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Chen X, Liu H, Zhang Q, Chen X, Wang L, Yu Y, Hao Y. Carboxymethyl chitosan stabilized AuNPs/ACP nanohybrids in enamel white spot lesions. Front Bioeng Biotechnol 2024; 12:1421887. [PMID: 39081333 PMCID: PMC11286484 DOI: 10.3389/fbioe.2024.1421887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 06/25/2024] [Indexed: 08/02/2024] Open
Abstract
Acidic bacterial biofilms-associated enamel white spot lesions (WSLs) are one of the hallmarks of early caries, causing demineralization and decomposition of dental hard tissues. Therefore, to effectively prevent and treat WSLs, it is important to inhibit the activity of cariogenic bacteria while promoting the remineralization of demineralized enamel. Amorphous calcium phosphate (ACP) favors hard tissue remineralization due to its biological activity and ability to release large amounts of Ca2+ and PO4 3-. However, ACP-based biomineralization technology is not effective due to its lack of antimicrobial properties. Here, carboxymethyl chitosan (CMCS) was employed as a reducing agent and stabilizer, and dual-functional nanohybrids CMCS/AuNPs/ACP with biofilm resistance and mineralization properties were successfully synthesized. The addition of AuNPs enhances the antimicrobial activity and participates in regulating the formation of hydroxyapatite (HAp). The nanohybrids exhibited significant destructive effects against cariogenic bacteria and their biofilms and showed bactericidal activity under bacteria-induced acidic conditions. More importantly, this nanohybrids showed superior results in promoting the remineralization of demineralized enamel, compared to fluoride and CMCS/ACP in vitro. The CMCS/AuNPs/ACP nanohybrids not only reverse the cariogenic microenvironment at the microbial level, but also promote self-repairing of enamel WSLs regarding the microstructure. The present work offers a theoretical and experimental basis for using the CMCS/AuNPs/ACP nanohybrids as a potential dual-functional agent for the clinical treatment of enamel WSLs.
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Affiliation(s)
- Xiaohua Chen
- School of Stomatology of Binzhou Medical University, Yantai, China
| | - Hengyu Liu
- Qingdao Stomatological Hospital Affiliated to Qingdao University, Qingdao, China
| | - Qianqian Zhang
- Qingdao Stomatological Hospital Affiliated to Qingdao University, Qingdao, China
| | | | - Lihui Wang
- Department of Stomatology, School of Shandong Second Medical University, Weifang, China
| | - Yanling Yu
- Qingdao Stomatological Hospital Affiliated to Qingdao University, Qingdao, China
| | - Yuanping Hao
- Qingdao Stomatological Hospital Affiliated to Qingdao University, Qingdao, China
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2
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Liu X, Lau CLB, Ding H, Matinlinna JP, Tsoi JKH. Enamel Remineralisation with a Novel Sodium Fluoride-Infused Bristle Toothbrush. Dent J (Basel) 2024; 12:142. [PMID: 38786540 PMCID: PMC11119043 DOI: 10.3390/dj12050142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/29/2024] [Accepted: 05/08/2024] [Indexed: 05/25/2024] Open
Abstract
This study aims to investigate whether toothbrushes with fluoride-infused bristles have any (re)mineralisation effects on bovine enamel. Bovine incisors (N = 160) were extracted, and the buccal side of the crown was cut into dimensions of ~5 mm × 5 mm with a low-speed saw. These specimens were randomly allocated into four groups: half (80 teeth) were stored in demineralising solution (DM), and the other half were stored in deionised water (DW) for 96 h. Then, they were brushed with a force of 2.0 ± 0.1 N for five min with a manual toothbrush with either fluoride-infused (TF) or regular (TR) bristles. Microhardness (Vickers), X-ray diffraction (XRD), energy-dispersive X-ray spectroscopy (EDS), and scanning electron microscopy (SEM) were used to investigate the surfaces of the bovine enamel specimens before and after brushing. Two-way ANOVA was used to analyse the hardness data, and the pairwise comparison method was used to analyse the Ca/P ratio, for each group at α = 0.05. The results show that brushing with either of these toothbrushes increased the Vickers microhardness on DM and DW enamel (p < 0.001), whereas hydroxyapatite was revealed in all groups by XRD. The DM samples showed a significant increase (p < 0.05) in the Ca/P ratios after brushing with TR and TF. Conversely, under DW conditions, these ratios decreased significantly after brushing. In terms of the F atomic%, TF increased significantly. SEM revealed mineral deposition in the DM groups after toothbrushing. To conclude, toothbrushing effectively induces the microhardness of sound and demineralised enamel, while fluoride-infused bristles might be able to retain fluoride on the enamel surface.
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Affiliation(s)
- Xiaotian Liu
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin 300041, China
- Dental Materials Science, Applied and Oral Science and Community Oral Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China (H.D.); (J.P.M.)
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin Stomatological Hospital, Tianjin 300041, China
| | - Chun Lok Bryan Lau
- Dental Materials Science, Applied and Oral Science and Community Oral Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China (H.D.); (J.P.M.)
| | - Hao Ding
- Dental Materials Science, Applied and Oral Science and Community Oral Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China (H.D.); (J.P.M.)
| | - Jukka Pekka Matinlinna
- Dental Materials Science, Applied and Oral Science and Community Oral Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China (H.D.); (J.P.M.)
- Division of Dentistry, School of Medical Sciences, University of Manchester, Manchester M13 9PL, UK
| | - James K. H. Tsoi
- Dental Materials Science, Applied and Oral Science and Community Oral Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China (H.D.); (J.P.M.)
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Gunasekara TDKSC, De Silva PMCS, Chandana EPS, Jayasinghe S, Herath C, Siribaddana S, Jayasundara N. Environmental fluoride exposure and implications on potential pediatric kidney health risks: an approach with urinary biomarkers. Pediatr Nephrol 2024; 39:1469-1480. [PMID: 38085354 DOI: 10.1007/s00467-023-06218-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/25/2023] [Accepted: 10/25/2023] [Indexed: 03/16/2024]
Abstract
BACKGROUND Environmental fluoride exposure at elevated levels is potentially linked to kidney injury, and may contribute to chronic kidney disease of uncertain etiology (CKDu) as a risk factor. However, this link remains unclear, and examining the risk of kidney damage from early life fluoride exposure may provide important insights. Hence, this study aimed to investigate associations of fluoride exposure with pediatric kidney health in CKDu impacted and unimpacted communities in Sri Lanka. METHODS Considering the geographical variations in environmental fluoride, climate, and prevalence of CKDu, four study groups were established within selected education zones in CKDu-endemic dry zone regions (D-En), and CKDu-nonendemic regions within the dry (D-NE), wet (W-NE), and intermediate (I-NE) climatic zones. The study population included 922 school students (11-18 years of age). Participants in each group were divided into four subgroups based on quartiles of respective urinary fluoride (UF) distribution for comparison of urinary kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and albumin-creatinine ratio (ACR). RESULTS UF levels in participants particularly in CKDu endemic dry zone regions were significantly high compared to the other regions. Significantly high median urinary NGAL (in D-NE) and ACR (in D-EN, and W-NE) levels were observed in subgroups of higher UF quartiles. Albuminuria was not particularly identified in subjects with high UF excretion. Urinary KIM-1 showed no significant variation across the UF quartile subgroups. Linear regression identified weak associations of UF with kidney injury biomarkers. CONCLUSIONS Fluoride exposure is particularly high in CKDu-endemic dry zone communities. As implied by kidney injury biomarkers, a strong link between fluoride exposure and pediatric kidney health was not evident at the observed exposure levels in the study regions.
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Affiliation(s)
- T D K S C Gunasekara
- Department of Zoology, Faculty of Science, University of Ruhuna, Matara, 81000, Sri Lanka
| | - P Mangala C S De Silva
- Department of Zoology, Faculty of Science, University of Ruhuna, Matara, 81000, Sri Lanka.
| | - E P S Chandana
- Department of Biosystems Technology, Faculty of Technology, University of Ruhuna, Matara, 81000, Sri Lanka
| | - Sudheera Jayasinghe
- Department of Pharmacology, Faculty of Medicine, University of Ruhuna, Galle, 80000, Sri Lanka
| | - Chula Herath
- Department of Nephrology, Sri Jayewardenepura General Hospital, Nugegoda, 10250, Sri Lanka
| | - Sisira Siribaddana
- Department of Medicine, Faculty of Medicine & Allied Sciences, Rajarata University, Saliyapura, 50008, Sri Lanka
| | - Nishad Jayasundara
- Nicholas School of the Environment, Duke University, Durham, NC, 27708, USA
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Alahmari MA. Treatment of Cases with Different Grades of Fluorosis by Lithium Disilicate Glass-Ceramic CAD/CAM Materials: A Case Report of Two Cases. J Contemp Dent Pract 2023; 24:342-348. [PMID: 38149813 DOI: 10.5005/jp-journals-10024-3461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
Over exposure to high amount of fluoride during the development of enamel leads to fluorosis. Dental fluorosis is considered to be the most common color disorders of the enamel. It presents with different clinical signs on the enamel of the patients. The diagnosis of dental fluorosis is very challenging in the clinical practice since the enamel defects could be confusing. This case report presented two cases and their treatment for different grades of dental fluorosis to improve the esthetic appearance of the teeth. Keywords: Dental fluorosis, Fluorosis index, Lithium disilicate glass-ceramic, Microabrasion, Resin infiltration.
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Affiliation(s)
- Maram A Alahmari
- College of Dentistry, King Khalid University, Abha, Saudi Arabia, e-mail:
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5
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Bhagavatula P, Comnick CL, Warren JJ, Levy SM. Patterns of fluoride intake from 6 to 17 years of age: The Iowa Fluoride Study. J Public Health Dent 2023; 83:18-25. [PMID: 36251680 PMCID: PMC10006287 DOI: 10.1111/jphd.12542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/17/2022] [Accepted: 08/09/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This article reports on estimated daily fluoride intake from water, other beverages and selected foods, dentifrice, and dietary fluoride supplements by both individual sources, and all sources combined, among 787 children participating in the Iowa Fluoride Study (IFS) from 6 to 17 years of age. METHODS Total daily fluoride intake (mg F) and fluoride intake per kilogram bodyweight (mg F/kg bw) were estimated using responses to questionnaires sent every 3-6 months. Dietary assessments included frequencies and amounts of beverage intake for the previous week from water, milk, ready-to-drink beverages, beverages made by adding water to concentrate or powder, and selected foods with substantial water content. Descriptive statistics and bivariate and multivariable analyses with linear mixed models were used to assess associations with each of mg F and mg F/kg bw. RESULTS Mean combined dietary fluoride (mg F) from all sources examined in the study increased slightly with age, whereas the fluoride intake per kg bw decreased with age. Age, sex, and socioeconomic status were significantly associated with fluoride intake (mg F and mg F/kg bw). Each year increase in age was associated with a 0.02-mg increase in fluoride consumption, on average, after adjusting for the effects of covariates. CONCLUSIONS Daily mean fluoride intakes from single and combined sources were relatively stable, while the intake of fluoride per kg bw decreased from 6 to 17 years of age. Fluoridated water was the major source of ingested fluoride, contributing over 50% of total daily intake at all ages.
