1
|
Malin AJ, Hu H, Martínez-Mier EA, Eckel SP, Farzan SF, Howe CG, Funk W, Meeker JD, Habre R, Bastain TM, Breton CV. Urinary fluoride levels and metal co-exposures among pregnant women in Los Angeles, California. Environ Health 2023; 22:74. [PMID: 37880740 PMCID: PMC10601173 DOI: 10.1186/s12940-023-01026-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/13/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Fluoride is ubiquitous in the United States (US); however, data on biomarkers and patterns of fluoride exposure among US pregnant women are scarce. We examined specific gravity adjusted maternal urinary fluoride (MUFsg) in relation to sociodemographic variables and metal co-exposures among pregnant women in Los Angeles, California. METHODS Participants were from the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) cohort. There were 293 and 490 women with MUFsg measured during first and third trimesters, respectively. An intra-class correlation coefficient examined consistency of MUFsg between trimesters. Kruskal-Wallis and Mann-Whitney U tests examined associations of MUFsg with sociodemographic variables. Covariate adjusted linear regression examined associations of MUFsg with blood metals and specific gravity adjusted urine metals among a subsample of participants within and between trimesters. A False Discovery Rate (FDR) correction accounted for multiple comparisons. RESULTS Median (IQR) MUFsg was 0.65 (0.5) mg/L and 0.8 (0.59) mg/L, during trimesters one and three respectively. During both trimesters, MUFsg was higher among older participants, those with higher income, and White, non-Hispanic participants than Hispanic participants. MUFsg was also higher for White, non-Hispanic participants than for Black, non-Hispanic participants in trimester three, and for those with graduate training in trimester one. MUFsg was negatively associated with blood mercury in trimester one and positively associated with blood lead in trimester three. MUFsg was positively associated with various urinary metals, including antimony, barium, cadmium, cobalt, copper, lead, nickel, tin, and zinc in trimesters one and/or three. CONCLUSIONS MUFsg levels observed were comparable to those found in pregnant women in Mexico and Canada that have been associated with poorer neurodevelopmental outcomes. Lower urinary fluoride levels among Hispanic and non-Hispanic Black participants in MADRES compared to non-Hispanic White participants may reflect lower tap water consumption or lower fluoride exposure from other sources. Additional research is needed to examine whether MUFsg levels observed among pregnant women in the US are associated with neurodevelopmental outcomes.
Collapse
Affiliation(s)
- Ashley J Malin
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Rd, Gainesville, 32603, USA.
| | - Howard Hu
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, 1845 N Soto Street, Los Angeles, CA, 90089-9239, USA
| | - E Angeles Martínez-Mier
- Department of Cariology, Operative Dentistry and Dental Public Health, School of Dentistry, Indiana University, 1121 W. Michigan St., Indianapolis, IN, 46202-2876, USA
| | - Sandrah P Eckel
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, 1845 N Soto Street, Los Angeles, CA, 90089-9239, USA
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, 1845 N Soto Street, Los Angeles, CA, 90089-9239, USA
| | - Caitlin G Howe
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, 1 Medical Center Drive, Williamson Translational Research Building, 7th Floor, Lebanon, NH, 03756, USA
| | - William Funk
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Dr Ste 1400, Chicago, IL, 60611, USA
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, 1420 Washington Hts, Ann Arbor, MI, 48109, USA
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, 1845 N Soto Street, Los Angeles, CA, 90089-9239, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, 1845 N Soto Street, Los Angeles, CA, 90089-9239, USA
| | - Carrie V Breton
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, 1845 N Soto Street, Los Angeles, CA, 90089-9239, USA
| |
Collapse
|
2
|
Castiblanco-Rubio GA, Muñoz-Rocha TV, Téllez-Rojo MM, Ettinger AS, Mercado-García A, Peterson KE, Hu H, Cantoral A, Martínez-Mier EA. Dietary Influences on Urinary Fluoride over the Course of Pregnancy and at One-Year Postpartum. Biol Trace Elem Res 2022; 200:1568-1579. [PMID: 34176079 DOI: 10.1007/s12011-021-02799-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/17/2021] [Indexed: 10/21/2022]
