Fluoride ingestion from toothpaste and diet in 1- to 3-year-old Brazilian children

[A new protocol for use and storage of tooth-brushing material for school children]

The aim of this study was to evaluate the storage and distribution of toothbrushing material for school children. Twenty individuals responsible for the collective oral hygiene of school children from Bauru - SP and São José dos Campos - SP participated in the first stage of the study, answering 2 questionnaires about five different kits for use by school children. The statistical analysis was performed using Wilcoxon (p<0,05). In the second stage, the amount of toothpaste or liquid cleanser applied to the toothbrush by 178 school children aged 4 to 8 years from 2 cities from the state of São Paulo (Bauru e Bariri) was weighed using a portable balance. The statistical analysis was obtained by using Pearson's correlation coefficient and analysis of covariance (p <0,05). Kit 5 obtained levels of satisfaction and high satisfaction when compared with the others kits (1 - 4). The school children from Bauru (0.41g) used smaller amounts of toothpaste than the school children from Bariri (0.48g). The average of the amount of liquid cleanser applied by the sample was 0.15g. The "drop technique" (liquid cleanser) was considered practical for dispensing a small, standardized quantity of the product. Kit 5 was considered a good alternative for establishing a collective oral health protocol in the Brazilian health system.

Prospective study of the association between fluoride intake and dental fluorosis in permanent teeth

OBJECTIVE

To evaluate the relationship between fluoride intake and dental fluorosis in permanent central incisors and first molars.

METHODS

Fluoride intake (mg F/kg body weight/day) from diet, dentifrice and both combined was determined on a single occasion in 1998 among children aged 19-39 months living in two fluoridated Brazilian communities (0.6-0.8 ppm F). Six years later, when the permanent teeth of these children had erupted (central incisors and first molars), 49 children aged 7-9 years [20 girls (40.8%) and 29 boys (58.2%)] were evaluated for dental fluorosis. To test the association between fluorosis and fluoride intake, children were dichotomized into two groups, cases (children with dental fluorosis on at least two teeth, TFI > or =1) and noncases (children without dental fluorosis, TFI = 0).

RESULTS

Among the case group (n = 29), median fluoride doses from diet, dentifrice and combined were 0.031, 0.050 and 0.083 mg F/kg/day, respectively. Among the noncase group (n = 20), median fluoride doses were 0.029, 0.049, 0.084 mg F/kg/day, respectively. There was no association between dental fluorosis in permanent teeth and fluoride intake from diet, dentifrice and combined (p > 0.05).

CONCLUSIONS

There was no difference between children with and without fluorosis in the permanent central incisors and first molars regarding fluoride intake. However, this study has limitations that must be recognized: fluoride intake was only measured once, and there were no children in the sample with severe degrees of dental fluorosis.

Fluoride intake from regular and low fluoride dentifrices by 2-3-year-old children: influence of the dentifrice flavor

This study evaluated the fluoride intake from dentifrices with different fluoride concentrations ([F]) by children aged 24-36 months, as well as the influence of the dentifrice flavor in the amount of fluoride ingested during toothbrushing. Thirty-three children were randomly divided into 3 groups, according to the [F] in the dentifrices: G-A (523 µgF/g), G-B (1,062 µgF/g) and G-C (1,373 µgF/g). Dentifrices A and B are marketed for children, while dentifrice C is a regular product. The amount of F ingested was indirectly obtained, subtracting the amount expelled and the amount left on the toothbrush from the amount initially loaded onto the brush. The results were analyzed by ANOVA, Tukey's test and linear regression analysis (p < 0.05). Children ingested around 60% of the dentifrice loaded onto the brush, but no significant differences were seen among the groups (p > 0.05). Mean daily fluoride intake from dentifrice for G-A, G-B and G-C was 0.022ª, 0.032ª and 0.061b mg F/kg body weight, respectively (p < 0.01). There was a strong positive correlation (r = 0.86, p < 0.0001) between the amount of dentifrice used and the amount of fluoride ingested during toothbrushing. The results indicate the need for instructing children's parents and care givers to use a small amount of dentifrice (< 0.3 g) to avoid excessive ingestion of fluoride. The use of low-[F] dentifrices by children younger than 6 years also seems to be a good alternative to minimize fluoride intake. Dentifrice flavor did not influence the percentage of fluoride intake.

Fluoride concentrations in industrialized beverages consumed by children in the city of Bauru, Brazil

The increasing consumption of juices, soft drinks and teas among children has increased significantly fluoride ingestion at the age range of risk for development of dental fluorosis.

OBJECTIVE

The purpose of this study was to evaluate fluoride concentrations in some brands of industrialized beverages consumed by children in the city of Bauru, SP, Brazil.

MATERIAL AND METHODS

98 brands of beverages were analyzed, divided into 3 lots, comprising 36, 32 and 30 brands, respectively, for the first, second and third lots. Fluoride concentrations were determined by HMDS-facilitated diffusion, using a fluoride ion-specific electrode (Orion 9409).

RESULTS

Fluoride concentrations ranged between 0.04 and 1.76 microg F/mL. It was observed a wide variation in fluoride concentrations among the different brands, as well as the different lots of the same brand. There was no information on fluoride concentrations on the labels of any product.

CONCLUSIONS

Some of the products analyzed could contribute significantly to the total fluoride intake and, thus, be important risk factors for development of dental fluorosis, which indicates the need of controlling the production of these beverages with respect to fluoride concentration.