9 - Failure to Thrive, Vitamin D Deficiency, and Early Childhood Caries

Abstract:

Purpose:
Nutrition is essential to oral development, influencing enamel formation and feeding behaviors that affect susceptibility to Early Childhood Caries (ECC). This study examines the relationship between Failure to Thrive (FTT) and ECC in young children and evaluates whether vitamin D deficiency and other behavioral considerations modify this risk.

Methods:
A retrospective review was conducted of patients under 6 years old seen at the Boston Medical Center Grow Clinic and Pediatric Dental Clinic from 2018 to 2022. Children with FTT were classified as cases, while age-, gender-, and insurance-matched peers without FTT served as controls. Data included ECC and severe ECC (S-ECC) status, vitamin D deficiency, and relevant social and behavioral covariates. Analyses included descriptive statistics, Pearson’s chi-square tests, and logistic regression.

Results:
A total of 217 subjects met inclusion criteria; 24.9% had FTT and 4.6% had vitamin D deficiency. ECC prevalence was 25.8% and S-ECC prevalence was 17.5%. Children with FTT had significantly higher rates of ECC (42.6% vs. 20.2%, p=0.011) and S-ECC (35.2% vs. 11.7%, p< 0.0001). Vitamin D deficiency was not independently associated with FTT or ECC. In logistic regression, FTT remained a significant predictor of ECC, while vitamin D deficiency did not contribute significantly.



Conclusion:
Children with FTT are at greater risk for ECC, while vitamin D deficiency does not independently increase caries risk or modify the FTT–ECC relationship. These findings underscore the need for coordinated medical–dental care for children with growth concerns to improve overall health outcomes.

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