Fluoride content of bottled drinking waters available in Riyadh, Saudi Arabia

Fluoride levels in Almadinah Almunawwarah bottled water

Objectives

This research aimed to determine the fluoride levels in commercially available bottled waters and assess the accuracy of the fluoride levels labels on the bottles.

Methods

We obtained the labels from 28 water bottles from markets in Almadinah Almunawwarah. Water samples were diluted with an equal volume of total ionic strength adjustment buffer at the General Administration for Water Services. The electrode potential of each sample was then directly compared to standard fluoride solutions. For each sample, two readings were taken, and the average was recorded. Fluoride-ion levels were determined using a fluoride-ion-selective electrode and a digital readout ion meter.

Results

On average, the mean fluoride levels in the labelled bottles were 0.94 ± 0.14 PPM. The level of the actual fluoride content was 1.13 ± 0.31 PPM. Inconsistencies between the brand labels and true levels of fluoride were detected. Only one brand of bottled water was comparable in terms of the fluoride levels on the labels and the analysed fluoride levels. Only 85.71% of the brands tested had fluoride levels within the permissible fluoride range (0.6-1.5 PPM), 10.71% had fluoride levels above the permissible fluoride range, and 3.57% had fluoride levels below the permissible fluoride range.

Conclusions

In the KSA, most brands of bottled waters had fluoride levels above the ideal levels that are vital to the prevention of dental caries. There were differences in the fluoride levels recorded on the labels and the true levels determined in the laboratory. Fluoride levels must be accurately reported if we are to achieve necessary aesthetic and cosmetic benefits. Bottled water must meet critical quality standards to avoid the negative consequences of higher fluoride levels. Dentists and parents should be aware of this discrepancy.

Health risk assessment of fluoride exposure due to groundwater consumption in Romania

Fluoride has both beneficial and detrimental effects on human health. Concentrations of fluoride less than 1.0 mg/L in ingested water are beneficial for the rate of tooth decay, especially in children. The aims of the paper are as follows: (i) to monitor fluoride concentrations in drinking water samples (well water and tap water from the rural district of Valea Râmnicului, Romania); (ii) to study and select the optimal buffer solution and the optimal volume used in the analyses and (iii) to validate the potentiometric method for determining fluoride ions with a selective ion electrode. The values of fluoride ion concentrations in the groundwater samples and in tap water varied from 0.01 to 0.138 mg^/L. The values for the hazard quotient for the studied samples varied from 0.01 to 0.13.

Dietary Micronutrients from Zygote to Senility: Updated Review of Minerals' Role and Orchestration in Human Nutrition throughout Life Cycle with Sex Differences

Micronutrients such as selenium, fluoride, zinc, iron, and manganese are minerals that are crucial for many body homeostatic processes supplied at low levels. The importance of these micronutrients starts early in the human life cycle and continues across its different stages. Several studies have emphasized the critical role of a well-balanced micronutrient intake. However, the majority of studies looked into or examined such issues in relation to a specific element or life stage, with the majority merely reporting the effect of either excess or deficiency. Herein, in this review, we will look in depth at the orchestration of the main element requirements across the human life cycle beginning from fertility and pregnancy, passing through infancy, childhood, adolescence, and reaching adulthood and senility, with insight on the interactions among them and underlying action mechanisms. Emphasis is given towards approaches to the role of the different minerals in the life cycle, associated symptoms for under- or overdoses, and typical management for each element, with future perspectives. The effect of sex is also discussed for each micronutrient for each life stage as literature suffice to highlight the different daily requirements and or effects.

Monitoring of Fluoride Content in Drinking Water by Ion Chromatography: A Case Study in the Suzhou Urban Area, China

BACKGROUND

Both deficient and excessive intake of fluoride can lead to adverse health problems.

OBJECTIVE

The aim of this study is to investigate the fluoride content in three types of drinking water in Suzhou urban area.

METHOD

Ion chromatography was employed to conduct the validation of analysis of fluoride ion in water and the method was applied to analyze the concentration of fluoride in 22 drinking water samples, including tap water, purified water, and commercially available bottled water, collected from five municipal districts of Suzhou urban area.

RESULTS

The used method was validated in the range of 0.05 and 2.00 mg/L with good repeatability and accuracy. Results of water analysis indicated that fluoride content in tap water ranged from 0.267 to 0.336 mg/L (average 0.304 mg/L), and the levels of fluoride in purified water and bottled water were 0.068-0.317 mg/L (average 0.134 mg/L) and 0-0.120 mg/L (average 0.080 mg/L), respectively.