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Affiliation(s)
| | | | - John J Warren
- College of Dentistry, University of Iowa, Iowa City, Iowa, USA
| | - Steven M Levy
- College of Dentistry, University of Iowa, Iowa City, Iowa, USA
- College of Public Health, University of Iowa, Iowa CIty, Iowa, USA
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6
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Araujo TT, Moraes SM, Carvalho TDS, Grizzo LT, Buzalaf MAR. Estimated Dietary Fluoride Intake by 24-Month-Olds from Chocolate Bars, Cookies, Infant Cereals, and Chocolate Drinks in Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3175. [PMID: 36833869 PMCID: PMC9965682 DOI: 10.3390/ijerph20043175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/06/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
The use of fluoride (F) in the prevention of dental caries is established. However, a high amount of F intake during tooth development can cause dental fluorosis The aim of this study was to analyze variations in F concentrations in chocolate bars (CB), chocolate cookies (CC), infant cereals (IC), and chocolate milk drinks (CD) to determine the daily intake of F from different sources by children at the age of risk for developing dental fluorosis. Distinct brands of CB, CC, IC, and CD were analyzed. Fluoride was separated by hexamethyldisiloxane-facilitated diffusion. Analysis was made in triplicate with an F ion-specific electrode. F ingestion (mg/kg body weight) was evaluated with the suggested consumption (0.05-0.07 mg/kg/day) for children aged 24 months (12 kg). The concentrations for all the analyzed products ranged from 0.025 to 1.827 µg/g F. The mean (range) F concentrations were CB= 0.210 ± 0.205 µg/g (0.073-0.698, n = 8), CC = 0.366 ± 0.416 µg/g (0.320-1.827, n = 9), IC = 0.422 ± 0.395 µg/g (0.073-1.061, n = 5), and CD = 0.169 ± 0.170 µg/mL (0.025-0.443, n = 12). The products that had the highest concentration in the categories CB, CC, IC, and CD, respectively, were Nescau-Ball (0.698 µg/g), Passatempo (1.827 µg/g), Milnutri (1.061 µg/g), and Toddynho (0.443 µg/mL). The consumption of only one unit of Toddynho (CD) is equivalent to more than 11% of the maximum suggested daily intake for a 24-month-old child (0.07 mg/kg body weight). When one product from each category is consumed together only once a day, this consumption is equivalent to approximately 24% of the suggested daily intake of fluoride for a 24-month-old child. The presence of high levels of fluoride in certain products suggests that they play a significant role in overall fluoride intake. It is crucial to closely monitor the fluoride content of food and drinks that are consumed by children who are at risk for dental fluorosis, and for product labels to clearly display the fluoride concentrations.
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Affiliation(s)
| | | | | | | | - Marilia Afonso Rabelo Buzalaf
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru 17012-901, São Paulo, Brazil
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7
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Caldas da Rocha DR, Ricomini Filho AP, Cury JA. Soluble fluoride in Na2FPO3/CaCO3-based toothpaste as an indicator of systemically bioavailable fluoride. Caries Res 2021; 56:55-63. [PMID: 34814135 DOI: 10.1159/000521068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 11/21/2021] [Indexed: 11/19/2022] Open
Abstract
Fluoride chemically soluble in toothpaste is an indicator of fluoride bioavailability when the teeth are brushed and the same should be expected systemically when toothpaste is ingested. A four-phases study was conducted, in which eight participants were subjected in each phase to one of the assigned treatment groups: Group I: fresh sample of a Na2FPO3/CaCO3 toothpaste with 1,334 μg F/g of total soluble fluoride (TSF); groups II-IV: aged samples of toothpaste presenting TSF concentrations of 1,128, 808, and 687 μg F/g, respectively. In all phases, the participants ingested an amount of toothpaste equivalent to 70.0 µg F/kg body weight, as total fluoride (TF). Blood was collected before (baseline) and up to 180 min after toothpaste ingestion as indicator of fluoride bioavailability. Total urine (24 h before and 24 h after ingestion) was collected as indicator of absorbed fluoride that was excreted. F concentration in blood plasma and urine was determined with a fluoride ion-specific electrode. The areas under the curve of F concentration vs. time (AUC=ng F/ml x min) and the peaks of fluoride concentration in blood plasma (Cmax) were calculated. The net amount of fluoride excreted (mg/day) was calculated by subtraction. A significant correlation of the amount (mg) of TSF ingested was found between the AUC (r= 0.76; p<0.01) and Cmax (r= 0.86; p<0.01) in plasma, and the fluoride excreted (r= 0.65; p<0.01). For TF no statistical correlations were found (p>0.05). Data suggest that the concentration of TSF found in Na2FPO3/CaCO3-based toothpastes is a useful predictor of how much fluoride will be systemically bioavailable when this type of formulation is ingested.
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Dietary Fluoride Intake by Children: When to Use a Fluoride Toothpaste? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115791. [PMID: 34071256 PMCID: PMC8198230 DOI: 10.3390/ijerph18115791] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/20/2021] [Accepted: 05/26/2021] [Indexed: 11/17/2022]
Abstract
Fluoride is recommended for its cariostatic effect, but excessive fluoride intake may have health risks. Increased prevalence of dental fluorosis in areas with low fluoride content in drinking water has been attributed to the inappropriate excessive intake of fluoride supplements (tablets and drops) and toothpaste ingestion. The aim of the present study was to estimate the fluoride intake and the risk of fluorosis in children (6 months-6 years) in the Castelli Romani area (province of Rome, Italy), which is volcanic, therefore with a higher concentration of fluorine. Measurements of the fluoride content in drinking water, mineral waters, vegetables and commercial toothpaste for children were performed. The fluoride concentrations of all samples were determined using a Fluoride Ion Selective Electrode (GLP 22, Crison, Esp). Data were analyzed by descriptive statistics. Differences between samples were determined by Student's t-test. The fluoride content in tap water samples collected from public sources averaged from 0.35 to 1.11 ppm. The Pavona area showed the highest content of fluoride with respect to the others (p ≤ 0.05). The fluoride content in mineral water samples averaged from 0.07 to 1.50 ppm. The fluoride content of some vegetables showed increased mean values when compared to control vegetables (p ≤ 0.05). Within the limitations of the present study, considerations should be made when prescribing fluoride toothpaste for infants (6 months-4 years) in the areas with high fluoride content, because involuntary ingestion is consistent.
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9
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Han J, Kiss L, Mei H, Remete AM, Ponikvar-Svet M, Sedgwick DM, Roman R, Fustero S, Moriwaki H, Soloshonok VA. Chemical Aspects of Human and Environmental Overload with Fluorine. Chem Rev 2021; 121:4678-4742. [PMID: 33723999 PMCID: PMC8945431 DOI: 10.1021/acs.chemrev.0c01263] [Citation(s) in RCA: 131] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Indexed: 12/24/2022]
Abstract
Over the last 100-120 years, due to the ever-increasing importance of fluorine-containing compounds in modern technology and daily life, the explosive development of the fluorochemical industry led to an enormous increase of emission of fluoride ions into the biosphere. This made it more and more important to understand the biological activities, metabolism, degradation, and possible environmental hazards of such substances. This comprehensive and critical review focuses on the effects of fluoride ions and organofluorine compounds (mainly pharmaceuticals and agrochemicals) on human health and the environment. To give a better overview, various connected topics are also discussed: reasons and trends of the advance of fluorine-containing pharmaceuticals and agrochemicals, metabolism of fluorinated drugs, withdrawn fluorinated drugs, natural sources of organic and inorganic fluorine compounds in the environment (including the biosphere), sources of fluoride intake, and finally biomarkers of fluoride exposure.
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Affiliation(s)
- Jianlin Han
- Jiangsu
Co-Innovation Center of Efficient Processing and Utilization of Forest
Resources, College of Chemical Engineering, Nanjing Forestry University, Nanjing 210037, China
| | - Loránd Kiss
- University
of Szeged, Institute of Pharmaceutical Chemistry
and Interdisciplinary Excellence Centre, Eötvös u. 6, 6720 Szeged, Hungary
| | - Haibo Mei
- Jiangsu
Co-Innovation Center of Efficient Processing and Utilization of Forest
Resources, College of Chemical Engineering, Nanjing Forestry University, Nanjing 210037, China
| | - Attila Márió Remete
- University
of Szeged, Institute of Pharmaceutical Chemistry
and Interdisciplinary Excellence Centre, Eötvös u. 6, 6720 Szeged, Hungary
| | - Maja Ponikvar-Svet
- Department
of Inorganic Chemistry and Technology, Jožef
Stefan Institute, Jamova
cesta 39, 1000 Ljubljana, Slovenia
| | - Daniel Mark Sedgwick
- Departamento
de Química Orgánica, Universidad
de Valencia, 46100 Burjassot, Valencia Spain
| | - Raquel Roman
- Departamento
de Química Orgánica, Universidad
de Valencia, 46100 Burjassot, Valencia Spain
| | - Santos Fustero
- Departamento
de Química Orgánica, Universidad
de Valencia, 46100 Burjassot, Valencia Spain
| | - Hiroki Moriwaki
- Hamari
Chemicals Ltd., 1-19-40, Nankokita, Suminoe-ku, Osaka 559-0034, Japan
| | - Vadim A. Soloshonok
- Department
of Organic Chemistry I, Faculty of Chemistry, University of the Basque Country UPV/EHU, 20018 San Sebastian, Spain
- IKERBASQUE,
Basque Foundation for Science, 48011 Bilbao, Spain
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Abstract
AbstractThe current review assesses the literature concerning the etiology of primary teeth staining and discoloration. The appearance of the dentition is of concern to many children and their caregivers seeking dental treatment as the color of the teeth is of aesthetic importance. The correct diagnosis of the cause of the discoloration is important as, invariably, it has a profound effect on treatment outcomes. It would seem reasonable, therefore, that dental practitioners understand the etiology of tooth discoloration to make a diagnosis and enable appropriate treatment to be conducted. Knowledge of the etiology of tooth staining is of importance to the dental practitioner to explain the patient the exact nature of the condition. In some instances, the mechanism of staining affects the outcome of the treatment and influences the options the dentist will be able to offer. Many of these contributing factors are preventable if parents are educated, managed by professional interventions, or provide a multidisciplinary approach. In this review, we highlight the importance of children smiles and the difference between primary and permanent teeth. We discuss the different types of primary teeth staining and discoloration and whether it is intrinsic or extrinsic, as well as the different impacts of some conditions on primary teeth compared with permanent teeth.
