Vitamin D deficiency as a risk factor for delayed tooth eruption in children - A systematic review and meta-analysis.

BACKGROUND

Vitamin D is essential for bone and tooth mineralization, and its deficiency may contribute to delayed tooth eruption (DTE) in children. Evidence on this association remains limited and inconsistent.

AIM: To systematically review and analyze the relationship between Vitamin D deficiency and delayed eruption of primary and permanent teeth in children.

METHODS

A systematic search of major databases was conducted up to May 2025 following meta-analysis of observational studies in epidemiology guidelines. Observational studies assessing serum Vitamin D in relation to DTE were included. Study quality was evaluated using the Newcastle-Ottawa Scale, and meta-analysis was performed using Review Manager 5.

RESULTS

Five studies met the criteria for qualitative review and three for meta-analysis. Although all studies measured Vitamin D in ng/mL and commonly defined deficiency as <20 ng/mL, considerable methodological heterogeneity was observed. Meta-analysis for primary dentition showed no significant association (mean difference [MD] = -11.90; confidence interval [CI]: -30.77-6.97; I2 = 95%). Combined analysis of primary and permanent dentition demonstrated a significant difference (MD = -16.46; CI: -23.86 to -9.05; I2 = 91%). Sensitivity analysis improved consistency (MD = -21.89; CI: -23.78 to -20.00; I2 = 0%). Calcium levels showed no significant association with DTE.

CONCLUSION

The findings suggest a possible association between low Vitamin D levels and DTE; however, high heterogeneity and limited evidence reduce certainty. Further well-designed studies are needed to confirm this relationship.