Fluoride content in bottled waters, juices and carbonated soft drinks in Mexico City, Mexico

Soft Drinks as a Dietary Source of Fluoride Exposure

High fluoride exposures can lead to adverse effects such as dental and bone fluorosis, as well as endocrine and cognitive developmental problems. Water is the main dietary source of this ion, although significant concentrations have also been detected in other beverages widely consumed by the population such as soft drinks. A total of 200 soft drink samples (60 flavoured, 70 extracts, 60 fruit juice and 10 soft drinks) were analysed by fluoride ion selective potentiometry. A consumption of 330 mL was estimated for exposure assessment and subsequent F-risk assessment by soft drink consumption. The highest average concentration was found in extract soft drinks (2.45 ± 1.15 mg/L), followed by flavoured (1.71 ± 2.29 mg/L) and carbonated soft drinks (1.38 ± 0.40 mg/L), while the lowest was found in fruit juice soft drinks (1.09 ± 0.62 mg/L). The flavours with the highest concentration were tea-melon and tea-passion fruit with 3.66 ± 0.40 and 3.17 ± 0.56 mg/L respectively and the lowest was lemon flavour with 0.69 mg/L. The contribution of these beverages, considering the UL (Upper level) reference values set by EFSA (European Food Safety Authority) are between 3.28-41.78%, depending on age group and sex.

Fluoride Exposure through Different Drinking Water Sources in a Contaminated Basin in Guanajuato, Mexico: A Deterministic Human Health Risk Assessment

Water fluoride levels above the World Health Organization’s guideline (1.5 mg/L), common in overexploited aquifers, represent a health hazard. Our objective was to assess the health risks posed by exposure to fluoride in different drinking water sources in a contaminated basin in Mexico. Fluoride was measured in mutual drinking water sources and in the urine of 39 children and women. Risks were estimated through hazard quotient (HQ) by drinking water source. Dental fluorosis was assessed in the children. Mean fluoride water concentrations (mg/L) were: well, 4.2; waterhole, 2.7; bottled, 2.1; rainwater, 0.4. The mean urinary fluoride concentrations (specific gravity adjusted) were 2.1 mg/L and 3.2 mg/L in children and women, respectively. Our multiple linear regression model showed children’s urinary fluoride concentrations increased 0.96 mg/L for every 1 mg/L increase in water fluoride (p < 0.001). Dental fluorosis was diagnosed in 82% of the children, and their HQ according to drinking water source was: well, 1.5; waterhole, 1.1; bottled, 0.8; harvested rainwater, 0.3. The pervasive dental fluorosis indicates a toxic past fluoride exposure; urinary fluoride levels and HQs indicate high exposure and current health risks for most children. Drinking harvested rainwater will likely prevent most of the local fluoride exposure.

Dental Fluorosis: the Risk of Misdiagnosis-a Review

Fluoride has been considered as the single factor most frequently responsible for causing enamel mottling. However, in humans, either endogenous and/or exogenous factors not related to fluoride exposure may also cause enamel mottling. In this sense, various studies in the international literature have reported severe mottling of the teeth that could not be attributed to fluoride exposure. Thus, misdiagnosis of non-fluoride-induced enamel defects may occur frequently. Reports of unexpectedly high population prevalence and individual cases of fluorosis, where such diagnoses are irreconcilable with the identified fluoride history, highlight the necessity for a more precise definition and diagnosis of dental fluorosis. Also, a more discriminating diagnostic procedure is suggested. Particularly, positive identification of environmental fluoride levels to which the communities and individuals are exposed shall be developed before the confirmation of a diagnosis of fluorosis. It is considered that a more critical methodology for the diagnosis of fluorosis will be helpful in the rational use and control of fluorides for dental health, and in the identification of factors that may induce enamel defects.

Fluoride Content in Foods and Beverages From Mexico City Markets and Supermarkets

BACKGROUND

Sources of fluoride exposure for Mexicans include foods, beverages, fluoridated salt, and naturally fluoridated water. There are no available data describing fluoride content of foods and beverages consumed in Mexico.

OBJECTIVE

To measure the content of fluoride in foods and beverages typically consumed and to compare their content to that of those from the United States and the United Kingdom.

METHODS

Foods and beverages reported as part of the Mexican Health and Nutrition Survey (n = 182) were purchased in the largest supermarket chains and local markets in Mexico City. Samples were analyzed for fluoride, at least in duplicate, using a modification of the hexamethyldisiloxane microdiffusion method. Value contents were compared to those from the US Department of Agriculture and UK fluoride content tables.

RESULTS

The food groups with the lowest and highest fluoride content were eggs (2.32 µg/100 g) and seafood (371 µg/100 g), respectively. When estimating the amount of fluoride per portion size, the lowest content corresponded to eggs and the highest to fast foods. Meats and sausages, cereals, fast food, sweets and cakes, fruits, dairy products, legumes, and seafood from Mexico presented higher fluoride contents than similar foods from the United States or the United Kingdom. Drinks and eggs from the United States exhibited the highest contents, while this was the case for pasta, soups, and vegetables from the United Kingdom.