CONCLUSION

The amount of fluoride in all samples analyzed were lower than the limit set for fluoride in drinking water according to the China standard (1.0 mg/L). The low fluoride exposure for the population in the studied area was observed, and the replacement of tap water with purified and bottled water could further aggravate the deficient of fluoride intake for local residents.

HIGHLIGHTS

The present study carried out is the first to characterize the fluoride content in these three types of drinking water in Suzhou urban area by ion chromatography.

A systematic comparison between infant formula compositions using the Bray-Curtis Similarity Index

BACKGROUND

Making an informed choice between the available infant formulas is challenging, as there is no unbiased tool allowing a systematic comparison between the very long lists of infant formula compositions.

AIM

The aim is to present the Bray-Curtis Similarity Index (BCSI) as a tool for systematic comparison between standard stage-1 infant formula (SS-1-IF) compositions.

METHODS

We obtained the nutrient levels from the packaging labels of 23 SS-1-IFs available in Al-Ahsa, Saudi Arabia, in April 2018. The international legislations that launched infant formula standards endorse targeting the minimum rather than the maximum proposed nutrients levels. Thus, we blindly compared between displayed nutrients levels on each of the 23-studied SS-1-IF and the minimum international proposed nutrient levels via using the BCSI.

RESULTS

The range of the total displayed components was 38-57. Except for docosahexaenoic acid, all displayed components were within the standard recommended range. The BCSI summarized all displayed nutrients in a single number. The BCSI of the studied SS-1-IF ranged from 0.4141 to 0.79730. We ranked the 23 studied SS-1-IFs based on the higher BCSI is the closer to the minimum proposed nutrient levels. A dendrogram segregated the SS-1-IFs into four clusters based on their BSCI and total numbers of all displayed components.

CONCLUSIONS

We think the BCSI is an appropriate tool for a systematic comparison between SS-1-IFs compositions and may help for choosing a SS-1-IF.

Annual variation of fluoride level in drinking water in certain regions of the Republic of North Macedonia

Fluoride levels in drinking water varies in a wide range, which mainly depends on the geological and physical-chemical characteristics of the soil, the porosity of the mineral rocks in the region, the temperature, and the depth of the aquifer. When present at appropriate levels is recommended for prevention of dental caries, but high levels may provoke fluorosis. Hence, determination of fluoride concentration considering the balance between benefits and risks to health is an important parameter for the water quality assessment. In this study, the annual variation of fluorides in drinking water comprising different regions of the Republic of North Macedonia was analyzed. The total dissolved fluoride was determined potentiometrically using a fluoride combined ion-selective electrode (ISE) and a pH meter with an enlarged millivolt (mV) scale. WHO recommended fluoride in drinking water to range from 0.5 to 1.5 mg/L in order good health of teeth to be provided. The results of this study indicated that analyzed 104 samples of water contained fluorides in lower quantities compared to upper safety limit established by our national legislation and Guidelines for Drinking Water Quality of the WHO. During the summer period, in the majority of the samples fluoride levels were further reduced compared to other seasons, which may due to a lower amount of rain. With regard to this, the obtained data for relatively low fluoride levels in water may serve to dentists both in clinical practice and public dental health, implying current information necessary for advising on fluoride supplementation to people. Keywords: Fluoride, drinking water, fluoride analysis, potentiometric method

Contribution of preventive methods in controlling caries among Saudi primary schoolchildren: a population-based cross-sectional study

OBJECTIVE

This study assessed the association between caries preventive measures including regular dental checkups, twice a day tooth brushing using fluoridated toothpaste and pit and fissure sealants on one side and the presence of caries among primary schoolchildren in the Eastern Province of Saudi Arabia.

MATERIALS AND METHODS

A cross-sectional study was conducted in 2016 including 1198, 6-12-year-old children from 13 randomly selected schools. The outcome variable was caries presence. The explanatory variables were brushing twice a day using fluoridated toothpaste, the presence of sealant and regular dental checkups. Multivariable logistic regression model was conducted to assess the associations controlling for confounders (age, gender, ability to get treatment, being health insured and school) using SPSS version 20.0.

RESULTS

Data of 921 participants (83.8%) were available. The prevalence of caries was 63.5%, whereas 67.6% brushed their teeth twice a day, 28.3% visited the dentist for regular checkups and 7.6% had sealant. In multivariable regression, out of the three main explanatory variables, only having regular checkups was significantly associated with caries presence (OR = 0.65, 95% CI = 0.48, 0.88).

CONCLUSIONS

Lower odds of caries presence were associated with regular dental checkups but not with regular brushing or having sealant.

