Vitamin D is key to the musculoskeletal system. Its deficiency can arise from lack of exposure to sunlight and through dietary insufficiency. This can have an impact upon the oral health of an individual, including resulting in chronological hypoplasia enamel defects. Enamel hypoplasia is a quantitative defect in the enamel, presenting as pits, grooves, missing enamel or smaller teeth. The management of these defects can present a challenge to the dentist. This paper outlines the oral manifestations of vitamin D deficiency in the permanent dentition and the treatment modalities used in their management.