Dental caries in fluorine exposure areas in China

Simulation study on the migration of F- in soil around Chagan Lake, China

Chagan Lake is located in the high-fluorine area of western Jilin, with high fluoride content in surface water, soil, and groundwater around it. Due to its unique topography and hydrogeological conditions, Chagan Lake collects surrounding water and is closely connected with groundwater. The complex surrounding water not only affects the groundwater quality through Chagan Lake, but also affects groundwater through the infiltration of vadose zone. In order to further study the characteristics of the migration of F^- in the soil around Chagan Lake along with water flow in the vadose zone and its impact on groundwater, soil column experiments were carried out using soil collected in the field, combined with HYDRUS-1D to simulate the migration characteristics of F^-. The model was verified by measured data, the sensitivity of each parameter was analyzed by the single-factor disturbance method, and the effect of F^- on groundwater was simulated and predicted. The results showed that (1) the soil column experiment was carried out using transport solutions of different pH value. The time required for F^- to penetrate the soil column under alkaline conditions was shorter, and the HYDRUS model used has a high degree of fitting. (2) The single-factor disturbance method is used to analyze the sensitivity of the parameters. The parameters that have a greater impact on the migration of fluoride ions in the soil are saturated hydraulic conductivity, adsorption coefficient, and soil bulk density. (3) In the prediction scenario, due to the adsorption and interception of the vadose zone, as the depth increases, the time it takes for F^- to accumulate is also longer. The groundwater around Chagan Lake is relatively shallow, and surface F^- in alkaline environment reaches the underground aquifer within 2 days. The F^- concentration in the groundwater reaches its maximum before the end of the irrigation period. In neutral environment, the F^- concentration in groundwater did not reach the maximum before the end of the irrigation period.

Immobilization of fluoride in the sediment of mine drainage stream using loess, Northwest China

Fluoride (F) is a necessary trace element in the human body, which would lead to some diseases if human body lacks or accumulates it excessively (1-1.5 mg d^-1). Fluoride contamination in sediments has become more and more serious, which has potential hazards to human body. In this paper, a novel sorbent (loess) was proposed to immobilize trace element F in sediment. The effectiveness of loess on F stabilization was evaluated by decreasing F bioavailability in contaminated sediment. The loess and the sediment were mixed at different proportions for stabilization. About 70 days after the application of loess, the soil column was subject to simulate acid rain leaching test to observe the leaching-migration of F, which can be used to predict the leaching migration of F in the study area. The results showed that when the loess dose was 5 kg, the loess converted highly effective fractions of F (i.e., water-soluble and exchangeable fractions) into a more stable state (i.e., residual state). After 30 days of leaching with HNO₃ solution with pH at 3.0, the lowest concentration of F was found in the leachate of soil column with 2 kg loess application. Correlation analysis showed that the F concentration in soil column profile was affected by CaCO₃, EC, pH, and OM, of which, pH and CaCO₃ have greater influence than other factors.

Refractive Errors in Northern China Between the Residents with Drinking Water Containing Excessive Fluorine and Normal Drinking Water

The purpose of this study was to evaluate the refractive errors and the demographic associations between drinking water with excessive fluoride and normal drinking water among residents in Northern China. Of the 1843 residents, 1415 (aged ≥40 years) were divided into drinking-water-excessive fluoride (DWEF) group (>1.20 mg/L) and control group (≤1.20 mg/L) on the basis of the fluoride concentrations in drinking water. Of the 221 subjects in the DWEF group, with 1.47 ± 0.25 mg/L (fluoride concentrations in drinking water), the prevalence rates of myopia, hyperopia, and astigmatism were 38.5 % (95 % confidence interval [CI] = 32.1-45.3), 19.9 % (95 % CI = 15-26), and 41.6 % (95 % CI = 35.1-48.4), respectively. Of the 1194 subjects in the control group with 0.20 ± 0.18 mg/L, the prevalence of myopia, hyperopia, and astigmatism were 31.5 % (95 % CI = 28.9-34.2), 27.6 % (95 % CI = 25.1-30.3), and 45.6 % (95 % CI = 42.8-48.5), respectively. A statistically significant difference was not observed in the association of spherical equivalent and fluoride concentrations in drinking water (P = 0.84 > 0.05). This report provides the data of the refractive state of the residents consuming drinking water with excess amounts of fluoride in northern China. The refractive errors did not result from ingestion of mild excess amounts of fluoride in the drinking water.

