Maternal vitamin D levels during pregnancy may be linked to a child’s risk of early caries and their decayed, missing, or filled teeth (DMFT) scores, according to a study published in JAMA Network Open.
Taking vitamin D supplements before and during pregnancy may lower the risk and severity of caries in children, the authors wrote.
“Higher maternal gestational vitamin D levels, particularly in the mid- to late-trimester, were associated with reduced odds of early childhood caries (ECC), lower offspring dmft scores, and caries rate,” wrote the authors, led by Nuo Xu, MPH, of the Second Affiliated Hospital of Zhejiang University School of Medicine in Hangzhou, China (JAMA Netw Open, December 2, 2025, Vol. 8:12, e2546166).
The study enrolled 4,109 pregnant women at Zhoushan Maternal and Child Health Hospital in China between August 2011 and May 2021 and followed their children until November 2022. Maternal plasma 25-hydroxyvitamin D (25[OH]D) levels were measured in all three trimesters to assess vitamin D deficiency, they wrote.
The primary outcome was ECC, while secondary outcomes included DMFT scores and caries rate. Oral health exams were performed on children under the age of 6, with DMFT scores recorded from 0 to 20. The caries rate was calculated as DMFT divided by the number of erupted teeth, and ECC was defined as a DMFT score of 1 or higher.
Higher maternal 25(OH)D levels were linked to lower odds of ECC, with odds ratios of 0.98 in both the first and second trimesters and 0.99 in the third trimester (all false discovery rate [FDR]-adjusted p ≤ 0.009). Cox regression models also showed that higher vitamin D levels throughout pregnancy consistently protected against ECC risk, they wrote.
Categorical analyses indicated that children of mothers with vitamin D insufficiency, deficiency, or severe deficiency had higher odds of ECC, though some associations weakened after FDR correction. Higher third-trimester 25(OH)D levels were additionally associated with lower DMFT scores (β = −9.97, p = .01) and lower caries rate (β = −50.87, p = .01). Furthermore, these inverse associations were supported by generalized estimation equation models.
The study, however, had limitations. The researchers did not account for factors such as children’s vitamin D intake, use of fluoride toothpaste, or sugar consumption, the authors added.
“These findings suggest that vitamin D supplementation during pregnancy and even before conception to maintain sufficient vitamin D status throughout pregnancy may help reduce the risk and severity of childhood dental caries,” they concluded.