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Affiliation(s)
- Abdulfatah Alazmah
- Pediatric Dentistry Division, Department of Preventive Dental Science, College of Dentistry, Prince Sattam University, Alkharj, Saudi Arabia
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11
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Koberová Ivančaková R, Radochová V, Kovácsová F, Merglová V. Exogenous Intake of Fluorides in Caries Prevention: Benefits and Risks. ACTA MEDICA (HRADEC KRALOVE) 2021; 64:71-76. [PMID: 34331425 DOI: 10.14712/18059694.2021.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Caries incidence and prevalence have decreased significantly over the last few decades due to widespread use of fluoride. However, an increase in the prevalence of dental fluorosis has been reported in both fluoridated and non-fluoridated communities. Care must be taken to ensure that a balance between the optimal fluoride preventive effect at the individual and community level and minimal risk of dental fluorosis is maintained. This review describes the main sources of fluoride intake that have been identified: fluoridated drinking water, dietary fluoride supplement, and topical forms comprising toothpastes, rinses, gels and varnishes. The cited data were taken from meta-analytic studies and reports from Cochrane database systematic reviews up to December 2019. Efficiency, but safety, of topically applied fluorides in individual home care is dependent on the degree of compliance of individuals/parents and on the level of competence of providers of preventive counselling. The broad spectrum of these resources allows individualization of fluoride prevention based on risk analysis of caries attack and taking into consideration other preventive measures.
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Affiliation(s)
- Romana Koberová Ivančaková
- Department of Dentistry, Faculty of Medicine, Charles University and University Hospital, Hradec Králové, Czech Republic.
| | - Vladimíra Radochová
- Department of Dentistry, Faculty of Medicine, Charles University and University Hospital, Hradec Králové, Czech Republic.
| | - Flóra Kovácsová
- Department of Dentistry, Faculty of Medicine, Charles University and University Hospital, Hradec Králové, Czech Republic
| | - Vlasta Merglová
- Department of Dentistry, Faculty of Medicine, Charles University and University Hospital, Pilsen, Czech Republic
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12
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Fluoride concentration of commercially available infant formulae in the United Arab Emirates. Eur Arch Paediatr Dent 2020; 21:657-666. [DOI: 10.1007/s40368-019-00502-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 11/28/2019] [Indexed: 11/26/2022]
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13
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Sampaio C, Delbem ACB, Paiva MF, Zen I, Danelon M, Cunha RF, Pessan JP. Amount of Dentifrice and Fluoride Concentration Influence Salivary Fluoride Concentrations and Fluoride Intake by Toddlers. Caries Res 2020; 54:234-241. [PMID: 32516769 DOI: 10.1159/000503780] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 09/26/2019] [Indexed: 11/19/2022] Open
Abstract
The present study evaluated fluoride (F) concentrations in saliva of toddlers after brushing with dentifrices containing different F concentrations, applied in different quantities, and estimated F intake from toothbrushing. The study comprised a double-blind, crossover protocol, in which toddlers (n = 18, 2-3 years old) were randomly assigned into six groups, according to possible combinations of dentifrices (0/550/1,100 ppm F, as NaF) and amounts (rice grain, pea size, and transverse technique). Volunteers used a F-free dentifrice during 1 week. On the 7th day, saliva samples were collected before (baseline), and at 5/15/30/60 min after toothbrushing. All dentifrice expectorated after brushing was collected. F concentrations (saliva and expectorate) were determined with an ion-specific electrode. Data were submitted to ANOVA or Kruskal-Wallis test, followed by Fisher's LSD or Student-Newman-Keuls' tests (p <0.05). Brushing with 550 ppm F dentifrice (pea size or transversal technique) increased the area under the curve (AUC) at similar levels compared to 1,100 ppm F (rice grain). The highest AUC and salivary F at 5 min after brushing were achieved by 1,100 ppm F (pea size), followed by 550 ppm F (transversal technique). Regarding F intake, the highest values were observed for 550 ppm F (transversal technique), followed by 1,100 ppm F (pea size). It is possible to conclude that the amount of dentifrice and F concentration in the product significantly affected both salivary F concentrations and F intake during toothbrushing.
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Affiliation(s)
- Caio Sampaio
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Alberto Carlos Botazzo Delbem
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Mayra Frasson Paiva
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Igor Zen
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Marcelle Danelon
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Robson Frederico Cunha
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Juliano Pelim Pessan
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil,
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Idowu OS, Duckworth RM, Valentine RA, Zohoori FV. Biomarkers for the Assessment of Fluoride Exposure in Children. Caries Res 2020; 54:134-143. [PMID: 31962326 DOI: 10.1159/000504166] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 10/14/2019] [Indexed: 11/19/2022] Open
Abstract
Due to practical difficulties in quantifying fluoride exposure, the ability of various biomarkers to predict exposure has been investigated previously. However, the results are inadequate for validation of their application and usefulness. This study aimed to investigate the association between contemporary/recent biomarkers of fluoride exposure and total daily fluoride intake (TDFI) of children with large differences in fluoride exposure through drinking water. TDFI was assessed in 61 healthy 4- to 5-year-old children who provided at least 1 biomarker sample; 32 lived in a low-fluoride area (0.04 mg F/L) and 29 lived in a high-fluoride area (3.05 mg F/L). Validated questionnaires were administered to evaluate fluoride intake from diets (including water) and toothpaste ingestion. Daily urinary fluoride excretion (UFE) and fluoride concentrations in plasma, fasting whole saliva, hair, and nails (toenails/fingernails) were evaluated and related to total fluoride exposure. TDFI, UFE, and fluoride concentrations of biomarkers were statistically significantly higher in the high-fluoride area than in the low-fluoride area. There was a strong statistically significant positive correlation between TDFI and UFE (ρ = 0.756, p < 0.001); plasma fluoride concentration (ρ = 0.770, p < 0.001); and toenail fluoride concentration (ρ = 0.604, p < 0.001). The statistically significant positive correlation between TDFI and fingernail fluoride concentration (ρ = 470, p < 0.001) as well as between TDFI and fasting whole saliva fluoride concentration (ρ = 0.453, p = 0.001) was moderate, whereas it was weak between TDFI and hair fluoride concentration (ρ = 0.306, p = 0.027). In conclusion, the current study confirmed the suitability of 24-h urine samples for estimating fluoride exposure in children. The strong correlations between TDFI and fluoride in plasma and toenails also suggest these biomarkers may be considered for health risk assessments of fluoride in children who are susceptible to development of dental fluorosis.
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Affiliation(s)
- Oladipo S Idowu
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Ralph M Duckworth
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Ruth A Valentine
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Fatemeh Vida Zohoori
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom,
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Chedid SJ, Tenuta LMA, Cury JA. Dispensing Device to Deliver Small and Standardized Amount of Fluoride Dentifrice on the Toothbrush. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2020. [DOI: 10.1590/pboci.2020.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Abstract
Since the classical epidemiological studies by Dean, it has been known that there should be an optimum level of exposure to fluoride that would be able to provide the maximum protection against caries, with minimum dental fluorosis. The "optimal" daily intake of fluoride for children (0.05-0.07 mg per kilogram bodyweight) that is still accepted worldwide was empirically determined. In the present review, we discuss the appropriateness of the current guidance for fluoride intake, in light of the windows of susceptibility to caries and fluorosis, the modern trends of fluoride intake from multiple sources, individual variations in fluoride metabolism, and recent epidemiological data. The main conclusion is that it is very difficult to think about a strict recommendation for an "optimal" range of fluoride intake at the individual level in light of existing knowledge of 1) the mechanisms of action of fluoride to control caries, 2) the mechanisms involved in dental fluorosis development, 3) the distinct factors that interfere in the metabolism of fluoride, and 4) the windows of susceptibility to both dental caries and fluorosis development. An "optimal" range of fluoride intake is, however, desirable at the population level to guide programs of community fluoridation, but further research is necessary to provide additional support for future decisions on guidance in this area. This list includes the effect of factors affecting fluoride metabolism, clinical trials on the effectiveness of low-fluoride dentifrices to prevent caries in the primary dentition, and validation of biomarkers of exposure to fluoride.
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Affiliation(s)
- M A R Buzalaf
- 1 Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Brazil
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Abstract
The purpose of this report is to examine critically the appropriateness of the current guidance for fluoride intake in the population (0.05-0.07 mg F/kg bodyweight/d), consider whether changes to the current guidance are desirable, and suggest further research that will strengthen the evidence base for future decisions on guidance/advice in this area. The benefits and the risks of using fluoride particularly concern preschool children because it is at this age that excessive fluoride intake may result in dental fluorosis. Data from mostly cross-sectional studies show a wide variation in exposure and a considerable variation in the amount of fluoride ingested. Fluorosis, mostly mild, is commonly observed. For considering changes in current guidance, there is a need for more knowledge on the relationship between exposure to fluoride at an early age and the development of fluorosis. For that, prospective epidemiological studies with sufficiently large and representative samples of children are required. It is also important to study children in communities both with and without water fluoridation and to include populations where salt or milk fluoridation is used. There is also a need for professional agreement on acceptable levels of mild and moderate/severe fluorosis and a more comprehensive knowledge on the appreciation of mild fluorosis among the public.
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Affiliation(s)
- I Mejàre
- 1 Malmö University, Malmö, Sweden
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Borjac J, Badr S, ElJoumaa M, Daas I, Kobeissi R. Oral and Dental Status of Lebanese and Syrian Refugees Living in Proximity to Deir Kanoun Ras El Ain Dump in Lebanon. J Int Soc Prev Community Dent 2019; 9:409-416. [PMID: 31516876 PMCID: PMC6714415 DOI: 10.4103/jispcd.jispcd_214_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 06/21/2019] [Indexed: 12/05/2022] Open
Abstract
Aims: In this study, we aimed at investigating the oral and dental health conditions of Lebanese and Syrian refugees living in proximity to Deir Kanoun Ras El Ain dump whereby its leachates influx into a canal used for irrigation and drinking purposes. Materials and Methods: This observational study involved oral and dental examinations of 589 Lebanese and Syrian Refugees participants living in the three villages: Deir Kanoun Ras El Ain, Klayleh, and Smaiyeh. Differences in oral and dental examination results were analyzed between different villages, sexes, nationalities, and age groups. Correlation tests were conducted between dental fluorosis, staining, papilla swelling, and several sociodemographic factors. Results: Dental fluorosis, staining, and papilla swelling were the most prominent problems among total participants. The highest percentages of individuals with the studied diseases were shown to be in Klayleh village, among females, and individuals aged between 21 and 40 years. Significant associations were observed between dental fluorosis and nationality; between dental staining and gender, nationality, age, and smoking; as well as between papilla swelling and age, smoking, and diabetes. Conclusions: Our study investigated and highlighted the prevalence of several oral and dental diseases among Lebanese and Syrian inhabitants that are related to environmental, social, and economic determinants and not just by individual behaviors. It also showed gaps of oral and dental health knowledge that recommend implementing health systems that focus on preventing oral diseases.
