Prenatal or Childhood Serum Levels of Vitamin D and Dental Caries in Paediatric Patients: A Systematic Review.

PURPOSE To assess the association between low prenatal or childhood levels of 25-hydroxyvitamin D (25(OH) D) and dental caries experience in children. MATERIALS AND METHODS PubMed, B-On, Web of Science, Scopus, and Cochrane Library databases were searched. The inclusion criteria were randomised controlled trials, cohort and cross-sectional studies published between 1998 and 2019; caries outcomes expressed as prevalence or based on the decayed missing and filled index for primary and permanent teeth/surfaces; and vitamin D levels assessed by laboratory analysis. Two authors independently selected studies, collected data, and assessed risk of bias. The quality of the studies was also assessed. A narrative synthesis of the studies was performed without quantitative pooling of data due to clinical and methodological heterogeneity. RESULTS Out of 399 studies identified, 13 were included in the data synthesis. Even though many of the included studies had a cross-sectional design, 11 were considered high quality. The studies indicated that vitamin D has an important role in caries experience, but also revealed that vitamin D levels equal to or above 75 nmol/l seem to be more closely related to caries experience than the reference value of the Institute of Medicine. CONCLUSION Evidence of an association exists between low 25(OH) D levels (<75 nmol/l) and caries experience in children. Hence, low vitamin D levels should be considered a potential factor associated with caries in children. Clinicians should be aware that good prenatal nutrition and early childhood diet might influence caries experience.