Evaluation of the impact of fluoride in drinking water and tea on the enamel of deciduous and permanent teeth

Recommendations on Topical Fluoride Usage for Caries Management in East Asia

Dental caries is a widespread oral health issue in Asia, affecting an estimated 30% to 90% of children and adults. Many caries cases remain untreated, resulting in pain and infection. In response, the Asian Academy of Preventive Dentistry (AAPD) emphasises comprehensive caries management and organised a fluoride workshop at the 15th International Conference of the AAPD in 2023. The AAPD invited a group of experts to form a fluoride working group to review existing literature and develop fluoride recommendations for stakeholders across Asian countries and regions. The working group assessed caries risk and identified commonly used topical fluoride products for home care, professional, and community settings in Asia. The working group concluded that fluoride is a safe and highly effective strategy to reduce caries prevalence and incidence. The working group provided key recommendations based on successful regional caries management practices: (1) use topical fluoride for prevention and control of dental caries; (2) encourage the use of fluoride toothpaste with a concentration of at least 1,000 ppm for effective caries reduction; (3) advise a 0.05% fluoride mouth rinse as soon as children can spit it out to prevent early childhood caries; (4) deliver professionally administered fluoride, such as 5% sodium fluoride varnish, 2% fluoride gel, or 1.23% acidulated phosphate fluoride preparations, to decrease dental caries in at-risk individuals; and (5) apply 38% silver diamine fluoride to arrest cavitated caries. These recommendations aim to help practitioners, health care providers, and parents/caregivers make informed decisions about fluoride use as part of comprehensive oral health care in the region.

Drinking brick tea containing high fluoride increases the prevalence of osteoarthritis in Tibetan, China

The prevalence of osteoarthritis (OA) in Tibetans is higher than that in Han, while Tibetans have a habit of drinking brick tea with high fluoride. A cross-sectional study was conducted to explore the association between fluoride exposure in drinking brick tea and OA. All subjects were divided into four groups by the quartiles (Q) of tea fluoride (TF) and urine fluoride (UF). ROC was plotted and OR were obtained using logistic regression model. The prevalence of OA in the Q3 and Q4 group of TF were 2.2 and 2.7 times higher than in the Q1 group, and the prevalence of OA in the Q2, Q3 and Q4 group of UF were 3.2, 3.5, and 4.1 times higher than in the Q1 group. ROC analysis showed the cutoff values were 4.523 mg/day (TF) and 1.666 mg/L (UF). In conclusion, excessive fluoride in drinking brick tea could be a risk factor for developing OA.

Effect of Drinking Water Fluoride on Gingivitis and Caries: A Study in Peat and Non-Peat Land: A Comparative Cross-Sectional Study

Aim

Humans get fluoride from food and water available in their environment. The source of clean water in peatlands comes from rainwater with a low mineral content, especially fluoride. The objective of this study was to investigate the correlation between the fluoride level in drinking water and salivary fluoride levels, as well as their potential impact on dental and oral health conditions.

Materials and Methods

It is a causal-comparative study with a cross-sectional approach at the Health Polytechnics of Pontianak and Yogyakarta. The population were indigenous people in peat land (Pontianak) and non-peat land (Yogyakarta). The data were pH and mineral content in drinking water, saliva, the number of Streptococcus mutans colonies, dental caries rates, and gingivitis.

Results

Drinking water fluoride is only significantly correlated with salivary fluoride on non-peat land. If these data are combined, it can be seen that drinking water fluoride is positively correlated (P < 0.05; CI 95%) with pH water, fluoride water, and pH saliva. Increased levels of fluoride in drinking water were negatively correlated with gingivitis, dental caries, and S. mutans.

Conclusion

Drinking water fluoride is negatively correlated with dental caries and gingivitis in peatland and non-peatland communities, but would be significantly associated with dental caries and gingivitis if both peatland and non-peatland data were analyzed together. This is due to the low content of fluoride in the drinking water of peatland. Therefore, it is necessary to add fluoride gel to the teeth to prevent the development of dental caries.