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Affiliation(s)
- Jamilah Borjac
- Department of Biological Sciences, Faculty of Science, Beirut Arab University, Debbieh Campus, Lebanon
| | - Shereen Badr
- Department of Pediatric Dentistry Division, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon
| | - Manal ElJoumaa
- Department of Biological Sciences, Faculty of Science, Beirut Arab University, Debbieh Campus, Lebanon
| | - Issa Daas
- Department of Pediatric Dentistry Division, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon
| | - Riham Kobeissi
- Department of Pediatric Dentistry Division, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon
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Idowu OS, Azevedo LB, Valentine RA, Swan J, Vasantavada PV, Maguire A, Zohoori FV. The use of urinary fluoride excretion to facilitate monitoring fluoride intake: A systematic scoping review. PLoS One 2019; 14:e0222260. [PMID: 31509581 PMCID: PMC6738609 DOI: 10.1371/journal.pone.0222260] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 08/25/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND As a recognised effective and economical agent for dental caries prevention, fluoride has been used in many different fluoridation schemes implemented across the world. Considering the narrow 'dose-gap' between the benefit of caries reduction and the risk of dental fluorosis, it is recommended that fluoride intake is monitored by measuring urinary fluoride excretion. The aim of this scoping review is to map the current literature/evidence on fluoride intake and excretion studies in relation to the study population, settings, type of study design, methodology, and analytical approach. METHODS Embase/Ovid, MEDLINE/Ovid, CINAHL/EBSCO, Scopus/Elsevier were searched for relevant articles until April 2018. Studies were included if they reported intake and excretion of fluoride in healthy humans of all age groups. Findings were explored using a narrative synthesis to summarise studies characteristics and outcome measures. RESULTS Removal of duplicates from the originally 2295 identified records yielded 1093 studies of which 206 articles were included. Only 21.6% of the studies were conducted in children (<8-year-olds). Most studies (38.8%) used drinking water concentration as a proxy for fluoride intake, whereas only 11.7% measured fluoride intake from all sources. Of the 72 studies that measured dietary fluoride intake, only 10 reported the validity of the employed dietary assessment method. Only 14 studies validated the urine sample collection methods. No information on the validity of the employed analytical method was reported by the majority (64.6%) of studies. Only a small proportion (8.7%) of the included studies investigated the association between fluoride intake and excretion. CONCLUSION The findings reveal much variability in terms of conducting the studies and reporting the findings, illustrating a high heterogeneity in data collection across settings and populations. Future studies should provide more detail on sampling technique, measurement protocols (including validation), and on clearly defining the relationship between intake and urinary excretion of fluoride.
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Affiliation(s)
- Oladipo S. Idowu
- School of Health and Social Care, Teesside University, Middlesbrough Tees Valley, United Kingdom
- School of Dental Sciences, Newcastle University, Framlington Place, Newcastle Upon Tyne, United Kingdom
| | - Liane B. Azevedo
- School of Health and Social Care, Teesside University, Middlesbrough Tees Valley, United Kingdom
| | - Ruth A. Valentine
- School of Dental Sciences, Newcastle University, Framlington Place, Newcastle Upon Tyne, United Kingdom
| | - Josie Swan
- School of Dental Sciences, Newcastle University, Framlington Place, Newcastle Upon Tyne, United Kingdom
| | - Priyanka V. Vasantavada
- School of Health and Social Care, Teesside University, Middlesbrough Tees Valley, United Kingdom
| | - Anne Maguire
- School of Dental Sciences, Newcastle University, Framlington Place, Newcastle Upon Tyne, United Kingdom
| | - Fatemeh V. Zohoori
- School of Health and Social Care, Teesside University, Middlesbrough Tees Valley, United Kingdom
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Vale G, Simões N, Santana G, Mota B, Moura M. Gastrointestinal Absorption and Renal Excretion of Fluoride After Ingestion of a High-Fluoride Dentifrice. Biol Trace Elem Res 2019; 190:24-29. [PMID: 30203224 DOI: 10.1007/s12011-018-1511-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 09/04/2018] [Indexed: 10/28/2022]
Abstract
This study aimed to evaluate the gastrointestinal absorption and renal excretion of fluoride after the ingestion of high-fluoride dentifrice. Twelve volunteers participated in this in vivo, crossover, and blinded study. In three experimental phases, the volunteers were randomly assigned to one of three treatment groups, who ingested either the following: distilled and deionized water (control), conventional dentifrice (1100 μg/g), or high-fluoride dentifrice (5000 μg/g). Both dentifrices contained fluoride in the form of NaF/SiO2. To determine the rate of fluoride absorption, non-stimulated saliva was collected for up to 120 min after ingestion and the area under the curve of the salivary fluoride concentration was plotted as a function of time and the maximum concentration determined. All urine produced during the 24 h before and after ingestion was collected, and urinary excretion was calculated from the difference between the urinary fluoride concentrations in the two periods. A specific ion electrode coupled to an ion analyzer was used to measure fluoride concentrations. Statistical analysis was performed by ANOVA followed by Tukey's test with p set at 5%. All measured parameters were highest after the ingestion of the dentifrice with 5000 μg/g (p < 0.001), confirming that this has an increased level of bioavailable fluoride compared with the conventional dentifrice. The high-fluoride dentifrice increases the concentration of salivary fluoride, which may explain its greater anticaries effect. However, it poses a potential risk of causing dental fluorosis and so should not be used by children.
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Affiliation(s)
- Glauber Vale
- Department of Restorative Dentistry, Federal University of Piaui, Campus Universitário Ministro Petrônio Portella - SG 10, Bairro Ininga, Teresina, Piauí, 64049-550, Brazil.
| | - Nícolas Simões
- Department of Restorative Dentistry, Federal University of Piaui, Campus Universitário Ministro Petrônio Portella - SG 10, Bairro Ininga, Teresina, Piauí, 64049-550, Brazil
| | - Guilherme Santana
- Department of Restorative Dentistry, Federal University of Piaui, Campus Universitário Ministro Petrônio Portella - SG 10, Bairro Ininga, Teresina, Piauí, 64049-550, Brazil
| | - Brenda Mota
- Department of Restorative Dentistry, Federal University of Piaui, Campus Universitário Ministro Petrônio Portella - SG 10, Bairro Ininga, Teresina, Piauí, 64049-550, Brazil
| | - Marcoeli Moura
- Department of Pathology and Dental Clinic, University of Piauí, Teresina, Piauí, Brazil
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Almeida LF, Marín LM, Martínez-Mier EA, Cury JA. Fluoride Dentifrice Overcomes the Lower Resistance of Fluorotic Enamel to Demineralization. Caries Res 2019; 53:567-575. [PMID: 31112976 DOI: 10.1159/000499668] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 03/16/2019] [Indexed: 01/22/2023] Open
Abstract
We evaluated if the low resistance of fluorotic enamel to demineralization could be overcome by fluoride dentifrice (FD) treatment. Paired enamel slabs of sound and fluorotic enamel (n = 20/group) from human teeth presenting Thylstrup and Fejerskov index (TF) scores from 0 to 4 were obtained. Half of the anatomic surface of the enamel slabs was isolated and used as a control (baseline) regarding enamel mineralization and fluoride concentration. The slabs were submitted to a pH-cycling model simulating a high cariogenic challenge, and 2×/day they were treated with placebo dentifrice (PD) or FD (1,100 µg F/g, as NaF). After 10 days, the slabs were cut into two halves. Enamel demineralization was evaluated by cross-sectional microhardness in one half, and the fluoride formed (FF) concentration was determined in the other half. For statistical analysis, the data on net demineralization area (ΔΔS) and FF (µg F/g) were grouped into TF0, TF1-2, and TF3-4, and analyzed by two-way ANOVA followed by Tukey's test (α = 5%). The factors studied were TF (0, 1-2, and 3-4) and dentifrice treatment (PD or FD). The effect of the factors was statistically significant for ΔΔS and FF (p < 0.05). In the PD group, the following pattern for ΔΔS was observed: TF3-4 > TF1-2 > TF0 (p < 0.05); however, the groups did not differ (p > 0.05) when FD was used. Regarding FF, the groups treated with PD did not differ (p > 0.05), but the greatest (p < 0.05) FF concentration was found in group TF3-4 treated with FD. These findings suggest that the higher susceptibility of fluorotic enamel to demineralization lesions is decreased by the use of FD.
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Affiliation(s)
| | - Lina María Marín
- Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Esperanza Angeles Martínez-Mier
- Department of Cariology, Operative Dentistry, and Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, USA
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Walsh T, Worthington HV, Glenny A, Marinho VCC, Jeroncic A. Fluoride toothpastes of different concentrations for preventing dental caries. Cochrane Database Syst Rev 2019; 3:CD007868. [PMID: 30829399 PMCID: PMC6398117 DOI: 10.1002/14651858.cd007868.pub3] [Citation(s) in RCA: 180] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Caries (dental decay) is a disease of the hard tissues of the teeth caused by an imbalance, over time, in the interactions between cariogenic bacteria in dental plaque and fermentable carbohydrates (mainly sugars). Regular toothbrushing with fluoride toothpaste is the principal non-professional intervention to prevent caries, but the caries-preventive effect varies according to different concentrations of fluoride in toothpaste, with higher concentrations associated with increased caries control. Toothpastes with higher fluoride concentration increases the risk of fluorosis (enamel defects) in developing teeth. This is an update of the Cochrane Review first published in 2010. OBJECTIVES To determine and compare the effects of toothpastes of different fluoride concentrations (parts per million (ppm)) in preventing dental caries in children, adolescents, and adults. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 15 August 2018); the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 7) in the Cochrane Library (searched 15 August 2018); MEDLINE Ovid (1946 to 15 August 2018); and Embase Ovid (1980 to 15 August 2018). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials (15 August 2018). No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA Randomised controlled trials that compared toothbrushing with fluoride toothpaste with toothbrushing with a non-fluoride toothpaste or toothpaste of a different fluoride concentration, with a follow-up period of at least 1 year. The primary outcome was caries increment measured by the change from baseline in the decayed, (missing), and filled surfaces or teeth index in all permanent or primary teeth (D(M)FS/T or d(m)fs/t). DATA COLLECTION AND ANALYSIS Two members of the review team, independently and in duplicate, undertook the selection of studies, data extraction, and risk of bias assessment. We graded the certainty of the evidence through discussion and consensus. The primary effect measure was the mean difference (MD) or standardised mean difference (SMD) caries increment. Where it was appropriate to pool data, we used random-effects pairwise or network meta-analysis. MAIN RESULTS We included 96 studies published between 1955 and 2014 in this updated review. Seven studies with 11,356 randomised participants (7047 evaluated) reported the effects of fluoride toothpaste up to 1500 ppm on the primary dentition; one study with 2500 randomised participants (2008 evaluated) reported the effects of 1450 ppm fluoride toothpaste on the primary and permanent dentition; 85 studies with 48,804 randomised participants (40,066 evaluated) reported the effects of toothpaste up to 2400 ppm on the immature permanent dentition; and three studies with 2675 randomised participants (2162 evaluated) reported the effects of up to 1100 ppm fluoride toothpaste on the mature permanent dentition. Follow-up in most studies was 36 months.In the primary dentition of young children, 1500 ppm fluoride toothpaste reduces caries increment when compared with non-fluoride toothpaste (MD -1.86 dfs, 95% confidence interval (CI) -2.51 to -1.21; 998 participants, one study, moderate-certainty evidence); the caries-preventive effects for the head-to-head comparison of 1055 ppm versus 550 ppm fluoride toothpaste are similar (MD -0.05, dmfs, 95% CI -0.38 to 0.28; 1958 participants, two studies, moderate-certainty evidence), but toothbrushing with 1450 ppm fluoride toothpaste slightly reduces decayed, missing, filled teeth (dmft) increment when compared with 440 ppm fluoride toothpaste (MD -0.34, dmft, 95%CI -0.59 to -0.09; 2362 participants, one study, moderate-certainty evidence). The certainty of the remaining evidence for this comparison was judged to be low.We included 81 studies in the network meta-analysis of D(M)FS increment in the permanent dentition of children and adolescents. The network included 21 different comparisons of seven fluoride concentrations. The certainty of the evidence was judged to be low with the following exceptions: there was high- and moderate-certainty evidence that 1000 to 1250 ppm or 1450 to 1500 ppm fluoride toothpaste reduces caries increments when compared with non-fluoride toothpaste (SMD -0.28, 95% CI -0.32 to -0.25, 55 studies; and SMD -0.36, 95% CI -0.43 to -0.29, four studies); there was moderate-certainty evidence that 1450 to 1500 ppm fluoride toothpaste slightly reduces caries increments when compared to 1000 to 1250 ppm (SMD -0.08, 95% CI -0.14 to -0.01, 10 studies); and moderate-certainty evidence that the caries increments are similar for 1700 to 2200 ppm and 2400 to 2800 ppm fluoride toothpaste when compared to 1450 to 1500 ppm (SMD 0.04, 95% CI -0.07 to 0.15, indirect evidence only; SMD -0.05, 95% CI -0.14 to 0.05, two studies).In the adult permanent dentition, 1000 or 1100 ppm fluoride toothpaste reduces DMFS increment when compared with non-fluoride toothpaste in adults of all ages (MD -0.53, 95% CI -1.02 to -0.04; 2162 participants, three studies, moderate-certainty evidence). The evidence for DMFT was low certainty.Only a minority of studies assessed adverse effects of toothpaste. When reported, effects such as soft tissue damage and tooth staining were minimal. AUTHORS' CONCLUSIONS This Cochrane Review supports the benefits of using fluoride toothpaste in preventing caries when compared to non-fluoride toothpaste. Evidence for the effects of different fluoride concentrations is more limited, but a dose-response effect was observed for D(M)FS in children and adolescents. For many comparisons of different concentrations the caries-preventive effects and our confidence in these effect estimates are uncertain and could be challenged by further research. The choice of fluoride toothpaste concentration for young children should be balanced against the risk of fluorosis.