Abstract
Dietary factors are known to influence urinary fluoride (UF) levels in nonpregnant people. Maternal UF is used as a biomarker of fluoride exposure; however, dietary influences on UF during pregnancy are unknown. We compared UF levels and assessed the associations between UF and five select dietary influences in pregnancy vs. one-year postpartum: dietary fluoride (F), calcium intake from diet (Ca-diet), calcium intake from supplements (Ca-sup), dietary acid load (AL), and table salt use (TS) in 421 women exposed to fluoridated salt in the Mexican diet. Spot UF (mg/L) was measured by microdiffusion/fluoride-specific electrode and dilution-corrected with specific gravity (SG). Dietary variables were estimated from a validated Food Frequency Questionnaire. Comparisons among UF in pregnancy vs. one-year postpartum were performed with non-parametric tests. Associations between dietary variables and UF were assessed using random effect models (for pregnancy) and linear regression (for one-year postpartum). SG-corrected UF (median, range) during pregnancy (0.77, 0.01-4.73 mg/L) did not significantly differ from one-year postpartum (0.75, 0.15-2.62 mg/L) but did increase every 10 gestational weeks, β = 0.05 (CI: 0.00-0.10). Different dietary influences on UF were identified at each state. Although Ca-diet and AL were not associated with UF in either state, Ca-sup decreased UF only during pregnancy, β = - 0.012 mg/L (CI: - 0.023-0.00). Reporting TS use was associated with 12% increase in UF only at one-year postpartum (p = 0.026). These results suggest different dietary influences on UF in the pregnant state, which need consideration when using UF as a biomarker of fluoride exposure.
Collapse
Affiliation(s)
- Gina A Castiblanco-Rubio
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, 415 Lansing St, Indianapolis, IN, 46202, USA.
| | - Teresa V Muñoz-Rocha
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública de México (INSP), Cuernavaca, Morelos, México
| | - Martha M Téllez-Rojo
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública de México (INSP), Cuernavaca, Morelos, México
| | - Adrienne S Ettinger
- Rutgers Biomedical and Health Sciences, Rutgers University, New Brunswick, NJ, USA
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Adriana Mercado-García
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública de México (INSP), Cuernavaca, Morelos, México
| | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Howard Hu
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - E Angeles Martínez-Mier
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, 415 Lansing St, Indianapolis, IN, 46202, USA
| |
Collapse
|
3
|
Martignon S, Cortes A, Douglas GVA, Newton JT, Pitts NB, Avila V, Usuga-Vacca M, Gamboa LF, Deery C, Abreu-Placeres N, Bonifacio C, Braga MM, Carletto-Körber F, Castro P, P Cerezo M, Chavarría N, Cifuentes OL, Echeverri B, Jácome-Liévano S, Kuzmina I, Lara JS, Manton D, Martínez-Mier EA, Melo P, Muller-Bolla M, Ochoa E, Osorio JR, Ramos K, Sanabria AF, Sanjuán J, San-Martín M, Squassi A, Velasco AK, Villena R, Zandona AF, Beltrán EO. CariesCare International adapted for the pandemic in children: Caries OUT multicentre single-group interventional study protocol. BMC Oral Health 2021; 21:329. [PMID: 34210281 PMCID: PMC8248759 DOI: 10.1186/s12903-021-01674-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/14/2021] [Indexed: 01/27/2023] Open
Abstract
Background Comprehensive caries care has shown effectiveness in controlling caries progression and improving health outcomes by controlling caries risk, preventing initial-caries lesions progression, and patient satisfaction. To date, the caries-progression control effectiveness of the patient-centred risk-based CariesCare International (CCI) system, derived from ICCMS™ for the practice (2019), remains unproven. With the onset of the COVID-19 pandemic a previously planned multi-centre RCT shifted to this “Caries OUT” study, aiming to assess in a single-intervention group in children, the caries-control effectiveness of CCI adapted for the pandemic with non-aerosols generating procedures (non-AGP) and reducing in-office time.
