The rachitic tooth: Refining the use of interglobular dentine in diagnosing vitamin D deficiency

PURPOSE: This study provides guidelines on how IGD can be differentiated from other microstructures that naturally occur in dentine. Interglobular dentine (IGD) has recently been linked to disruption in vitamin D, calcium, and phosphorous pathways offering a valuable method to investigate vitamin D deficiency in archaeological individuals, but not all dentine defects are IGD. METHODS: A detailed review of dental literature and dental histology cases gathered from known living and archaeological individuals were incorporated into interpretations. RESULTS: Investigation of tooth dentine revealed that there can be instances where IGD is not linked to vitamin D deficiency. Information on how to differentiate different forms of defects in dentine were identified. CONCLUSIONS: We conclude that caution is required when evaluating low-grade IGD, as it may be misidentified. CONTRIBUTION TO KNOWLEDGE: Information reviewed and assimilated contributes to refining the role of IGD to act as a biological marker, particularly in less severe cases of vitamin D deficiency through provision of clear guidance. LIMITATIONS OF THIS STUDY: Information from earlier experimental work is limited and until recently understanding of vitamin D and deficiency of this pro-hormone was restricted. SUGGESTIONS FOR FURTHER RESEARCH: Further data could be gathered from living individuals with known biological/medical information.