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Affiliation(s)
- Tanya Walsh
- The University of ManchesterDivision of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and HealthCoupland Building 3Oxford RoadManchesterUKM13 9PL
| | - Helen V Worthington
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthCoupland Building 3Oxford RoadManchesterUKM13 9PL
| | - Anne‐Marie Glenny
- The University of ManchesterDivision of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and HealthCoupland Building 3Oxford RoadManchesterUKM13 9PL
| | - Valeria CC Marinho
- Queen Mary University of LondonClinical and Diagnostic Oral Sciences, Barts and The London School of Medicine and DentistryTurner StreetWhitechapelLondonUKE1 2AD
| | - Ana Jeroncic
- University of Split School of MedicineDepartment of Research in Biomedicine and HealthSoltanska 2SplitCroatia21000
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Yanagida R, Satou R, Sugihara N. Estimation of daily fluoride intake of infants using the microdiffusion method. J Dent Sci 2019; 14:1-6. [PMID: 30988873 PMCID: PMC6445924 DOI: 10.1016/j.jds.2018.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/13/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND/PURPOSE The standard of daily fluoride intake (DFI) has been discussed mainly for adults since 1950s in Japan. Although dietary habits have changed significantly in recent years, there have been no further studies on DFI in the past 10 years, and the need for further review has been discussed. Additionally, fluoride bioavailability in infants is higher than that in adults; hence, an excess fluoride intake often manifests symptoms. However, the number of studies on the DFI of infants is less than that of adults. The purpose of this study is to investigate the DFI for Japanese infants to provide adequate fluoride application. MATERIALS AND METHODS 20 products of infant foods for 4 age groups, 5 products of infant formulas, and 5 products of bottle water available in retail stores in Japan were prepared for this study. Fluoride concentration of each product was measured by microdiffusion method and fluoride ion-selective electrode, and then DFI in infants aged 5, 7, 9, and 12 months were calculated. RESULTS According to our study, the DFI in infants aged 5, 7, 9, and 12 months is 185.34 μg/day, 181.16 μg/day, 174.59 μg/day, and 179.19 μg/day, respectively. CONCLUSION From this result, it is estimated that the DFI from infant food and beverages in Japan is lower than the standard in other countries. Lifestyles and dietary habits are different in each country, and a new standard of DFI for Japanese children is required to meet the adequate fluoride recommendation.
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Affiliation(s)
| | - Ryouichi Satou
- Department of Epidemiology and Public Health, Tokyo Dental College, Tokyo, Japan
| | - Naoki Sugihara
- Department of Epidemiology and Public Health, Tokyo Dental College, Tokyo, Japan
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Aesthetic treatment of dental fluorosis in a 9-year-old girl: Case report. BALKAN JOURNAL OF DENTAL MEDICINE 2019. [DOI: 10.2478/bjdm-2019-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background/Aim: Dental fluorosis is a specific disturbance of tooth formation caused by excessive intake of fluoride. The discoloration of teeth is the most common reason for parents to seek treatment. The purpose of this paper is to describe the therapeutic management performed in a 9-year-old girl with fluorosis. Case report: A clinical case of a 9-year-old girl diagnosed with fluorosis is reported. The treatment of this clinical case was achieved using microabrasion, which is a minimally invasive method. This technique improves the aesthetics of the teeth without causing significant loss of dental tissue; a characteristic making microabrasion applicable to children as well. Its implementation involved the combined use of 18% hydrochloric acid and pumice on the enamel surface of upper incisors. The improved appearance of the teeth was aesthetically pleasing and, consequently, the patient gained in self-confidence. Conclusions: In the literature, several treatment choices are proposed, depending on the severity of the fluorosis. In our case, microabrasion was applied and the aesthetic outcome satisfied both the patient and the dentist.
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Sezgin BI, Onur ŞG, Menteş A, Okutan AE, Haznedaroğlu E, Vieira AR. Two-fold excess of fluoride in the drinking water has no obvious health effects other than dental fluorosis. J Trace Elem Med Biol 2018; 50:216-222. [PMID: 30262282 DOI: 10.1016/j.jtemb.2018.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 06/22/2018] [Accepted: 07/09/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND There is concern that fluorides in the drinking water is hazardous to health. METHODS We conducted an observational study in the village of Hanliyenice (population 280), Turkey, which has 2.5 times higher than optimal levels of fluoride in the drinking water and evaluated all children 7-13 years of age (N = 30). We collected information on dental decay, fluorosis, daily water consumption and diet, child history and her family history of cancer, cardiovascular risks/diseases, and asthma, and obtained a blood sample for extraction of genomic DNA. We genotyped ten single nucleotide polymorphisms in aquaporins. RESULTS As expected, a high number of children were dental caries free (19 out of 30) and had fluorosis (25 out of 30). Family history of cancer, cardiovascular events, and asthma was not different from the expected figures based on Turkey. One variant just upstream of AQP5 was associated with being fluorosis free. (G allele of AQP5 rs296763, p = 6.0E-6). CONCLUSIONS Exposure to levels of fluoride twice as high than the optimum in the drinking water increases the prevalence of fluorosis, dramatically decreases dental caries, and does not increase the risk of cancer, cardiovascular events, and asthma.
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Affiliation(s)
- Batın Ilgıt Sezgin
- Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Turkey.
| | - Şirin Güner Onur
- Department of Pediatric Dentistry, School of Dentistry, Trakya University, Edirne, Turkey.
| | - Ali Menteş
- Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Turkey.
| | - Alev Eda Okutan
- Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Turkey.
| | - Eda Haznedaroğlu
- Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Turkey.
| | - Alexandre Rezende Vieira
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, USA.
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Sousa ETD, Alves VF, Maia FBM, Nobre-dos-Santos M, Forte FDS, Sampaio FC. Influence of Fluoridated Groundwater and 1,100 Ppm Fluoride Dentifrice on Biomarkers of Exposure to Fluoride. Braz Dent J 2018; 29:475-482. [DOI: 10.1590/0103-6440201801959] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 06/25/2018] [Indexed: 11/21/2022] Open
Abstract
Abstract This research aimed to determine the influence of fluoridated groundwater and 1,100 ppm fluoride dentifrice on biomarkers of exposure to fluoride in preschoolers. A cross-sectional study was performed on thirty preschoolers recruited from naturally fluoridated and non-fluoridated areas (n=15). Total Daily Fluoride Intake (TDFI) from diet and dentifrice, and Daily Urinary Fluoride Excretion (DUFE) was measured over 24 h. Nails samples were collected twice during 30 days. Fluoride analyses were performed using a fluoride-ion-specific electrode. Data were evaluated using the Student and paired t-test, Pearson correlation analysis, multiple linear regression analysis (α≤0.05). Fluoridated groundwater and dentifrice were the dominant sources (r2 > 0.83) of TDFI in children from a naturally fluoridated and a non-fluoridated area, respectively. A positive correlation between TDFI and DUFE (r=0.50), and between [F] in fingernails and toenails (r=0.60) were found in children from a naturally fluoridated area. The [F] in nails of finger and toe were not correlated to TDFI. The consumption of fluoridated groundwater influenced the fluoride concentration in urine. In addition, the use of 1,100 ppm fluoride dentifrice did not influence the fluoride concentration in urine and fingernails.
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Vieira TI, Mangabeira A, Alexandria AK, Ferreira DMTP, Fidalgo TKDS, Valença AMG, Maia LC. Does flavoured dentifrice increase fluoride intake compared with regular toothpaste in children? A systematic review and meta-analysis. Int J Paediatr Dent 2018; 28:279-290. [PMID: 29345027 DOI: 10.1111/ipd.12354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Toothpaste manufacturers encourage through aggressive marketing strategies the overconsumption of fluoridated dentifrices. There are conflicting results regarding fluoride intake from toothpastes in children. AIM The aim of this systematic review and meta-analysis was to determine whether dentifrice flavour increases fluoride ingestion by children. DESIGN We included clinical trials on children that evaluated the use of flavoured dentifrice - FD vs regular dentifrice - RD to identify the fluoride intake. An electronic search was performed in PubMed, Web of Science, Scopus, The Cochrane Library, LILACS/BBO, and grey literature followed by manual search. The methodological quality of the studies was assessed using the Cochrane Collaboration common scheme for bias and ROBINS-I tool. Data were analysed in subgroups such as low (G1) and ordinary (G2) fluoride concentrations of dentifrices. We carried out heterogeneity and sensitive analyses. RESULTS For G1, the fluoride intake from RD was significantly higher than from FD [standardised mean difference = -2.57 (-3.26, -1.89), P < 0.00001]. For G2, the fluoride ingestion from RD was significantly higher than from FD [mean difference = -0.00 (-0.00, -0.00), P = 0.02]. CONCLUSIONS There is evidence to support the null hypothesis that flavouring from dentifrice does not increase fluoride intake in young children.
