to the practitioner, to studies on child behavior and growth and development. JDC also provides information on the physical, psychological and emotional conditions of children as they relate to and affect their dental health.
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