Geochemical processes regulating F-, as and NO3- content in the groundwater of a sector of the Pampean Region, Argentina

The presence of F(-) and As in groundwater is common in volcanic aquifers. Excessive concentrations of these ions affect the quality of drinking water and can be harmful to health. When there is an anthropogenic source in phreatic aquifers, NO3(-) is incorporated to the groundwater components, deteriorating its quality. The objective of this work is to assess the geochemical processes that regulate the contents of F(-), As and NO3(-) of the groundwater in a sector of the Pampean Region in Argentina. This area is supplied with water by exploiting a multilayer aquifer, composed of a phreatic aquifer occurring in loess sediments and a fluvial semi-confined aquifer, separated by an aquitard. The results obtained show that the phreatic aquifer has a higher concentration of F(-), As and NO3(-) than the semi-confined aquifer. Fluoride derives from the dissolution of volcanic glass at a slightly alkaline pH and from anion exchange; however, it may also be absorbed by the reprecipitating carbonates. The As is released by desorption, with the main source being the glass and lithic fragments of the loess. The NO3(-) originates from the decomposition of organic matter, mainly in the septic tanks of the peri-urban areas. Meanwhile, the As and F(-) content in the semi-confined aquifer is lower and its origin is the result of water inflow by vertical downward infiltration from the phreatic aquifer through the aquitard. The Pampean Region is one of the areas with the largest volume of agricultural exports in the world and at present it is undergoing a strong social and economic growth. Understanding the geochemical processes that regulate the quality of drinking water is of vital importance to generate water management guidelines aiming at minimizing the deterioration of drinking water sources.

Water fluoridation for the prevention of dental caries

BACKGROUND

Dental caries is a major public health problem in most industrialised countries, affecting 60% to 90% of school children. Community water fluoridation was initiated in the USA in 1945 and is currently practised in about 25 countries around the world; health authorities consider it to be a key strategy for preventing dental caries. Given the continued interest in this topic from health professionals, policy makers and the public, it is important to update and maintain a systematic review that reflects contemporary evidence.

OBJECTIVES

To evaluate the effects of water fluoridation (artificial or natural) on the prevention of dental caries.To evaluate the effects of water fluoridation (artificial or natural) on dental fluorosis.

SEARCH METHODS

We searched the following electronic databases: The Cochrane Oral Health Group's Trials Register (to 19 February 2015); The Cochrane Central Register of Controlled Trials (CENTRAL; Issue 1, 2015); MEDLINE via OVID (1946 to 19 February 2015); EMBASE via OVID (1980 to 19 February 2015); Proquest (to 19 February 2015); Web of Science Conference Proceedings (1990 to 19 February 2015); ZETOC Conference Proceedings (1993 to 19 February 2015). We searched the US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization's WHO International Clinical Trials Registry Platform for ongoing trials. There were no restrictions on language of publication or publication status in the searches of the electronic databases.

SELECTION CRITERIA

For caries data, we included only prospective studies with a concurrent control that compared at least two populations - one receiving fluoridated water and the other non-fluoridated water - with outcome(s) evaluated at at least two points in time. For the assessment of fluorosis, we included any type of study design, with concurrent control, that compared populations exposed to different water fluoride concentrations. We included populations of all ages that received fluoridated water (naturally or artificially fluoridated) or non-fluoridated water.