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Affiliation(s)
- Thiago Isidro Vieira
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Adrielle Mangabeira
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Adílis Kalina Alexandria
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Tatiana Kelly da Silva Fidalgo
- Department of Preventive and Community Dentistry, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Ana Maria Gondim Valença
- Department of Clinic and Social Dentistry, School of Dentistry, Universidade Federal da Paraíba, Paraíba, Brazil
| | - Lucianne Cople Maia
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Oliveira PFTD, Cury JA, Lima CV, Vale GC, Lima MDDMD, Moura LDFADD, Moura MSD. Is the fluoride intake by diet and toothpaste in children living in tropical semi-arid city safe? Braz Oral Res 2018; 32:e26. [DOI: 10.1590/1807-3107bor-2018.vol32.0026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 02/23/2018] [Indexed: 11/22/2022] Open
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Lima-Arsati YBDO, Gomes ARLF, Santos HKA, Arsati F, Oliveira MC, Freitas VS. Exposição a fluoreto por crianças na faixa etária crítica para fluorose dentária, residentes no semiárido brasileiro. CIENCIA & SAUDE COLETIVA 2018; 23:1045-1054. [DOI: 10.1590/1413-81232018234.07952016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 06/23/2016] [Indexed: 11/21/2022] Open
Abstract
Resumo Há uma preocupação com o aumento da prevalência de fluorose dentária, que depende da dose de fluoreto (F) a que as crianças são submetidas durante a formação dos dentes. A temperatura ambiental afeta a ingestão de água e, portanto, seria importante avaliar se as crianças que vivem em uma região de clima semiárido estão expostas a uma dose excessiva de F. Assim, o objetivo do presente estudo foi determinar a dose total de F a que as crianças são expostas durante a idade crítica para a fluorose dentária, tendo dieta (água e alimentos) e dentifrício como fontes de F, em uma região de clima semiárido no Brasil. Metodologia: foram selecionadas 26 crianças com idade de 25,2 ± 9,1 meses, residentes em Feira de Santana-BA. Foram coletadas amostras de dieta-duplicada, água, produtos de escovação e dentifrícios. A concentração de F foi determinada após o devido preparo das amostras, utilizando um eletrodo específico. Resultados: a média e o desvio padrão de dose (mg F / kg / dia) em função da dieta, dentifrício e total foram, respectivamente: 0,016 ± 0,010; 0,030 ± 0,039 e 0,047 ± 0,043. Conclusões: as crianças avaliadas, residentes em uma região de clima semiárido, não estão expostas a uma dose de risco de fluorose dentária.
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Bhagavatula P, Curtis A, Broffitt B, Weber-Gasparoni K, Warren J, Levy SM. The relationships between fluoride intake levels and fluorosis of late-erupting permanent teeth. J Public Health Dent 2018; 78:165-174. [PMID: 29286185 PMCID: PMC7901719 DOI: 10.1111/jphd.12260] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 10/26/2017] [Accepted: 11/10/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine the relationships between fluoride intake levels and fluorosis of late-erupting permanent teeth. METHODS The current study used information collected from 437 children in the longitudinal Iowa Fluoride Study. Participants' fluoride intake information was collected using questionnaires from birth to age 10 years. Estimated mean daily fluoride intake was categorized into low, moderate, and high intake tertiles for each age interval (2-5, 5-8, and 2-8 years). Bivariate analyses were performed to study the relationships between self-reported fluoride intake levels during three age intervals and dental fluorosis. RESULTS For canines and second molars, the prevalence of mostly mild fluorosis was less than 10% in the lowest fluoride intake tertile and more than 25% in the highest intake tertile. For both first and second premolars, the prevalence in the low and high intake tertiles was approximately 10-15% and 25-40%, respectively. When estimated total daily fluoride intake was 0.04 mg/kg BW during ages 2-8 years, the predicted probability of fluorosis was 16.0%, 20.5%, 21.8%, and 15.4% for canines, 1st and 2nd and premolars and 2nd molars, respectively. We found that an incremental increase in fluoride intake during the age 5- to 8-year interval led to greater odds for development of mostly mild dental fluorosis in late-erupting teeth compared to increases in fluoride intake during other age intervals. CONCLUSIONS Our results clearly show that dental fluorosis prevalence is closely related to fluoride intake levels and that teeth have greater susceptibility to fluoride intake during certain age intervals.
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Affiliation(s)
- Pradeep Bhagavatula
- Department of Clinical Services, Marquette University School of Dentistry, Milwaukee, WI, USA
| | - Alexandra Curtis
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Barbara Broffitt
- Department of Preventive & Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Karin Weber-Gasparoni
- Department of Pediatric Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - John Warren
- Department of Preventive & Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Steven M Levy
- Department of Preventive & Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
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Zohoori FV, Maguire A. Are there good reasons for fluoride labelling of food and drink? Br Dent J 2018; 224:215-217. [DOI: 10.1038/sj.bdj.2018.123] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2017] [Indexed: 11/09/2022]
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Affiliation(s)
- E A Martinez-Mier
- 1 Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN, USA
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Spencer A, Do L, Mueller U, Baines J, Foley M, Peres M. Understanding Optimum Fluoride Intake from Population-Level Evidence. Adv Dent Res 2018; 29:144-156. [DOI: 10.1177/0022034517750592] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Policy on fluoride intake involves balancing caries against dental fluorosis in populations. The origin of this balance lies with Dean’s research on fluoride concentration in water supplies, caries, and fluorosis. Dean identified cut points in the Index of Dental Fluorosis of 0.4 and 0.6 as critical. These equate to 1.3 and 1.6 mg fluoride (F)/L. However, 1.0 mg F/L, initially called a permissible level, was adopted for fluoridation programs. McClure, in 1943, derived an “optimum” fluoride intake based on this permissible concentration. It was not until 1944 that Dean referred to this concentration as the “optimal” concentration. These were critical steps that have informed health authorities through to today. Several countries have derived toxicological estimates of an adequate and an upper level of intake of fluoride as an important nutrient. The US Institute of Medicine (IOM) in 1997 estimated an Adequate Intake (AI) of 0.05 mg F/kg bodyweight (bw)/d and a Tolerable Upper Intake Level (UL) of 0.10 mg F/kg bw/d. These have been widely promulgated. However, a conundrum has existed with estimates of actual fluoride intake that exceed the UL without the expected adverse fluorosis effects being observed. Both the AI and UL need review. Fluoride intake at an individual level should be interpreted to inform more nuanced guidelines for individual behavior. An “optimum” intake should be based on community perceptions of caries and fluorosis, while the ultimate test for fluoride intake is monitoring caries and fluorosis in populations.
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Affiliation(s)
- A.J. Spencer
- Australian Research Centre for Population Oral Health (ARCPOH), The University of Adelaide, Adelaide, Australia
| | - L.G. Do
- Australian Research Centre for Population Oral Health (ARCPOH), The University of Adelaide, Adelaide, Australia
| | - U. Mueller
- Chemical Safety and Nutrition Section, Food Standards Australia New Zealand, Canberra, Australia
| | - J. Baines
- Formerly of Food Data Analysis Section, Food Standards Australia New Zealand, Canberra, Australia
| | - M. Foley
- Research and Advocacy, Metro North Oral Health Services, Brisbane, Australia
| | - M.A. Peres
- Australian Research Centre for Population Oral Health (ARCPOH), The University of Adelaide, Adelaide, Australia
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Mariño R, Traub F, Lekfuangfu P, Niyomsilp K. Cost-effectiveness analysis of a school-based dental caries prevention program using fluoridated milk in Bangkok, Thailand. BMC Oral Health 2018; 18:24. [PMID: 29448929 PMCID: PMC5815217 DOI: 10.1186/s12903-018-0485-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 02/09/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study modelled the cost-effectiveness, from a societal perspective, of a program that used fluoridated milk to prevent dental caries in children who were 6 years old at the beginning of the program, versus non-intervention, after 6 years. METHODS After 6 years, children in the milk-fluoridation program had a significant (34%) reduction in dental caries experience compared to those in the comparison community (i.e., received school milk without added fluoride) (DMFS: 1.06 vs. 1.60). RESULTS This improvement was achieved with an investment of Thailand Baht (THB) 5,345,048 over 6 years (or THB 11.88 per child, per year) (1 US$ = THB(2011) 30.0). When comparing the costs of the operation of the program and dental treatment in the test community with those of the comparison community, the program resulted in a net societal savings of THB 8,177,179 (range 18,597,122 to THB 7,920,711) after 6 years. This investment would result in 40,500 DMFS avoided in a community with a childhood population of 75,000 [DMFS avoided: 75,000 x (- 0.54)]. CONCLUSIONS While the analysis has inherent limitations due to its dependence on a range of assumptions, the results suggest that, from a societal perspective, when compared with the non-intervention group, the Bangkok Metropolitan Administration intervention appeared to be a more cost-efficient option than current standard oral health care.
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Affiliation(s)
- Rodrigo Mariño
- Melbourne Dental School, Oral Health Cooperative Research Centre, University of Melbourne, Melbourne, VIC 3010 Australia
| | - Fernando Traub
- Melbourne Dental School, Oral Health Cooperative Research Centre, University of Melbourne, Melbourne, VIC 3010 Australia
| | - Puangtong Lekfuangfu
- Dental Health Bureau, Department of Health, Ministry of Public Health, Bangkok, Thailand
| | - Kornkamol Niyomsilp
- Dental Health Bureau, Department of Health, Ministry of Public Health, Bangkok, Thailand
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Linhares DPS, Garcia PV, Amaral L, Ferreira T, Dos Santos Rodrigues A. Safety Evaluation of Fluoride Content in Tea Infusions Consumed in the Azores-a Volcanic Region with Water Springs naturally Enriched in Fluoride. Biol Trace Elem Res 2017; 179:158-164. [PMID: 28120305 DOI: 10.1007/s12011-017-0947-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 01/18/2017] [Indexed: 10/20/2022]
Abstract
Tea is the second most commonly consumed beverage in the world. It is well recognized that the consumption of tea in high quantities can promote the development of fluorosis. The main objective of this study is to estimate the exposure to fluoride in the Azores through drinking tea prepared with water from different volcanic locations, by i) investigating the fluoride (F) content of various commercial brands of tea (Camellia sinensis) marketed in Azores and ii) comparing tea releasing rates of F according to brewing time, considering the fluoride concentration in the different types of water used for the infusion. Fluoride contents were determined by ion-selective electrode in 30 samples of drinking water from three different locations and in 450 samples of tea (black and green tea) from three different brands. Fluoride concentration in water ranged from 0.29 to 1.56 ppm (Porto Formoso and Sete Cidades village, respectively). Fluoride concentrations increased with brewing time, reaching the highest values in the Azorean black and green tea infusions. For all the studied brands, a negative correlation was found between tea fluoride contents and the pH of the water used to prepare the infusion. Fluoride concentration in infusions was significantly associated with the background fluoride concentration in drinking water. Since the fluoride concentration in groundwater varies accordingly to the geological conditions and tea consumption can contribute to fluoride intake, it is important to define the limits for tea consumption, particularly in fluoride-rich areas. Graphical Abstract Fluoride concentrations in black and green tea for 3 minutes of brewing time and, association between fluoride concentration and pH with brewing time.