Fluoride Concentration of Water Supply in Eastern Saudi Arabia: A Preliminary Study

BACKGROUND

Community water fluoridation is known to play a significant role in enhancing oral health by reducing the incidence of dental caries. However, the level of fluoride in the supplied public water in the Eastern Province of Saudi Arabia is unknown.

OBJECTIVE

To determine water fluoride levels at the main sources supplying water to households and schools in two major cities (Dammam and Al-Khobar) of the Eastern Province of Saudi Arabia.

METHODS

From the Directorate of Water Agency and Directorate of Education, the following were identified as the main sources of public water supply in Dammam and Al-Khobar: the water agency, public water tanks and four contracted companies. Two samples were collected from each of these six identified water sources at two different time points (in January and July 2016; 2 samples/site/time point; N = 24) using 500 mL polythene bottles. Each sample was analyzed using an ion chromatography system at different detection limits (including the lowest detection limit of 0.065 ppm) to determine the fluoride level.

RESULTS

There was no fluoride detected in any sample even at the lowest detection limit, indicating that fluoride levels in the studied water samples were <0.065 ppm.

CONCLUSION

This study found that in the cities studied, fluoride levels, if any, are considerably below the optimum recommended level for the prevention of dental caries (i.e., 0.7 ppm).

Isotopic composition of bottled water in Saudi Arabia

The ¹⁸O/¹⁶O and ²H/¹H ratios of 18 water brands representing the most popular bottled water brands in the Saudi market were measured using a system based on the latest advancements in tunable off-axis integrated cavity output diode laser spectroscopy (OA-ICOS) in the near-infrared spectral region. Utilizing δ¹⁸O and the δ²H values of locally produced water samples, a meteoric water line (δ²H = 7.84 δ¹⁸O + 2.11) was extracted and found to be consistent with the slope of the global meteoric water line (GMWL) and the geographic location of Saudi Arabia.

Health risk assessment to fluoride in drinking water of rural residents living in the Poldasht city, Northwest of Iran

This study analyzes the concentrations and health risks of fluoride in 112 drinking water samples collected from 28 villages of the Poldasht city, West Azerbaijan province in Iran. Results indicated that fluoride content in drinking water ranged from0.27 to 10.3mgL^-1 (average 1.70mgL^-1). The 57% of samples analyzed exceeded the limit set for fluoride in drinking water. Based on findings from health risk assessment this study, the highest fluoride exposure for different regions of Poldasht city was observed in young consumers, children and teenager's groups. Also, most of the rural residents suffered from fluoride contaminated drinking water. The calculated HQ value was > 1 for all groups of residents in Agh otlogh and Sari soo areas. Therefore, it is imperative to take measures to reduce fluoride concentration in drinking water and control of fluorosis. Action should be implemented to enhance monitoring of fluoride levels to avoid the potential risk to the population.

Estimation of fluoride concentration in drinking water and common beverages in United Arab Emirates (UAE)

Objective

To assess fluoride concentration in drinking water which include tap water of 4 emirates - Abu Dhabi, Dubai, Sharjah and Ajman plus bottled water, commonly available soft drinks & juices in United Arab Emirates.

Methods

Five different samples of tap water collected from each of the four emirates of UAE: Ajman, Sharjah, Abu Dhabi and Dubai; twenty-two brands of bottled water and fifteen brands of popular cold beverages, purchased from different supermarkets in U.A.E were tested using ion selective electrode method and the fluoride concentration was determined.

Results

The mean fluoride content of tap water samples was 0.14 mg F/L with a range of 0.04–0.3 mg F/L; with Ajman tap water samples showing the highest mean fluoride content of 0.3 mg F/L. The mean fluoride content for both bottled drinking water and beverages was 0.07 mg F/L with a range of 0.02–0.50 mg F/L and 0.04–0.1 mg F/L respectively. Majority (68.2%) of the bottled water are produced locally within U.A.E while a few (31.8%) are imported.

Conclusions

The tap water, bottled water and beverages available in U.A.E show varying concentrations of fluoride, however none showed the optimal level necessary to prevent dental caries. Dental professionals in U.A.E should be aware of the fluoride concentrations before prescribing fluoride supplements to children.

