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Lavalle-Carrasco J, Vergara-Onofre M, González-González R, Bologna-Molina R, Isiordia-Espinoza MA, Gaona E, Molina-Frechero N. A Systematic Review and Meta-Analysis of the Relationship Between the Severity of Dental Fluorosis and Fluoride Biomarkers in Endemic Areas. Biol Trace Elem Res 2023; 201:1051-1062. [PMID: 35397104 DOI: 10.1007/s12011-022-03227-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/30/2022] [Indexed: 02/07/2023]
Abstract
The intake of high concentrations of fluoride, mainly through drinking water, diet and fluoridated dentifrices, produces fluorosis, which in its early stages is manifested as dental fluorosis (DF). To recognize exposure to fluoride in endemic areas and to evaluate the risk of developing health impairment, the WHO has established several biomarkers that are used to determine systemic fluorine (F-) exposure. Thus, the aim of this study was to conduct a systematic review and meta-analysis of the relationship between the severity of DF and fluoride biomarkers in endemic areas. The protocol of this study was previously registered as CRD42021244974. A digital search was carried out in PubMed/Medline, SpringerLink, Scopus, Cochrane and Google Scholar by employing the keywords "urine", "nails", "hair", "plasma", "saliva" and "dental fluorosis" for the original studies with content associated with F- for the biomarkers and DF. The mean difference was established as the effect measure for the meta-analysis. Seven studies fulfilled the eligibility criteria, among which five assessed urine and two employed nails as fluoride biomarkers. A positive significant difference was found between the biomarkers and the severity of DF (0.27, p < 0.001) and individually for each biomarker (urine: 0.14, p = 0.001; nails: 0.88, p < 0.05). The F- concentration in urine and nails is correlated with the severity of DF, with the most evident differences between healthy individuals and those with mild severity. Both biomarkers are adequate to assess this relationship in endemic areas of fluoride and DF.
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Affiliation(s)
- Jesús Lavalle-Carrasco
- Dental Sciences, Autonomous Metropolitan University Xochimilco (UAM), 04960, Mexico City, Mexico
| | - Marcela Vergara-Onofre
- Division of Biological and Health Sciences, Autonomous Metropolitan University Xochimilco (UAM), 04960, Mexico City, Mexico
| | - Rogelio González-González
- Department of Research, School of Dentistry, Juarez University of the Durango State (UJED), 34000, Durango, Mexico
| | - Ronell Bologna-Molina
- Department of Research, School of Dentistry, Juarez University of the Durango State (UJED), 34000, Durango, Mexico
- Molecular Pathology Area, School of Dentistry, University of the Republic (UDELAR), 11200, Montevideo, Uruguay
| | - Mario Alberto Isiordia-Espinoza
- Institute of Research in Medical Sciences, Department of Clinics, Los Altos University Center, University of Guadalajara (UdG), 47650, Tepatitlán de Morelos, Jalisco, Mexico
| | - Enrique Gaona
- Division of Biological and Health Sciences, Autonomous Metropolitan University Xochimilco (UAM), 04960, Mexico City, Mexico
| | - Nelly Molina-Frechero
- Division of Biological and Health Sciences, Autonomous Metropolitan University Xochimilco (UAM), 04960, Mexico City, Mexico.
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Michel-Crosato E, Raggio DP, Coloma-Valverde ANDJ, Lopez EF, Alvarez-Velasco PL, Medina MV, Balseca MC, Quezada-Conde MDC, de Almeida Carrer FC, Romito GA, Araujo ME, Biazevic MGH, Braga MM, Fratucci MVB, Mendes FM, Frias AC, Pannuti CM. Oral health of 12-year-old children in Quito, Ecuador: a population-based epidemiological survey. BMC Oral Health 2019; 19:184. [PMID: 31412847 PMCID: PMC6694588 DOI: 10.1186/s12903-019-0863-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/24/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND There is a paucity of population-based surveys on oral health conditions in Ecuador. Thus, the aim of this study was to conduct an epidemiological survey with a representative sample of children aged 12 years from public schools of Quito, Ecuador. The aim of this initial report was to describe the methodology used in the survey, as well to present results regarding calibration procedures and prevalence of oral-health related outcomes. METHODS We invited 33 public schools' coordinators from the urban area of Quito, and 1100 children (12 years old) to take part in this study. Six trained and calibrated examiners conducted clinical examinations using oral mirrors and ball-ended probes to assess: dental caries, traumatic dental injuries, malocclusion, gingival bleeding, presence of calculus and fluorosis. Children also responded a questionnaire on Oral Health-Related Quality of Life (OHRQoL). Individual sociodemographic data was collected through a questionnaire sent to parents. Moreover, some contextual data on school environment (infrastructure conditions, promotion of health practices and negative episodes) were also evaluated. Prevalence values, crude and weighted by sampling weights, and 95% confidence intervals (95%CI) were calculated. RESULTS Nine hundred and ninety-eight children from 31 schools were examined from March to May 2017. The adjusted prevalence values (95%CI) for the six outcomes evaluated were: dental caries = 60.3% (55.3 to 65.0%); traumatic dental injuries = 20.7% (17.2 to 24.8%); dental fluorosis = 63.7% (58.5 to 68.5%); gingival bleeding = 92.0% (87.1 to 95.2%); presence of calculus = 69.9 (60.5 to 77.9%); and malocclusion = 25.8% (21.8 to 30.3%). Adjusted mean of number of decayed, missed or filled permanent teeth (DMF-T) was 1.61 (1.37 to 1.84). Results on OHRQoL and other contextual variables will be reported in other articles. CONCLUSION The prevalence of the majority of oral health problems in 12-year-old children from public schools in Quito-Ecuador was compatible with those observed in other similar cities. However, periodontal health and fluorosis seem to be highly prevalent in children from Quito.