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Affiliation(s)
- Diana Paula Silva Linhares
- Faculty of Sciences and Technology, University of the Azores, Rua da Mãe de Deus, Apartado 1422, 9501-801, Ponta Delgada, Azores, Portugal.
- IVAR, Instituto de Investigação em Vulcanologia e Avaliação de Riscos, University of the Azores, 9501-801 Ponta Delgada, Azores, Portugal.
| | - Patrícia Ventura Garcia
- Faculty of Sciences and Technology, University of the Azores, Rua da Mãe de Deus, Apartado 1422, 9501-801, Ponta Delgada, Azores, Portugal
- cE3c, Centre for Ecology, Evolution and Environmental Changes and Azorean Biodiversity Group, University of the Azores, 9501-801 Ponta Delgada, Azores, Portugal
| | - Leslie Amaral
- Faculty of Sciences and Technology, University of the Azores, Rua da Mãe de Deus, Apartado 1422, 9501-801, Ponta Delgada, Azores, Portugal
- School of Sciences, University of Minho, Gualtar Campus, 4710-057, Braga, Portugal
| | - Teresa Ferreira
- Faculty of Sciences and Technology, University of the Azores, Rua da Mãe de Deus, Apartado 1422, 9501-801, Ponta Delgada, Azores, Portugal
- IVAR, Instituto de Investigação em Vulcanologia e Avaliação de Riscos, University of the Azores, 9501-801 Ponta Delgada, Azores, Portugal
| | - Armindo Dos Santos Rodrigues
- Faculty of Sciences and Technology, University of the Azores, Rua da Mãe de Deus, Apartado 1422, 9501-801, Ponta Delgada, Azores, Portugal
- cE3c, Centre for Ecology, Evolution and Environmental Changes and Azorean Biodiversity Group, University of the Azores, 9501-801 Ponta Delgada, Azores, Portugal
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Zohoori FV, Maguire A. Determining an Upper Reference Value for the Urinary Fluoride-Creatinine Ratio in Healthy Children Younger than 7 Years. Caries Res 2017; 51:283-289. [PMID: 28535503 DOI: 10.1159/000472263] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 03/21/2017] [Indexed: 11/19/2022] Open
Abstract
The urinary fluoride/creatinine ratio (UF/Cr) in a spot urine sample could be a useful systemic F exposure monitoring tool. No reference value for UF/Cr currently exists, therefore this study aimed to establish an upper reference value for a UF/Cr, corresponding to excessive systemic F exposure, i.e., >0.07 mg F/kg body weight (b.w.)/day, in children. Subsidiary aims were to examine the relationship between (i) total daily F intake (TDFI) and 24-h urinary F excretion (DUFE); (ii) DUFE and UF/Cr, and (iii) TDFI and UF/Cr. Simultaneously collected TDFI, DUFE, and urinary creatinine (UCr) data in children <7 years were taken from UK studies conducted from 2002 to 2014 in order to calculate UF/Cr (mg/g) for each child. For the 158 children (mean age 5.8 years) included in the data analysis, mean TDFI and DUFE were 0.049 (SD 0.033) and 0.016 (SD 0.008) mg/kg b.w./day, respectively, and the mean UF/Cr was 1.21 (SD 0.61) mg/g. Significant (p < 0.001) positive linear correlations were found between TDFI and DUFE, DUFE and UF/Cr, and TDFI and UF/Cr. The estimated upper reference value for UF/Cr was 1.69 mg/g; this was significantly (p = 0.019) higher than the UF/Cr (1.29) associated with optimal F exposure (0.05-0.07 mg/kg b.w./day). In conclusion, the strong positive correlation between TDFI and UF/Cr confirms the strong association of these 2 F exposure variables and the value of a spot urine sample for prediction of TDFI (i.e., the most important risk factor in determining fluorosis occurrence and severity) in young children. Establishing an estimation of an upper reference value of 1.69 mg/g for UF/Cr in spot urine samples could simplify and facilitate their use as a valuable tool in large epidemiological studies.
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Affiliation(s)
- F Vida Zohoori
- School of Health and Social Care, Teesside University, Middlesbrough, UK
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Liu Y, Maguire A, Tianqui G, Yanguo S, Zohoori FV. Fluoride concentrations in a range of ready-to-drink beverages consumed in Heilongjiang Province, north-east China. Nutr Health 2017; 23:25-32. [PMID: 28032531 DOI: 10.1177/0260106016685726] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Consumption of ready-to-drink beverages, as a potential source of fluoride (F), has increased considerably in China over the last decade. To help inform the public and policy makers, this study aimed to measure F concentration of ready-to-drink beverages on sale in Heilongjiang province, north east China. Three batches of 106 drink products manufactured by 26 companies were purchased from the main national supermarkets in Harbin, Heilongjiang province, China. The F concentration of all samples was determined, in triplicate, using a fluoride ion-selective electrode in conjunction with a meter and a direct method of analysis. The products were categorised into 10 groups according to product type. F concentrations of the samples ranged from 0.012-1.625 mg/l with a mean of 0.189 mg/l and a median of 0.076 mg/l. More than half of the products (55%) had an F concentration of ≤0.1 mg/l, while <5% had a F concentration of >0.7 mg/l. The 'tea with milk' group contained the highest mean F concentration (1.350 mg/l), whereas the lowest mean F concentration (0.027 mg/l) was found for the 'fruit juice' group. For some products, such as tea, fruit juice and carbonated beverages, there were substantial variations in F concentration between batches, manufacturers and production sites. In conclusion, ready-to-drink products (apart from tea), sold in Heilongjiang province, China, when consumed in moderation are unlikely to constitute a substantial risk factor for the development of dental or skeletal fluorosis.
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Affiliation(s)
- Ying Liu
- 1 Harbin University of Commerce, PR China
| | | | | | - Shi Yanguo
- 1 Harbin University of Commerce, PR China
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Cury JA, Del Fiol FS, Tenuta LMA, Rosalen PL. Low-fluoride Dentifrice and Gastrointestinal Fluoride Absorption after Meals. J Dent Res 2016; 84:1133-7. [PMID: 16304442 DOI: 10.1177/154405910508401208] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A low-fluoride (F) dentifrice has been recommended to reduce the risk of dental fluorosis, but its anti-caries efficacy is questionable compared with that of conventional dentrifices (1000–1100 μg F/g). The tested hypothesis was that conventional dentifrices might be safe if used soon after meals, since food interferes with F absorption. In a crossover, double-blind study, 11 volunteers ingested a dentifrice slurry containing 0 (placebo), 550 (low F), or 1100 μg F/g in 3 gastric content situations: on fasting, or 15 min after breakfast or lunch. F was analyzed in saliva and 24-hour urine samples. The conventional dentifrice ingested after lunch resulted in only 10% higher F absorption than the low-F ingested on fasting. Analysis of the data suggests that the risk of fluorosis could be reduced by the use of either a low-F dentifrice or a conventional dentifrice, if toothbrushing occurred soon after meals.
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Affiliation(s)
- J A Cury
- Faculty of Dentistry of Piracicaba, UNICAMP, Av. Limeira 901, 13414-903, Piracicaba, SP, Brazil.
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Omid N, Maguire A, O'Hare WT, Zohoori FV. Total daily fluoride intake and fractional urinary fluoride excretion in 4- to 6-year-old children living in a fluoridated area: weekly variation? Community Dent Oral Epidemiol 2016; 45:12-19. [DOI: 10.1111/cdoe.12254] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 08/05/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Narges Omid
- Health and Social Care Institute; Teesside University; Middlesbrough UK
| | - Anne Maguire
- Centre for Oral Health Research; School of Dental Sciences; Newcastle University; Newcastle-upon-Tyne UK
| | - William T. O'Hare
- School of Science and Engineering; Teesside University; Middlesbrough UK
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Abstract
AIM To provide a comprehensive report of fluoride concentration in UK infant milks and estimate their contribution to daily fluoride intake. METHODS A total of 60 formula milk products available commercially or within a hospital environment were analysed, along with eight pasteurised cow's milk samples. Formula milk products requiring preparation were reconstituted with fresh Leeds tap water (0.02 ppmF). Fluoride concentration was measured for all products directly using an ion selective electrode after addition of low-level total ionic strength adjustment buffer. RESULTS The overall median fluoride concentration for the 68 infant milks was 0.025 ppmF, with a wide range of 0.002-0.282 ppmF. Analysis revealed variation between composition and manufacturer, in addition to differences between measured and labeled fluoride concentration. Although all products contained low fluoride concentration, the fluoride concentrations for formula milks used within the hospital setting (0.029 ppmF) were statistically higher in comparison to the commercial formula milk (0.016 ppmF) and cow's milk (0.017 ppmF) products. The daily fluoride contribution from infant milks was low; 0.0034 mgF/kg body weight per day was estimated between birth and 6 months of age, further decreasing as intake of infant milk decreased with age. CONCLUSIONS Fluoride concentration of the analysed infant milks is low, providing minimal contribution towards total daily F intake and alone are unlikely to pose a threat for the development of dental fluorosis.
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Oliveira LFBD, Souza JGS, Mendes RIP, Oliveira RCN, Oliveira CDC, Lima CV, Martins AMEDBL. Is there an association between the presence of dental fluorosis and dental trauma amongst school children? CIENCIA & SAUDE COLETIVA 2016; 21:967-76. [PMID: 26960108 DOI: 10.1590/1413-81232015213.12952015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 07/24/2015] [Indexed: 11/22/2022] Open
Abstract
Our objective was to evaluate whether there is an association with the different levels of dental fluorosis and the presence of dental trauma amongst school children. A transversal study was conducted amongst school children from the age of 12. Dental examinations were conducted by 24 well trained and fully qualified dental surgeons. Data was collected from 36 randomly selected public schools amongst 89 schools in a municipality. The criteria used to diagnose dental fluorosis was based on the Dean's fluorosis Index and for diagnosing dental trauma we looked for clinical signs of crown fractures and dental avulsions. Multiple descriptive analysis, which was bivariate, was carried out. Amongst the 2,755 school children that took part in the study 1,089 (39.6%) were diagnosed with dental fluorosis and 106 (3.8%) had one tooth or more with dental trauma. We noted a high prevalence of dental fluorosis, independent of the level of severity, amongst individuals with one tooth or more who had dental trauma. This association was even more evident where there were severely high levels of fluorosis. We also noted that the presence of fluorosis was greater amongst those that actively paid more attention to discoloration on their teeth and who received treatment from a dental professional at their schools. Nevertheless dental fluorosis was associated with the presence of dental trauma, independent of its severity.