Methods In this 1-year multi-centre single-group interventional trial the adapted-CCI effectiveness will be assessed in one single group in terms of tooth-surface level caries progression control, and secondarily, individual-level caries progression control, children’s oral-health behaviour change, parents’ and dentists’ process acceptability, and costs exploration. A sample size of 258 3–5 and 6–8 years old patients was calculated after removing half from the previous RCT, allowing for a 25% dropout, including generally health children (27 per centre). The single-group intervention will be the adapted-CCI 4D-cycle caries care, with non-AGP and reduced in-office appointments’ time. A trained examiner per centre will conduct examinations at baseline, at 5–5.5 months (3 months after basic management), 8.5 and 12 months, assessing the child’s CCI caries risk and oral-health behaviour, visually staging and assessing caries-lesions severity and activity without air-drying (ICDAS-merged Epi); fillings/sealants; missing/dental-sepsis teeth, and tooth symptoms, synthetizing together with parent and external-trained dental practitioner (DP) the patient- and tooth-surface level diagnoses and personalised care plan. DP will deliver the adapted-CCI caries care. Parents’ and dentists’ process acceptability will be assessed via Treatment-Evaluation-Inventory questionnaires, and costs in terms of number of appointments and activities. Twenty-one centres in 13 countries will participate. Discussion The results of Caries OUT adapted for the pandemic will provide clinical data that could help support shifting the caries care in children towards individualised oral-health behaviour improvement and tooth-preserving care, improving health outcomes, and explore if the caries progression can be controlled during the pandemic by conducting non-AGP and reducing in-office time. Trial registration: Retrospectively-registered-ClinicalTrials.gov-NCT04666597-07/12/2020: https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000AGM4&selectaction=Edit&uid=U00019IE&ts=2&cx=uwje3h. Protocol-version 2: 27/01/2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01674-1.
Collapse
Affiliation(s)
- Stefania Martignon
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia.
| | - Andrea Cortes
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Gail V A Douglas
- Dental Public Health, Leeds Dental Institute, University of Leeds, Leeds, UK
| | - J Timothy Newton
- Dental Innovation and Impact, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Nigel B Pitts
- Dental Innovation and Impact, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Viviana Avila
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Margarita Usuga-Vacca
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Luis F Gamboa
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Christopher Deery
- School of Clinical Dentistry, The University of Sheffield, Sheffield, UK
| | - Ninoska Abreu-Placeres
- Biomaterials and Dentistry Research Center (CIBO-UNIBE), Academic Research Department, Universidad Iberoamericana UNIBE, Santo Domingo, Dominican Republic
| | - Clarisa Bonifacio
- Department of Pediatric Dentistry, Academic Center for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Mariana M Braga
- Department of Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Fabiana Carletto-Körber
- Comprehensive Children and Adolescents Clinic, Paediatric Dentistry, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Patricia Castro
- School of Dentistry, Corporación Universitaria Rafael Núñez, Cartagena, Colombia
| | - María P Cerezo
- School of Dentistry, Universidad Autónoma de Manizales, Manizales, Colombia
| | - Nathaly Chavarría
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Olga L Cifuentes
- School of Dentistry, Universidad Autónoma de Manizales, Manizales, Colombia
| | - Beatriz Echeverri
- School of Dentistry, Universidad Cooperativa de Colombia, Envigado, Colombia
| | - Sofía Jácome-Liévano
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Irina Kuzmina
- Department of Preventive Dentistry, Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - J Sebastián Lara
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - David Manton
- Centrum Voor Tandheelkunde en Mondzorgkunde, UMCG, University of Groningen, Groningen, The Netherlands
