Low Vitamin D in Pregnancy Linked to Higher Tooth Decay Risk in Children: Study
China: A new cohort study published in JAMA Network Open highlights a strong association between vitamin D levels during pregnancy and the likelihood of early dental caries in children.
The research, led by Nuo Xu and colleagues from the Department of Public Health and the Department of Anesthesiology at the Second Affiliated Hospital of Zhejiang University School of Medicine, suggests that adequate vitamin D status before and during pregnancy may play a meaningful role in safeguarding children's oral health.
The investigation draws data from the long-running Zhoushan Pregnant Women Cohort, which enrolled expectant mothers between August 2011 and May 2021 in Zhoushan, Zhejiang Province, China. The team analyzed outcomes for 4,109 mother–child pairs, following children until November 2022. Maternal plasma 25-hydroxyvitamin D (25[OH]D) levels were measured during each trimester, allowing researchers to assess how vitamin D status across pregnancy influenced dental health in offspring.
The key findings of the study were as follows:
- Among the children assessed, 960 were diagnosed with early childhood caries (ECC), while 3,149 had no caries.
- An inverse association was observed between maternal vitamin D levels and the odds of ECC in offspring.
- Higher maternal 25(OH)D concentrations during all three trimesters were linked with a lower likelihood of ECC.
- The strongest protective associations were noted in the mid- to late stages of pregnancy.
- Increased vitamin D levels were associated with reduced odds of ECC in the first (OR 0.98), second (OR 0.98), and third trimesters (OR 0.99), with statistically significant results after false discovery rate adjustments.
- Children born to mothers with vitamin D insufficiency or deficiency had higher odds of developing ECC, although some associations lost significance after statistical correction.
- Maternal vitamin D status was also related to the severity of dental caries in children.
- Higher 25(OH)D levels during the third trimester were linked with lower dmft scores, indicating fewer decayed, missing, or filled primary teeth.
- Increased third-trimester vitamin D levels were further associated with a reduced overall caries rate.
- Generalized estimation equation models and Cox regression analyses consistently supported the protective effect of adequate maternal vitamin D throughout pregnancy.
The authors emphasize that while previous studies have hinted at a link between prenatal vitamin D status and dental outcomes in children, evidence has been inconsistent. Their findings, based on robust prospective data, add weight to the argument that maintaining adequate vitamin D levels could help curb the risk and severity of childhood dental caries, a common and preventable condition worldwide.
The researchers conclude that integrating vitamin D screening and supplementation into routine prenatal care—even beginning before conception—may be a practical strategy for improving long-term oral health in children. Ensuring vitamin D sufficiency throughout pregnancy, particularly during the second and third trimesters, could contribute to meaningful reductions in early childhood caries burden.
Reference:
Xu N, Chen Z, Wang B, et al. Vitamin D Levels During Pregnancy and Dental Caries in Offspring. JAMA Netw Open. 2025;8(12):e2546166. doi:10.1001/jamanetworkopen.2025.46166
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