Serum and Saliva 25(OH)D Levels in Relation to Dental Caries in Young Children

Objective: Several studies have reported that low levels of vitamin D (25(OH)D) are associated with an increased risk of dental caries and that optimal levels may offer protection This study aimed to assess the relationship between serum and saliva 25(OH)D levels and caries among young children. Study design: A total of 120 healthy children were recruited; 93 with caries and 27 caries-free. Dental caries status was evaluated using decayed, missing and filled in primary teeth (dmft) index. Blood and unstimulated whole saliva samples were collected. Laboratory analysis was performed using Enzyme-Linked Immunosorbent Assay Kit. Data were analyzed with descriptive statistics, bivariate and Spearman’s rank correlation analysis. Results: There were no significant associations between serum and saliva 25(OH)D levels and caries status (P > 0.05). Levels of 25(OH)D in serum were significantly higher than levels found in saliva (P < 0.05), and a correlation between serum and saliva 25(OH)D levels was observed (P < 0.05). Conclusions: The association between serum and saliva 25(OH)D and dental caries in young children was inconclusive. However, a positive and significant correlation was observed between serum and saliva 25(OH)D levels. Further studies are warranted to investigate the definite relation between 25(OH)D levels and dental caries and using saliva 25(OH)D as a non-invasive alternative method over blood samples.

Caries; Children; Saliva; Vitamin D; 25(OH)D

1. Correâ-Faria P, Viana KA, Raggio DP, Hosey MT, Costa LR. Recommended procedures for the management of early childhood caries lesions-A scoping review by the Children Experiencing Dental Anxiety: Collaboration on Research and Education (CEDACORE). BMC Oral Health. 2020;20(1):1-1.

2. Kassebaum NJ, Smith AGC, Bernabé E, et al. Global , Regional , and National Prevalence , Incidence , and Disability- Adjusted Life Years for Oral Conditions for 195 Countries , 1990 – 2015 : A Systematic Analysis for the Global Burden of Diseases , Injuries , and Risk Factors. J Dent Res. 2017; 96(4):380-387.

3. Pesaressi Eraldo; Villena Rita; Frencken Jo. Dental caries and oral health ‐ related quality of life of 3 ‐ year ‐ olds living in Lima , Peru. Int J Paediatr Dent. 2020;30:57-65.

4. Schroth RJ, Levi J, Kliewer E, Friel J, Moffatt ME. Association between iron status, iron deficiency anaemia, and severe early childhood caries: a case-control study. BMC Pediatr. 2013;13(1):22.

5. Babu NSV, Bhanushali PV. Evaluation and association of serum iron and ferritin levels in children with dental caries. 2017;35(2):106-109.

6. Schroth RJ, Jeal NS, Kliewer E, Sellers EAC. The relationship between vitamin D and severe early childhood caries: a pilot study. Int J Vitam Nutr Res , 2012; 82(1):53-62.

7. Schroth RJ, Levi JA, Sellers EA, Friel J, Kliewer E, Moffatt ME. Vitamin D status of children with severe early childhood caries: a case-control study. BMC Pediatr. 2013; 13(1):174.

8. Botelho J, Machado V, Proença L, Delgado AS, Mendes JJ. Vitamin D deficiency and oral health: A comprehensive review. Nutrients. 12(5),2020. doi:10.3390/nu12051471

9. Almoudi MM, Hussein AS, Abu Hassan MI, Schroth RJ. Dental Caries and Vitamin D Status among Children in Asia: A literature review. Pediatr Int. 2019;61(4):327-338.

10. Bener A, Al-Darwish MS, Hoffmann GF. Vitamin D deficiency and risk of dental caries among young children: a public health problem. Indian J Oral Sci. 2013; 4(2):75-82.

11. Schroth RJ, Rabbani R, Loewen G, Moffatt ME. Vitamin D and Dental Caries in Children. J Dent Res. 2016; 95(2):173-179.

12. Ali N, Rahim A, Ali S, Iqbal MH. Impact of Vitamin D on Development of Early Childhood Caries. Pakistan Armed Forces Med J. 2017;67(3):429-433.

13. 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(3):199-204.

14. Wójcik D, Krzewska A, Szalewski L, et al. Dental caries and Vitamin D 3 in children with growth hormone deficiency. Med (United States). 97:8(e9811),2018.

15. Institute of Medicine 2011 Dietary reference intakes for calcium and vitamin D. Washington, DC: The National Academies Press.