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Affiliation(s)
- Edgard Michel-Crosato
- Graduate Program in Dental Sciences, School of Dentistry, University of Sao Paulo, Av Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - Daniela Prócida Raggio
- Graduate Program in Dental Sciences, School of Dentistry, University of Sao Paulo, Av Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - Alba Narcisa de Jesus Coloma-Valverde
- Graduate Program in Dental Sciences, School of Dentistry, University of Sao Paulo, Av Lineu Prestes, 2227, São Paulo, 05508-000, Brazil.,School of Dentistry, Universidad Central del Ecuador, Quito, Ecuador
| | - Edisson Fernando Lopez
- Graduate Program in Dental Sciences, School of Dentistry, University of Sao Paulo, Av Lineu Prestes, 2227, São Paulo, 05508-000, Brazil.,School of Dentistry, Universidad Central del Ecuador, Quito, Ecuador
| | - Patricia Lourdes Alvarez-Velasco
- Graduate Program in Dental Sciences, School of Dentistry, University of Sao Paulo, Av Lineu Prestes, 2227, São Paulo, 05508-000, Brazil.,School of Dentistry, Universidad Central del Ecuador, Quito, Ecuador
| | - Marco Vinicio Medina
- Graduate Program in Dental Sciences, School of Dentistry, University of Sao Paulo, Av Lineu Prestes, 2227, São Paulo, 05508-000, Brazil.,School of Dentistry, Universidad Central del Ecuador, Quito, Ecuador
| | - Mariela Cumanda Balseca
- Graduate Program in Dental Sciences, School of Dentistry, University of Sao Paulo, Av Lineu Prestes, 2227, São Paulo, 05508-000, Brazil.,School of Dentistry, Universidad Central del Ecuador, Quito, Ecuador
| | - Maritza Del Carmen Quezada-Conde
- Graduate Program in Dental Sciences, School of Dentistry, University of Sao Paulo, Av Lineu Prestes, 2227, São Paulo, 05508-000, Brazil.,School of Dentistry, Universidad Central del Ecuador, Quito, Ecuador
| | - Fernanda Campos de Almeida Carrer
- Graduate Program in Dental Sciences, School of Dentistry, University of Sao Paulo, Av Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - Giuseppe Alexandre Romito
- Graduate Program in Dental Sciences, School of Dentistry, University of Sao Paulo, Av Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - Maria Ercilia Araujo
- Graduate Program in Dental Sciences, School of Dentistry, University of Sao Paulo, Av Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - Maria Gabriela Haye Biazevic
- Graduate Program in Dental Sciences, School of Dentistry, University of Sao Paulo, Av Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - Mariana Minatel Braga
- Graduate Program in Dental Sciences, School of Dentistry, University of Sao Paulo, Av Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - Maristela Vilas Boas Fratucci
- Graduate Program in Dental Sciences, School of Dentistry, University of Sao Paulo, Av Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - Fausto Medeiros Mendes
- Graduate Program in Dental Sciences, School of Dentistry, University of Sao Paulo, Av Lineu Prestes, 2227, São Paulo, 05508-000, Brazil.
| | - Antonio Carlos Frias
- Graduate Program in Dental Sciences, School of Dentistry, University of Sao Paulo, Av Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - Claudio Mendes Pannuti
- Graduate Program in Dental Sciences, School of Dentistry, University of Sao Paulo, Av Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
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