Fluoride Content of Bottled Drinking Waters in Qatar

Fluoridation of drinking water has been recognized as one of the most effective ways of achieving community-wide exposure to the caries prevention effects of fluoride (F). A vast majority of people in Qatar use bottled water for drinking. Use of bottled water without knowing the F level may expose children to dental caries risk if the F level is lower than optimal or to dental fluorosis if the F level is too high. The aim of this study was to determine the F concentration of bottled water available in Qatar. A total of 32 brands of bottled water were evaluated. The F concentrations displayed on the labels were recorded. The F ion-selective electrode method was used to measure the F concentration in water samples, and three measurements were taken for every sample to ensure reproducibility. The p value was set at 0.05. The F concentration ranged from 0.06 to 3.0 ppm with a mean value of 0.8 ppm (±0.88). The F levels were provided by the manufacturers on the labels of 60 % of the samples, but this was significantly lower than the measured F levels (p < 0.0001). Moreover, bottled water that was produced in Saudi Arabia had significantly higher levels of F when compared to those produced in other countries (p < 0.05). There was a wide variation in the F levels in the different brands of bottled water. Furthermore, there was a significant disparity between the F levels which were measured and those that were provided on the labels.

Evaluation of fluoride levels in bottled water and their contribution to health and teeth problems in the United Arab Emirates

Fluoride is needed for better health, yet if ingested at higher levels it may lead to health problems. Fluoride can be obtained from different sources, with drinking water being a major contributor. In the United Arab Emirates (UAE), bottled water is the major source for drinking. The aim of this research is to measure fluoride levels in different bottled water brands sold in UAE, to determine whether fluoride contributes to better health or health problems. The results were compared to international and local standards. Fluoride was present in seven out of 23 brands. One brand exhibited high fluoride levels, which exceeded all standards, suggesting it may pose health problems. Other brands were either below or above standards, suggesting either contribution to better health or health problems, depending on ingested amount. A risk assessment suggested a potential for non-cancer effects from some brands. The results were compared to fluoride levels in bottled water sold in UAE and neighboring countries (e.g. Saudi Arabia, Qatar, Kuwait, and Bahrain), over 24 years, to reflect on changes in fluoride levels in bottled water in this region. The research presents the need for creating, stricter regulations that require careful fluoride monitoring and new regulations that require listing fluoride level on the bottled water label, internationally and regionally. The research will have local and global health impact, as bottled water sold in UAE and neighboring countries, is produced locally and imported from international countries, e.g. Switzerland, the USA, France, Italy, New Zealand, and Fiji.

The prevalence of dental fluorosis and its associated factors in Salem district

Context:

There are various regions in India that have high levels of fluoride in drinking water sources. Many people residing in such places suffer from dental fluorosis (DF).

Aims:

To evaluate the prevalence of DF in children residing in Salem and also to find any correlation between DF and other related factors.

Materials and Methods:

One school from each block of Salem (total 21 blocks) was selected for the study. A single examiner had evaluated untreated caries, lesions, and DF (for permanent anterior teeth and molars) using the Dean's fluorosis index, in all children. Water fluoride level determination at each school was done using the Tamil Nadu Water Fluoridation and Drainage Board field kit. Other factors that may have contributed to DF were assessed using a questionnaire, which was provided to each student. The data obtained were statistically analyzed using the SPSS software version 11.5.

Statistical Analysis:

Chi-square test was used for statistical analysis.

Results:

DF was present in 56.9% of the children examined. It was mostly seen in 9 years old (72%) and male (59%) children. A positive correlation was found between the occurrence of DF and the duration of residence in a place with high water fluoride content, consumption of borewell water (64%), the parts per million of fluoride in drinking water, consumption of black tea (59%). However, no correlation was found between DF, dental caries, consumption of milk, or consumption of foods cooked in aluminum vessels.

Conclusion:

There was a correlation between DF and factors such as male gender, bore well water consumption, black tea consumption and the duration of residence in a place with high water fluoride content.

Fluoride Content of Bottled Drinking Water in Chennai, Tamilnadu

CONTEXT

The optimum level of fluoride in drinking water is 0.7 to 1.2 ppm. Decreased fluoride concentration leads to increased risk of caries and increased concentration can lead to dental or skeletal fluorosis. One crore liters of water is supplied to Chennai and surrounding areas through pouches and bottles which carters about one third of city population.

AIM

The aim of this study is to determine the fluoride concentration in top 10 bottled waters in Chennai and to check the accuracy of their labelling.

MATERIALS AND METHODS

Top selling bottled waters, 6 multinational and 4 Non- multinational brands were selected for the study. Three different batches of each brand were purchased. The labels of the bottled were removed after collecting the details regarding fluoride content. All the bottles were numbered and sent for fluoride content analysis using SPADNS calorimetric method.

RESULTS

All the brands and batches which were analysed for the study had less than optimal fluoride content and there is a significant variation in fluoride concentration of each brand and among different batches of same brand bottled waters. The range of fluoride level in tested samples was between 0.27 to 0.59. Only one brand's label had information regarding the fluoride content.

CONCLUSION

Standardization of fluoride levels in bottled waters and labelling of fluoride content should become mandatory.