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Affiliation(s)
- Lorenna Fonseca Braga de Oliveira
- Departamento de Odontologia, Centro de Ciências Básicas e da Saúde, Universidade Estadual de Montes Claros, Montes Claros, MG, Brasil,
| | - João Gabriel Silva Souza
- Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, SP, Brasil
| | | | - Rodrigo Caldeira Nunes Oliveira
- Departamento de Odontologia, Centro de Ciências Básicas e da Saúde, Universidade Estadual de Montes Claros, Montes Claros, MG, Brasil,
| | - Carolina de Castro Oliveira
- Departamento de Odontologia, Centro de Ciências Básicas e da Saúde, Universidade Estadual de Montes Claros, Montes Claros, MG, Brasil,
| | - Carolina Veloso Lima
- Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, SP, Brasil
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Association between estimated fluoride intake and dental caries prevalence among 5-year-old children in Korea. BMC Oral Health 2015; 15:169. [PMID: 26715525 PMCID: PMC4696346 DOI: 10.1186/s12903-015-0153-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 12/15/2015] [Indexed: 11/17/2022] Open
Abstract
Background The purposes of this study were to estimate the fluoride intake from food and drink in 5-year-old Korean children, and to measure the association between estimated fluoride intake and dental caries prevalence. Methods The study involved a secondary analysis of raw data from the 4th Korea National Health and Nutrition Examination Survey (KNHANES; 2007–2009). The study subjects were 167 boys and 147 girls aged 5 years who had undergone both physical and nutritional examination as part of the survey. The KNHANES comprised a health questionnaire, a physical examination, and a nutritional examination. The nutritional examination of KNHANES consisted of 3 parts: a dietary life survey, a food-frequency questionnaire, and a food intake investigation. The food intake investigation used the 24-h recall method, with information being provided by the children’s parents. On the basis of this information, we evaluated the fluoride content in a total of 310 food items using the hexamethyldisiloxane (HMDS)-facilitated diffusion method, modified using Taves’ microdiffusion method. As part of the KNHANES survey, oral examinations were conducted at a mobile examination centre by trained dentists using dental mirrors under a fluorescent light. These examinations were performed using methods proposed by the World Health Organization. Results The dietary fluoride intake of 5-year-old Korean children was estimated to be 0.35 mg/day, or 0.016 mg/kg/day. The “decayed or filled surfaces” (dfs) indices of primary teeth were higher in children who had a lower dietary intake of fluoride. There was a significant inverse association between dietary fluoride intake and the prevalence of dental caries. Conclusion The inverse association between dietary fluoride intake levels and prevalence of dental caries implies that the introduction of community caries prevention programmes may be beneficial. Such programmes would include water fluoridation and a fluoride supplementation programme.
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Abstract
The 3-d food diary method (3-d FD) or the 2-d duplicate plate (2-d DP) method have been used to measure dietary fluoride (F) intake by many studies. This study aimed to compare daily dietary F intake (DDFI) estimated by the 3-d FD and 2-d DP methods at group and individual levels. Dietary data for sixty-one healthy children aged 4-6 years were collected using 3-d FD and 2-d DP methods with a 1-week gap between each collection. Food diary data were analysed for F using the Weighed Intake Analysis Software Package, whereas duplicate diets were analysed by an acid diffusion method using an F ion-selective electrode. Paired t test and linear regression were used to compare dietary data at the group and individual levels, respectively. At the group level, mean DDFI was 0·025 (sd 0·016) and 0·028 (sd 0·013) mg/kg body weight (bw) per d estimated by 3-d FD and 2-d DP, respectively. No statistically significant difference (P=0·10) was observed in estimated DDFI by each method at the group level. At an individual level, the agreement in estimating F intake (mg/kg bw per d) using the 3-d FD method compared with the 2-d DP method was within ±0·011 (95 % CI 0·009, 0·013) mg/kg bw per d. At the group level, DDFI data obtained by either the 2-d DP method or the 3-d FD method can be replaced. At an individual level, the typical error and the narrow margin between optimal and excessive F intake suggested that the DDFI data obtained by one method cannot replace the dietary data estimated from the other method.
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Lima CV, Cury JA, Vale GC, Lima MD, Moura LDFA, de Moura MS. Total Fluoride Intake by Children from a Tropical Brazilian City. Caries Res 2015; 49:640-6. [DOI: 10.1159/000442029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 10/28/2015] [Indexed: 11/19/2022] Open
Abstract
The main sources of fluoride intake by children are fluoridated water and toothpaste. Little has been studied regarding fluoride intake from these sources in regions with tropical climates and high temperatures throughout the year. This study aimed to determine the amount of fluoride ingested from diet and tooth brushing by children who live in a city with a tropical climate. Sixty-seven children from Teresina, Piauí, Brazil, took part in this study. The city's water supply was optimally fluoridated. The duplicate-diet method was used to determine the fluoride intake from diet. The intake of fluoride from dentifrice was determined by subtracting the amount of fluoride placed on the toothbrush and that recovered after brushing. The concentration of fluoride was measured using an ion-specific electrode and is expressed as milligrams/kilogram of body weight/day. The mean (±SD) total amount was 0.071 ± 0.036 mg F/kg body weight/day, and the relative contributions of diet and toothpaste were 0.025 ± 0.010 and 0.046 ± 0.035, respectively. The factors associated with fluoride intake from toothpaste were: use of children's toothpaste (p = 0.003), use of large amounts of toothpaste (p < 0.001), and a high frequency of tooth brushing (p = 0.003). Sixty-four percent of children had an intake of less than 0.07 mg F/kg body weight/day, which is considered the upper limit for an aesthetically tolerable fluorosis risk. The results suggest that the amount of fluoride ingested by most children who live in a Brazilian city with a tropical climate is considered safe in terms of the risk of dental fluorosis.
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Letter to the Editor. Eur Arch Paediatr Dent 2015; 16:431-2. [DOI: 10.1007/s40368-015-0188-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 04/24/2015] [Indexed: 11/27/2022]
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Mostafaei F, Blake SP, Liu Y, Sowers DA, Nie LH. Compact DD generator-based neutron activation analysis (NAA) system to determine fluorine in human bone in vivo: a feasibility study. Physiol Meas 2015; 36:2057-67. [PMID: 26289795 DOI: 10.1088/0967-3334/36/10/2057] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The subject of whether fluorine (F) is detrimental to human health has been controversial for many years. Much of the discussion focuses on the known benefits and detriments to dental care and problems that F causes in bone structure at high doses. It is therefore advantageous to have the means to monitor F concentrations in the human body as a method to directly assess exposure. F accumulates in the skeleton making bone a useful biomarker to assess long term cumulative exposure to F. This study presents work in the development of a non-invasive method for the monitoring of F in human bone. The work was based on the technique of in vivo neutron activation analysis (IVNAA). A compact deuterium-deuterium (DD) generator was used to produce neutrons. A moderator/reflector/shielding assembly was designed and built for human hand irradiation. The gamma rays emitted through the (19)F(n,γ)(20)F reaction were measured using a HPGe detector. This study was undertaken to (i) find the feasibility of using DD system to determine F in human bone, (ii) estimate the F minimum detection limit (MDL), and (iii) optimize the system using the Monte Carlo N-Particle eXtended (MCNPX) code in order to improve the MDL of the system. The F MDL was found to be 0.54 g experimentally with a neutron flux of 7 × 10(8) n s(-1) and an optimized irradiation, decay, and measurement time scheme. The numbers of F counts from the experiment were found to be close to the (MCNPX) simulation results with the same irradiation and detection parameters. The equivalent dose to the irradiated hand and the effective dose to the whole body were found to be 0.9 mSv and 0.33 μSv, respectively. Based on these results, it is feasible to develop a compact DD generator based IVNAA system to measure bone F in a population with moderate to high F exposure.
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Bhagavatula P, Levy SM, Broffitt B, Weber-Gasparoni K, Warren JJ. Timing of fluoride intake and dental fluorosis on late-erupting permanent teeth. Community Dent Oral Epidemiol 2015. [PMID: 26198477 DOI: 10.1111/cdoe.12187] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Very few studies have examined the relationship between timing of fluoride intake and development of dental fluorosis on late-erupting permanent teeth using period-specific fluoride intake information. This study examined this relationship using longitudinal fluoride intake information from the Iowa Fluoride Study. METHODS Participants' fluoride exposure and intake (birth to 10 years of age) from water, beverages, selected food products, dietary fluoride supplements, and fluoride toothpaste was collected using questionnaires sent to parents at 3- and 4- month intervals from birth to 48 months of age and every 6 months thereafter. Three trained and calibrated examiners used the Fluorosis Risk Index (FRI) categories to assess 16 late-erupting teeth among 465 study participants. A tooth was defined as having definitive fluorosis if any of the zones on that tooth had an FRI score of 2 or 3. Participants with questionable fluorosis were excluded from analyses. Descriptive and logistic regression analyses were performed to assess the importance of fluoride intake during different time periods. RESULTS Most dental fluorosis in the study population was mild, with only four subjects (1%) having severe fluorosis (FRI Score 3). The overall prevalence of dental fluorosis was 27.8%. Logistic regression analyses showed that fluoride intake from each of the individual years from age 2 to 8 plays an important role in determining the risk of dental fluorosis for most late-erupting permanent teeth. The strongest association for fluorosis on the late-erupting permanent teeth was with fluoride intake during the sixth year of life. CONCLUSION Late-erupting teeth may be susceptible to fluorosis for an extended period from about age 2 to 8. Although not as visually prominent as the maxillary central incisors, some of the late-erupting teeth are esthetically important and this should be taken into consideration when making recommendations about dosing of fluoride intake.
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Affiliation(s)
- Pradeep Bhagavatula
- Department of Clinical Services, Marquette University School of Dentistry Milwaukee, WI, USA
| | - Steven M Levy
- Department of Preventive and Community Dentistry, University of Iowa, College of Dentistry, Iowa City, IA, USA.,Department of Epidemiology, University of Iowa, College of Public Health, Iowa City, IA, USA
| | - Barbara Broffitt
- Department of Preventive and Community Dentistry, University of Iowa, College of Dentistry, Iowa City, IA, USA
| | - Karin Weber-Gasparoni
- Department of Pediatric Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - John J Warren
- Department of Preventive and Community Dentistry, University of Iowa, College of Dentistry, Iowa City, IA, USA
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Vithanage M, Bhattacharya P. Fluoride in Drinking Water: Health Effects and Remediation. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/978-3-319-11906-9_4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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An in situ caries study on the interplay between fluoride dose and concentration in milk. J Dent 2014; 42:883-90. [DOI: 10.1016/j.jdent.2014.01.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 12/20/2013] [Accepted: 01/21/2014] [Indexed: 11/20/2022] Open
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