Maternal vitamin D status in pregnancy and molar incisor hypomineralisation and hypomineralised second primary molars in the offspring at 7-9 years of age: a longitudinal study.

PURPOSE: The study aimed to investigate associations between maternal vitamin D status during pregnancy and molar incisor hypomineralisation (MIH) and hypomineralised second primary molars (HSPM) among children. METHODS: The study had a longitudinal design using prospectively collected data from 176 mother and child pairs. Mothers were initially recruited in a randomised controlled trial to assess a pregnancy exercise programme. Along with the 7-year follow-up, we invited the children to a dental examination. The exposure variable was maternal serum 25-hydroxyvitamin D in gestational weeks 18-22 and 32-36, categorised as insufficient (< 50 nmol/l) and sufficient (≥ 50 nmol/l). Negative binomial hurdle models were used to analyse potential associations between the exposure variables and MIH or HSPM. The models were adjusted for potential confounders. RESULTS: Among the children (7-9 years old), 32% and 22% had at least one tooth with MIH or HSPM, respectively. A significant association was found between insufficient maternal vitamin D measured in gestational weeks 18-22 and the number of affected teeth among those with MIH at 7-9 years (adjusted RR = 1.82, 95% CI 1.13-2.93). CONCLUSION: Considering any limitations of the present study, it has been shown that insufficient maternal serum vitamin D at mid-pregnancy was associated with a higher number of affected teeth among the offspring with MIH at 7-9 years of age. Further prospective studies are needed to investigate whether this finding is replicable and to clarify the role of maternal vitamin D status during pregnancy and MIH, as well as HSPM, in children.

Factors influencing the use of oral health services among adolescents in New Zealand.

OBJECTIVES: This study investigated the impact of parental use of dental services, ethnicity and socio-economic background on adolescents' recent use of dental services. DESIGN: Secondary analysis of cross-sectional data from the 2009 New Zealand Oral Health Survey (2009 NZOHS). PARTICIPANTS/MATERIALS AND METHODS: A sub-sample of all adolescent participants aged 12-17 years (n = 509) from the nationally representative 2009 NZOHS. The NZOHS included self-report data on oral health status, risks and protective factors, and utilisation of oral health services. MAIN OUTCOME MEASURES: Outcome measures were 'most recent dental visit' and 'type of provider last visited'. Key exposure factors were 'most recent dental visit by primary caregiver' (among 12-14-year-olds), ethnicity, and socioeconomic deprivation. Univariate analysis for each outcome was conducted using survey-weighted estimates, followed by multivariable analysis using logistic regression. RESULTS: Four in five adolescents reported having visited a dental provider within the last year (79.9%), with almost half having last visited a private general dental practice (46.6%). No significant associations were found for either outcome with the primary caregiver exposure factor (Most recent dental visit outcome fully adjusted OR (primary caregiver not visited) = 0.93, 95% CI 0.32, 2.72; Visited provider other than private general dental practice outcome fully adjusted OR (primary caregiver not visited) = 1.60, 95% CI 0.39, 6.57). Compared to European/Other adolescents, Maori and Pacific adolescents were significantly more likely to have not visited in the last year (Maori 12-14 years fully adjusted OR = 4.20, 95% CI 1.54, 11.50; Pacific 12-17 years fully adjusted OR = 2.61, 95% CI 0.84, 8.07--the latter was not significant after adjusting for socioeconomic deprivation), and significantly less likely to have last visited a private general dental practice (Maori 12-17 years fully adjusted OR = 2.16, 95% CI 1.13, 4.12; Pacific 12-17 years fully adjusted OR = 5.15, 95% CI 1.69, 15.74). CONCLUSION: Ethnicity was strongly associated with use of oral health services among New Zealand adolescents. No statistically significant evidence was found that primary caregiver use of oral health services or socioeconomic deprivation were impacting on adolescent uptake of oral health services.