Severe early childhood caries (S-ECC), also known as bottle rot, is a syndrome characterized by severe decay in the teeth of infants or toddlers. S-ECC is commonly caused by a bacterial infection with Streptococcus mutans. Its prevalence is epidemic; in the US, the rate is highest in minorities, at times infecting over 70% of minority children. The disease process begins with the transmission of the bacteria to the child, usually from the mother. Parents with untreated dental disease present a very high risk to their children.
A tragic number of infants with S-ECC need extensive dental surgery for S-ECC, surgery usually associated with age 70, not age two. In spite of the fact that these children brush their teeth a little more often than unaffected children do, for largely unknown reasons, these young unfortunates are plagued at an early age with the need for extensive dental surgery under general anesthesia. Subsequent cavities and surgery is common.
Now researcher Robert J. Schroth and colleagues from the University of Manitoba may have rediscovered why.
I say rediscovered because Dr. May Mellanby discovered this in the 1920s, her work proved vitamin D supplementation decreased cavities. Unfortunately, her work was forgotten. In addition, early work showed sunbeds were more effective in preventing cavities than was D2.
Mellanby M and Pattison, C. (1928) The action of vitamin D in preventing the spread and promoting the arrest of caries in children. Br, Med J. 2, 1079-1082.
The current Canadian authors simply measured vitamin D levels in children with S-ECC and compared them to children with no cavities. Sure enough, children with S-ECC had significantly lower vitamin D levels than normal children (20 ng/ml versus 25ng/ml) and were twice as likely to have levels below 30 ng/ml.
Even more interesting, children with S-ECC had much higher levels of parathyroid hormone (high PTH is a marker for severe vitamin D deficiency) than cavity free children had. In fact, their PTH was more than triple the normal children and eight times more likely to be elevated than cavity free children.
As the variation in PTH was greater than the variation in 25(OH)D, it made me think the obvious: that children all have different set points for vitamin D preventing carries. Thus, all children should have natural levels, around 50 ng/ml, to prevent S-ECC, a level where PTH is quite low, like the cavity free children had. This requires 1,000 IU/day/25 pounds of body weight, rounded up.