CONCLUSION

The majority of items analyzed contained higher fluoride contents than their US and UK counterparts. Data generated provide the first and largest table on fluoride content, which will be useful for future comparisons and estimations.

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.

Erosive characteristics and fluoride content of cola-type drinks

AIM

Excessive consumption of carbonated soft drinks is detrimental to general and oral health. This study determined endogenous pH, titratable acidity (TA) and fluoride (F) ion concentration of cola-type drinks available in the UK. Subsidiary aims were to compare: (i) endogenous pH and TA of drinks upon opening (T0) and after 20 minutes (T20); (ii) endogenous pH, TA and F ion concentration of diet vs regular and plastic bottle vs canned drinks.

METHODS

Endogenous pH, TA (mls 0.1M NaOH) and F ion (mg/L) of 71 products were measured using a pH meter and F-ISE. A Wilcoxon Signed Ranks Test compared pH and TAs at T0 and T20; a Mann-Whitney U test compared pH, TAs and F ion concentration for; a) regular vs diet drinks; and b) plastic bottle vs canned drinks.

RESULTS

Mean (±SD) pH for regular and diet drinks was 2.44 ± 0.12 and 2.83 ± 0.33 respectively (p = 0.001). Mean NaOH (ml) to raise pH to 5.5 and 5.7 was 5.49 ± 0.76 and 6.40 ± 0.78 (regular drinks); 5.17 ± 1.03 and 6.03 ± 1.07 (diet drinks). Diet (p = 0.040) and regular (p = 0.041) drinks had higher TA to pH 5.7 at T0 compared with T20; at T20 regular drinks had higher TA to pH 5.5 (p = 0.026) and pH 5.7 (p = 0.030) than diet drinks. There was no difference in F ion concentration between regular vs diet drinks (p = 0.754) and no significant container effect.

CONCLUSION

Erosive characteristics were similar between manufacturers, but higher erosive potentials were evident at T0 compared with 20 minutes later and for regular compared with diet drinks. F ion concentration of drinks was low.

[Fluoride content of bottled natural mineral waters in Spain and prevention of dental caries]

Objetivo

El propósito del estudio es conocer la concentración en flúor de las aguas minerales naturales comercializadas en España para poder prevenir la caries dental sin el riesgo de causar fluorosis dental.

Diseño

Estudio descriptivo y transversal a lo largo de 2012.

Emplazamiento

Aguas minerales naturales comercializadas en España.

Participantes

Tres muestras con fechas distintas de embotellado de 109 marcas de aguas minerales naturales (97 marcas españolas y 12 aguas importadas).

Medición principal

Determinación analítica por cromatografía iónica del contenido en fluoruro en el agua.

Resultados

La concentración mediana de fluoruro de las aguas minerales naturales españolas es de 0,22 (rango 0,00-4,16; rango intercuartil: 0,37). La gran mayoría (61 marcas, 62%) contenían menos de 0,30 mg/L. Hay 19 marcas que contienen más de 0,6 mg/L. Hay 19 marcas españolas que contienen más de 0,6 mg/L. En las 12 aguas minerales importadas, la mediana es de 0,35 (rango 0,10-1,21; rango intercuartil: 0,23). Sólo en 28 de las 109 marcas examinadas (25,6%) se especificaba el contenido de fluoruro en la etiqueta. Se observa una buena correlación entre las concentraciones indicadas y los valores analizados.

Conclusiones

Las concentraciones de fluoruro en las aguas minerales naturales comercializadas en España muestran una gran variabilidad. Dado el creciente consumo de las aguas minerales naturales en España, este tipo de información es de suma importancia para poder hacer una correcta utilización de flúor en la prevención primaria de la caries dental.

Fluoride content of water used to reconstitute infant formula

OBJECTIVE

To assess the fluoride content of water used to reconstitute infant formula by a Latino population living in the Indianapolis, Indiana, area.

BACKGROUND

Negligible as well as excessive fluoride can be detrimental to oral health. Estimates of fluoride intake and exposure for individuals may aid in the determination of their risk for developing dental fluorosis or caries.

METHODS

Interviews were conducted to determine brands of bottled water used to reconstitute infant formula. Identified brands were analyzed for fluoride concentration.

RESULTS

Of the 458 samples tested (from 20 brands), fluoride concentration ranged from 0.006 to 0.740 μg/mL. All brands but one had fluoride concentration less than 0.7 μg/mL, with 16 brands having less than 0.22 μg/mL. Most bottled waters analyzed in the study comply with the American Dental Association recommendation to prevent fluorosis. Comparisons made demonstrated that only waters targeted for infants and that are fluoridated do not comply with recent American Dental Association recommendations.