DATA COLLECTION AND ANALYSIS

We used an adaptation of the Cochrane 'Risk of bias' tool to assess risk of bias in the included studies.We included the following caries indices in the analyses: decayed, missing and filled teeth (dmft (deciduous dentition) and DMFT (permanent dentition)), and proportion caries free in both dentitions. For dmft and DMFT analyses we calculated the difference in mean change scores between the fluoridated and control groups. For the proportion caries free we calculated the difference in the proportion caries free between the fluoridated and control groups.For fluorosis data we calculated the log odds and presented them as probabilities for interpretation.

MAIN RESULTS

A total of 155 studies met the inclusion criteria; 107 studies provided sufficient data for quantitative synthesis.The results from the caries severity data indicate that the initiation of water fluoridation results in reductions in dmft of 1.81 (95% CI 1.31 to 2.31; 9 studies at high risk of bias, 44,268 participants) and in DMFT of 1.16 (95% CI 0.72 to 1.61; 10 studies at high risk of bias, 78,764 participants). This translates to a 35% reduction in dmft and a 26% reduction in DMFT compared to the median control group mean values. There were also increases in the percentage of caries free children of 15% (95% CI 11% to 19%; 10 studies, 39,966 participants) in deciduous dentition and 14% (95% CI 5% to 23%; 8 studies, 53,538 participants) in permanent dentition. The majority of studies (71%) were conducted prior to 1975 and the widespread introduction of the use of fluoride toothpaste.There is insufficient information to determine whether initiation of a water fluoridation programme results in a change in disparities in caries across socioeconomic status (SES) levels.There is insufficient information to determine the effect of stopping water fluoridation programmes on caries levels.No studies that aimed to determine the effectiveness of water fluoridation for preventing caries in adults met the review's inclusion criteria.With regard to dental fluorosis, we estimated that for a fluoride level of 0.7 ppm the percentage of participants with fluorosis of aesthetic concern was approximately 12% (95% CI 8% to 17%; 40 studies, 59,630 participants). This increases to 40% (95% CI 35% to 44%) when considering fluorosis of any level (detected under highly controlled, clinical conditions; 90 studies, 180,530 participants). Over 97% of the studies were at high risk of bias and there was substantial between-study variation.

AUTHORS' CONCLUSIONS

There is very little contemporary evidence, meeting the review's inclusion criteria, that has evaluated the effectiveness of water fluoridation for the prevention of caries.The available data come predominantly from studies conducted prior to 1975, and indicate that water fluoridation is effective at reducing caries levels in both deciduous and permanent dentition in children. Our confidence in the size of the effect estimates is limited by the observational nature of the study designs, the high risk of bias within the studies and, importantly, the applicability of the evidence to current lifestyles. The decision to implement a water fluoridation programme relies upon an understanding of the population's oral health behaviour (e.g. use of fluoride toothpaste), the availability and uptake of other caries prevention strategies, their diet and consumption of tap water and the movement/migration of the population. There is insufficient evidence to determine whether water fluoridation results in a change in disparities in caries levels across SES. We did not identify any evidence, meeting the review's inclusion criteria, to determine the effectiveness of water fluoridation for preventing caries in adults.There is insufficient information to determine the effect on caries levels of stopping water fluoridation programmes.There is a significant association between dental fluorosis (of aesthetic concern or all levels of dental fluorosis) and fluoride level. The evidence is limited due to high risk of bias within the studies and substantial between-study variation.

Fluoride contamination - Artificial neural network modeling and inverse distance weighting approach

The underground waters in the Mamundiyar basin, India, present real chemical quality problems. Their fluoride content always exceeds the recommended levels. The Inverse Distance Weighted (IDW) method has been used for spatial interpolation of various key chemical parameters. Artificial Neural Network (ANN) modeling was applied to understand the correlation and sensitivity of all chemical parameters with respect to fluorides. The correlation of all the considered parameters is found to be poor where the highest correlation observed was only 0.37. This result showed that four of the parameters, namely pH, chlorides, sulphates and calcium, were found to have greater capacity of influencing fluorides than the other eight parameters. Chlorides were found to be the parameter that was the most sensitive and most correlated to fluorides.