16. Williamson S, Munro C, Pickler R, Grap MJ, Elswick RK. Comparison of Biomarkers in Blood and Saliva in Healthy Adults. Nurs Res Pract. 2012; 2012:1-4.

17. Arunkumar S, Arunkumar J, Burde K, Shakunthala G. Developments in diagnostic applications of saliva in oral and systemic diseases-A comprehensive review. J Sci Innov Res. 2014; 3(3):372-387.

18. Hegde MN. Saliva as a biomarker for dental caries: A systematic review. Conserv Dent Endod. 2019; 22:2-6.

19. Fairney a, Saphier PW. Studies on the measurement of 25-hydroxy vitamin D in human saliva. Br J Nutr.1987; 57(1):13-25.

20. Higashi T, Shibayama Y, Fuji M, Shimada K. Liquid chromatography-tandem mass spectrometric method for the determination of salivary 25- hydroxyvitamin D3: A noninvasive tool for the assessment of vitamin D status. Anal Bioanal Chem. 2008; 391(1):229-238.

21. Hussein, A.S., Almoudi M.M., Schroth, Abu Hassan, M.I., Robert J., Saripudin, B., Chinna K. Comparison of saliva and serum total 25(OH)D levels in young children: a pilot study. J Int Dent Med Res.2020; 13(4):1405-1410.

22. Gyll J, Ridell K, Öhlund I, Karlsland Åkeson P, Johansson I, Lif Holgerson P. Vitamin D status and dental caries in healthy Swedish children. Nutr J. 2018; 17(1):1-10.

23. WHO. Oral Health Surveys: Basic Methods. 4th ed. WHO: Geneva, Switzerland; 1997.

24. Bulent Kargi A, Demir M. Vitamin D Deficiency as a Risk Factor in Non-Squamous Lung Cancer Subgroups–A Preliminary Study. J Clin Respir Dis Care. 2016; 2(2):2-5.

25. Dwivedi R, Gupta YK, Singh M, et al. Correlation of saliva and serum free valproic acid concentrations in persons with epilepsy. Seizure. 2015; 25:187-190.

26. Sethu S, Shetty R, Deshpande K, Pahuja N, Chinnappaiah N, Agarwal A. Correlation between tear fluid and serum vitamin D levels. Eye Vis. 2016; 3(1)22.

27. Hussein AS, Almoudi MM, Zen SANM, Azmi NH, Schroth RJ, Abu Hassan MI. Parental awareness and knowledge of vitamin D and its health benefits for children. J Int Dent Med Res. 2018; 11(3):916-924.

28. Wimalawansa SJ, Razzaque MS, Al-Daghri NM. Calcium and vitamin D in human health: Hype or real? J Steroid Biochem Mol Biol. 2018; 180(2010):4-14.

29. Seminario AL, Velan E. Vitamin D and Dental Caries in Primary Dentition. J Dent Child (Chic). 2016; 83(3):114-119.

30. Singleton R, Day G, Thomas T, et al. Association of Maternal Vitamin D Deficiency with Early Childhood Caries. J Dent Res. 2019: 98(5):549-555.

31. Ribeiro TR, Dria KJ, de Carvalho CBM, et al. Salivary peptide profile and its association with early childhood caries. Int J Paediatr Dent. 2013;23(3):225-234.

32. D’Ortenzio L, Ribot I, Kahlon B, et al. The rachitic tooth: The use of radiographs as a screening technique. Int J Paleopathol. 2018; 23:32-42.

33. Kim IJ, Lee HS, Ju HJ, Na JY, Oh HW. 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(1):1-6.

34. Herzog K, Scott JM, Hujoel P, Seminario AL. Association of Vitamin D and dental caries in children Findings from the National Health and Nutrition Examination Survey, 2005-2006. J Am Dent Assoc. 2016;147(6):413-420.

35. Rugg-Gunn A. Dental caries: strategies to control this preventable disease. Acta Med Acad. 2013;42(2):117-130.

36. Hujoel PP. Vitamin D and dental caries in controlled clinical trials: Systematic review and meta-analysis. Nutr Rev. 2013;71(2):88-9.

37. Bahramian A, Falsafi P, Abbasi T, et al. Comparing Serum and Salivary Levels of Vitamin D in Patients with Recurrent Aphthous Stomatitis and Healthy Individuals. J Dent. 2018;19(4):295-300.