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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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Yadav KK, Kumar S, Pham QB, Gupta N, Rezania S, Kamyab H, Yadav S, Vymazal J, Kumar V, Tri DQ, Talaiekhozani A, Prasad S, Reece LM, Singh N, Maurya PK, Cho J. Fluoride contamination, health problems and remediation methods in Asian groundwater: A comprehensive review. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2019; 182:109362. [PMID: 31254856 DOI: 10.1016/j.ecoenv.2019.06.045] [Citation(s) in RCA: 131] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 06/10/2019] [Accepted: 06/14/2019] [Indexed: 05/21/2023]
Abstract
In low concentration, fluoride is considered a necessary compound for human health. Exposure to high concentrations of fluoride is the reason for a serious disease called fluorosis. Fluorosis is categorized as Skeletal and Dental fluorosis. Several Asian countries, such as India, face contamination of water resources with fluoride. In this study, a comprehensive overview on fluoride contamination in Asian water resources has been presented. Since water contamination with fluoride in India is higher than other Asian countries, a separate section was dedicated to review published articles on fluoride contamination in this country. The status of health effects in Asian countries was another topic that was reviewed in this study. The effects of fluoride on human organs/systems such as urinary, renal, endocrine, gastrointestinal, cardiovascular, brain, and reproductive systems were another topic that was reviewed in this study. Different methods to remove fluoride from water such as reverse osmosis, electrocoagulation, nanofiltration, adsorption, ion-exchange and precipitation/coagulation were introduced in this study. Although several studies have been carried out on contamination of water resources with fluoride, the situation of water contamination with fluoride and newly developed technology to remove fluoride from water in Asian countries has not been reviewed. Therefore, this review is focused on these issues: 1) The status of fluoride contamination in Asian countries, 2) health effects of fluoride contamination in drinking water in Asia, and 3) the existing current technologies for defluoridation in Asia.
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Affiliation(s)
- Krishna Kumar Yadav
- Institute of Environment and Development Studies, Bundelkhand University, Kanpur Road, Jhansi, 284128, India
| | - Sandeep Kumar
- Centre for Environment Science and Climate Resilient Agriculture, Indian Agricultural Research Institute, New Delhi, 110012, India
| | - Quoc Bao Pham
- Department of Hydraulic and Ocean Engineering, National Cheng-Kung University, Tainan 701, Taiwan
| | - Neha Gupta
- Institute of Environment and Development Studies, Bundelkhand University, Kanpur Road, Jhansi, 284128, India
| | - Shahabaldin Rezania
- Department of Environment and Energy, Sejong University, Seoul, 05006, South Korea
| | - Hesam Kamyab
- UTM Razak School of Engineering and Advanced Technology, Universiti Teknologi Malaysia, Malaysia
| | - Shalini Yadav
- Department of Civil Engineering Rabindranath Tagore University Raisen, Madhya Prades, India
| | - Jan Vymazal
- Czech University of Life Sciences Prague, Faculty of Environmental Sciences, Kamýcká 129, 165 21 Praha 6, Czech Republic
| | - Vinit Kumar
- Institute of Environment and Development Studies, Bundelkhand University, Kanpur Road, Jhansi, 284128, India
| | - Doan Quang Tri
- Sustainable Management of Natural Resources and Environment Research Group, Faculty of Environment and Labour Safety, Ton Duc Thang University, Ho Chi Minh City, Viet Nam.
