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.

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