17, 18 Vitamin D stimulates mineralization of dental enamel and bone by binding to receptors that are expressed in both dental cells and bone cells. The main function of vitamin D is to maintain plasma calcium concentrations at a constant level, which is important for healthy bone development and increasing evidence suggests also for healthy tooth development. Several other studies examined vitamin D in relation to caries and generally observed that vitamin D supplementation in early life may be preventative for dental caries, as reviewed by Hujoel et al 16 To our knowledge, this is the only study to have examined 25(OH)D and dental enamel hypomineralization. 4, 11, 12, 13, 14 In the search to unravel the aetiology of dental hypomineralization, a recent study of Kühnisch et al 15 showed that higher serum 25‐hydroxyvitamin D (25(OH)D) concentrations were correlated with less MIH and dental caries in 1048 German children at age ten. 12, 13 The exact aetiology of dental enamel hypomineralization, however, remains unclear. 11 Other illnesses in early life and the use of antibiotics were proposed as risk factors for MIH. For HSPM, maternal alcohol consumption during pregnancy, low birth weight and fever during the first year of life are mentioned. Several early life risk factors for HSPM and MIH have been identified. 9, 10 Identifying modifiable risk factors is important to prevent development of dental enamel hypomineralization in children. 3, 5, 7, 8 Children with HSPM have a higher chance of developing MIH. 7 For MIH, the prevalence ranges between 8% and 19% among Dutch and Scandinavian children aged six to thirteen years. 6 The prevalence of HSPMs is about 4.9% in 6‐year‐old Dutch children. 3 Although hypomineralization is not restricted to those few index teeth and can be diagnosed in any tooth of both dentitions, a patient can only be diagnosed with HSPM/MIH if he or she has at least one affected second primary molar or first permanent molar, respectively. 3, 4, 5 In patients with MIH incisors of the upper jaw can also be involved and in rare cases incisors of the lower jaw. 1, 2, 3 This anomaly can be divided into hypomineralization of second primary molars, called hypomineralized second primary molars (HSPMs), and hypomineralization of permanent first molars, called molar incisor hypomineralization (MIH).
Dental enamel hypomineralization is an anomaly of dental enamel in which the affected enamel contains less mineral than sound enamel and is more susceptible to caries.
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