| | | | - Shiv Prasad
- Centre for Environment Science and Climate Resilient Agriculture, Indian Agricultural Research Institute, New Delhi, 110012, India
| | - Lisa M Reece
- Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston, TX, 77555, USA
| | - Neeraja Singh
- Department of Botany, University of Delhi, New Delhi, 110007, India
| | - Pradip Kumar Maurya
- Department of Zoology and Environmental Science, Gurukula Kangari Vishwavidyalaya, Haridwar, Uttarakhand, India
| | - Jinwoo Cho
- Department of Environment and Energy, Sejong University, Seoul, 05006, South Korea
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Ganta S, Yousuf A, Nagaraj A, Pareek S, Sidiq M, Singh K, Vishnani P. Evaluation of Fluoride Retention Due to Most Commonly Consumed Estuarine Fishes Among Fish Consuming Population of Andhra Pradesh as a Contributing Factor to Dental Fluorosis: A Cross-Sectional Study. J Clin Diagn Res 2015; 9:ZC11-5. [PMID: 26266208 PMCID: PMC4525598 DOI: 10.7860/jcdr/2015/12271.6035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 04/09/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Fluoride in drinking water is known for both beneficial and detrimental effects on health. The principal sources of fluoride include water, some species of vegetation, certain edible marine animals, dust and industrial processes. The purpose of this study was to evaluate the fluoride retention of most commonly consumed estuarine fishes among fish consuming population of Andhra Pradesh. MATERIALS AND METHODS A cross-sectional study was conducted to evaluate the amount of fluoride retention due to ten most commonly consumed estuarine fishes as a contributing factor to Fluorosis by SPADNS Spectrophotometric method. The presence and severity of dental fluorosis among fish consuming population was recorded using Community Fluorosis Index. Statistical analysis was done using MedCalc v12.2.1.0 software. RESULTS For Sea water fishes, the fluoride levels in bone were maximum in Indian Sardine (4.22 ppm). Amongst the river water fishes, the fluoride levels in bone were maximum in Catla (1.51 ppm). Also, the mean total fluoride concentrations of all the river fishes in skin, muscle and bone were less (0.86 ppm) as compared to the sea water fishes (2.59 ppm). It was unveiled that sea fishes accumulate relatively large amounts of Fluoride as compared to the river water fishes. The mean Community Fluorosis Index was found to be 1.06 amongst a sampled fish consuming population. Evaluation by Community Index for Dental fluorosis (CFI) suggested that fluorosis is of medium public health importance. CONCLUSION It was analysed that bone tends to accumulate more amount of fluoride followed by muscle and skin which might be due to the increased permeability and chemical trapping of fluoride inside the tissues. The amount of fluoride present in the fishes is directly related to the severity of fluorosis amongst fish consuming population, suggesting fishes as a contributing factor to fluorosis depending upon the dietary consumption.
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Affiliation(s)
- Shravani Ganta
- Senior Lecturer, Department of Public Health Dentistry, Jaipur Dental College, Jaipur, Rajasthan, India
| | - Asif Yousuf
- Registrar, Department of Public Health Dentistry, Government Dental College, Srinagar, J&K, India
| | - Anup Nagaraj
- Professor and Head, Department of Public Health Dentistry, Jaipur Dental College, Jaipur, Rajasthan, India
| | - Sonia Pareek
- Assistant Professor, Department of Public Health Dentistry, Government Dental College, Jaipur. Rajasthan, India
| | - Mohsin Sidiq
- Registrar, Department of Pedodontics, Govt. Dental College, Srinagar, J&K, India
| | - Kushpal Singh
- Senior Lecturer, Department of Public Health Dentistry, Panineeya Institute of Dental Sciences & Research Centre, Dilsukhnagar, Hyderabad, India
| | - Preeti Vishnani
- Post Graduate, Department of Public Health Dentistry, Jaipur Dental College, Jaipur, Rajasthan, India
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Freitas AR, Aznar FD, Tinós AM, Yamashita JM, Sales-Peres A, Sales-Peres SH. Association between dental caries activity, quality of life and obesity in Brazilian adolescents. Int Dent J 2014; 64:318-23. [DOI: 10.1111/idj.12121] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Levy FM, Olympio KPK, Philippi ST, Buzalaf MAR. Fluoride intake from food items in 2- to 6-year-old Brazilian children living in a non-fluoridated area using a semiquantitative food frequency questionnaire. Int J Paediatr Dent 2013; 23:444-51. [PMID: 23216445 DOI: 10.1111/ipd.12015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Estimating fluoride intake (FI) using the 'duplicate plate' method is difficult and can raise ethical dilemmas. AIM To apply a semiquantitative food frequency questionnaire (FFQ) to 2- to 6-year-old Brazilian children in a non-fluoridated area (i) to estimate their FI and (ii) to provide additional validity to the questionnaire by comparing the results obtained with those found previously in a fluoridated municipality. DESIGN The FFQ was administered to parents of 398 children residing in a non-fluoridated community. Constituents of the diet were divided into solids, water and other beverages and their fluoride content was analysed with the electrode. Data were analysed using unpaired t-test. RESULTS The mean (±SD) FIs from solids, water and other beverages were 0.009 ± 0.004, 0.001 ± 0.001 and 0.007 ± 0.007 mg F/kg body weight/day, respectively, totalling 0.017 ± 0.009 mg F/kg body weight/day. Total FI from food/beverage items ingested in the non-fluoridated area was significantly lower than that observed in a study previously conducted in a fluoridated area (P < 0.0001). CONCLUSIONS This result reinforces the use of the FFQ as a promising alternative to duplicate diet in order to estimate FI in children in this age range, with potential application in broad epidemiological surveys.
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Affiliation(s)
- Flavia Mauad Levy
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
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Bardal PAP, Olympio KPK, Buzalaf MAR, Dallari SG. [Current issues regarding health surveillance of fluoride concentrations in foods]. CAD SAUDE PUBLICA 2012; 28:573-82. [PMID: 22415189 DOI: 10.1590/s0102-311x2012000300017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Accepted: 11/21/2011] [Indexed: 11/21/2022] Open
Abstract
This study analyzed the position of the Federal (Brazil), State (São Paulo), and municipal (Bauru, São Paulo) governments, civil society representatives, the regulated sector, and research associations concerning issues with fluoride content in foods. Analysis of the interviews (N = 15) used a qualitative methodology (collective subject discourse theory). Various central ideas were identified, including the need for stronger health surveillance in monitoring and controlling fluoride levels, educational measures, and more research in the area. The study concludes that the health surveillance approach to fluoride levels in foods is necessary, but still incipient. There is a mismatch between research output and surveillance. Regulation alone does not suffice to solve all the issues. Health risk communication and health education measures need to be implemented. Issues with fluoride on food labels need further research for the intervention to be effective.
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Miziara APB, Philippi ST, Levy FM, Buzalaf MAR. Fluoride ingestion from food items and dentifrice in 2-6-year-old Brazilian children living in a fluoridated area using a semiquantitative food frequency questionnaire. Community Dent Oral Epidemiol 2009; 37:305-15. [PMID: 19515197 DOI: 10.1111/j.1600-0528.2009.00477.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the fluoride intake of 2-6-year-old Brazilian children using a semiquantitative food frequency questionnaire (FFQ) which also estimated fluoride intake from dentifrice. METHODS The FFQ was previously validated through application to 78 2-6-year-old Brazilian children and then administered to 379 children residing in an optimally fluoridated community in Brazil (Bauru, State of São Paulo). The FFQ was applied to the parents and used to estimate the food intake of the children. The constituents of the diet were divided into solids, water and other beverages. The fluoride content of the diet items was analyzed with the fluoride electrode. The questionnaire also estimated fluoride intake from dentifrice. RESULTS The average (+/-SD) fluoride intake from solids, water, other beverages and dentifrice was 0.008 +/- 0.005; 0.011 +/- 0.004; 0.009 +/- 0.014 and 0.036 +/- 0.028 mg F/kg body weight/day, respectively, totalizing 0.064 +/- 0.035 mg F/kg body weight/day. The dentifrice and the diet contributed with 56.3% and 43.7% of the daily fluoride intake, respectively. Among the children evaluated, 31.2% are estimated to have risk to develop dental fluorosis (intake>0.07 mg F/kg body weight/day). CONCLUSIONS The dentifrice was the main source of fluoride intake by the children evaluated. However, the fluoride concentration in food items also significantly contributed to the daily ingestion by 2-6-year-old children. The questionnaire used seems to be a promising alternative to duplicate diet to estimate the fluoride intake at this age range and may have potential to be used in broad epidemiological surveys.
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Lodi CS, Ramires I, Pessan JP, Neves LTD, Buzalaf MAR. Fluoride concentrations in industrialized beverages consumed by children in the city of Bauru, Brazil. J Appl Oral Sci 2007; 15:209-12. [PMID: 19089131 PMCID: PMC4327468 DOI: 10.1590/s1678-77572007000300010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2006] [Revised: 02/13/2007] [Accepted: 05/07/2007] [Indexed: 11/30/2022] Open
Abstract
UNLABELLED The increasing consumption of juices, soft drinks and teas among children has increased significantly fluoride ingestion at the age range of risk for development of dental fluorosis. OBJECTIVE The purpose of this study was to evaluate fluoride concentrations in some brands of industrialized beverages consumed by children in the city of Bauru, SP, Brazil. MATERIAL AND METHODS 98 brands of beverages were analyzed, divided into 3 lots, comprising 36, 32 and 30 brands, respectively, for the first, second and third lots. Fluoride concentrations were determined by HMDS-facilitated diffusion, using a fluoride ion-specific electrode (Orion 9409). RESULTS Fluoride concentrations ranged between 0.04 and 1.76 microg F/mL. It was observed a wide variation in fluoride concentrations among the different brands, as well as the different lots of the same brand. There was no information on fluoride concentrations on the labels of any product. CONCLUSIONS Some of the products analyzed could contribute significantly to the total fluoride intake and, thus, be important risk factors for development of dental fluorosis, which indicates the need of controlling the production of these beverages with respect to fluoride concentration.
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Affiliation(s)
- Carolina Simonetti Lodi
- DDS, MSc Student, Araçatuba Dental School, São Paulo State University, Araçatuba, SP, Brazil
| | - Irene Ramires
- DDS, MSc in Public Health in Dentistry, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Juliano Pelim Pessan
- DDS, MSc, PhD Student, Araçatuba Dental School, São Paulo State University, Araçatuba, SP, Brazil
| | - Lucimara Teixeira das Neves
- DDS, MSc, Professor, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
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Buzalaf MAR, Pinto CS, Rodrigues MHC, Levy FM, Borges AS, Furlani TA, da Silva Cardoso VE. Availability of fluoride from meals given to kindergarten children in Brazil. Community Dent Oral Epidemiol 2006; 34:87-92. [PMID: 16515672 DOI: 10.1111/j.1600-0528.2006.00266.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the amount of fluoride supplied daily in the meals given in 44 public kindergarten schools in Bauru, Brazil. In addition, the fluoride concentration of water supplies and its impact on the amount of fluoride found in the meal samples were also investigated. METHODS Meal samples and water were collected during 2 weeks (10 working days) in public kindergarten schools. Samples of meals were homogenized with known volumes of deionized water. Fluoride present in meal samples was analyzed with the ion-specific electrode (Orion 9609), after hexamethyldisilazane-facilitated diffusion. Fluoride in water samples was analyzed with the same electrode, after buffering with TISAB II. All the analyses were made in duplicate. RESULTS Fluoride analyzed (mean+/-SD) was 0.50+/-0.20 microg/ml, ranging from nondetectable to 1.42 microg/ml for water samples (n=424) and 0.067+/-0.059 mg, ranging from 0.007 to 0.580 mg for meal samples (n=431). A weak but significant correlation was observed between the amount of fluoride in meals and fluoride concentration in water supplies (r=0.139, P=0.0042). CONCLUSIONS Despite the seemingly small role played by school meals in the total daily fluoride intake, they can contribute to the total fluoride intake of children on a chronic basis, when in association with other fluoride products. Additionally, the impact of fluoridated public water supply on the final fluoride concentration of the school meals analyzed may be regarded as low.
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Affiliation(s)
- Marília Afonso Rabelo Buzalaf
- Department of Biological Sciences, Area of Biochemistry, Bauru Dental School, University of São Paulo, São Paulo, SP, Brazil
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Buzalaf MAR, Pessan JP, Fukushima R, Dias A, Rosa HM. Fluoride content of UHT milks commercially available in Bauru, Brazil. J Appl Oral Sci 2006; 14:38-42. [PMID: 19089028 PMCID: PMC4327169 DOI: 10.1590/s1678-77572006000100008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2005] [Revised: 09/16/2005] [Accepted: 09/27/2005] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The aims of the present study were to evaluate the fluoride (F) concentrations in whole, defatted and chocolate milks commercially available in Brazil and to estimate the daily F intake from these sources. MATERIAL AND METHODS F concentrations were determined for 23 brands of milks, after HMDS-facilitated diffusion, using a F ion-specific electrode. Possible F ingestion per kg body weight was estimated, based on suggested volumes of formula consumption, for infants aging 1 to 12 months. RESULTS F concentrations ranged from 0.02 to 1.6 microg/mL F for all brands analyzed. Whole and defatted milks had the lowest F concentrations, ranging from 0.02 to 0.07 microg/mL. With respect to chocolate milks, three brands had F concentrations above 0.5 microg/mL. Some brands of chocolate milks exceeded the dose regarded as the threshold level for the development of dental fluorosis, without taking into account other sources of fluoride intake. CONCLUSION The high fluoride concentrations found in some brands of chocolate milks in the present study indicate that many products may be important contributors to the total fluoride intake, reinforcing the need of assaying fluoride content of foods and beverages consumed by small children.
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