| | - E Angeles Martínez-Mier
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - Paulo Melo
- EpiUnit, Faculty of Dental Medicine, Institute of Public Health, University of Porto, Porto, Portugal
| | | | - Emilia Ochoa
- School of Dentistry, Universidad Cooperativa de Colombia, Envigado, Colombia
| | | | - Ketty Ramos
- School of Dentistry, Universidad de Cartagena, Cartagena, Colombia
| | - Angie F Sanabria
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Johanna Sanjuán
- Paedriatric Dentistry Department, Fundación Universitaria de Colegios de Colombia (UNICOC), Bogotá, Colombia
| | - Magdalena San-Martín
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia.,School of Dentistry, Universidad Católica de Uruguay, Montevideo, Uruguay
| | - Aldo Squassi
- School of Dentistry, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - A Karina Velasco
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Rita Villena
- Paediatric Dentistry Department, Universidad San Martín de Porres, Lima, Peru
| | - Andrea Ferreira Zandona
- Department of Comprehensive Care, School of Dental Medicine, Tufts University, Boston, MA, USA
| | - Edgar O Beltrán
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| |
Collapse
|
4
|
Maupome G, Martínez-Mier EA, Holt A, Medina-Solís CE, Mantilla-Rodríguez A, Carlton B. The association between geographical factors and dental caries in a rural area in Mexico. CAD SAUDE PUBLICA 2013; 29:1407-14. [DOI: 10.1590/s0102-311x2013000700014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 03/04/2013] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to investigate the association between markers of oral disease and geographical factors influencing access to dental care (DMFT score) among school children in Central Mexico. Retrospective data were collected during an international service-learning program between 2002 and 2009. A sample of 1,143 children (55% females; mean age 12.7±13.1years) was analyzed. The mean DMFT score, represented largely by untreated tooth decay, was 4.02 (4.76). The variables that had the most significant effect on the DMFT score were proportion of paved roads between the community and dental services, and the availability of piped potable water. The DMFT score increased in proportion to the percentage of paved roads. In contrast, the DMFT score decreased with the availability of piped potable water. Similar results were found for untreated tooth decay. The main variable associated with a significant increase in dental fillings was proportion of paved roads. Together with Brazilian reports, this is one of the first investigations of the association between geographical factors and oral health in an underdeveloped setting.
Collapse
|
5
|
Maupome G, Martínez-Mier EA, Holt A, Medina-Solís CE, Mantilla-Rodríguez A, Carlton B. The association between geographical factors and dental caries in a rural area in Mexico. CAD SAUDE PUBLICA 2013. [DOI: 10.1590/s0102-311x2013001100014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
6
|
Abstract
Fluoride is a naturally occurring element with multiple implications for human health. This review discusses its metabolism and toxicity, along with the current understanding of the mechanism of action of fluoride and its role as a safe and effective agent in the prevention of dental caries. The relationship between excessive fluoride intake during periods of dental enamel formation and the development of dental fluorosis is also reviewed.
Collapse
|
7
|
Martínez-Mier EA, Cury JA, Heilman JR, Katz BP, Levy SM, Li Y, Maguire A, Margineda J, O'Mullane D, Phantumvanit P, Soto-Rojas AE, Stookey GK, Villa A, Wefel JS, Whelton H, Whitford GM, Zero DT, Zhang W, Zohouri V. Development of gold standard ion-selective electrode-based methods for fluoride analysis. Caries Res 2010; 45:3-12. [PMID: 21160184 PMCID: PMC3696354 DOI: 10.1159/000321657] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2008] [Accepted: 10/04/2010] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Currently available techniques for fluoride analysis are not standardized. Therefore, this study was designed to develop standardized methods for analyzing fluoride in biological and nonbiological samples used for dental research. METHODS A group of nine laboratories analyzed a set of standardized samples for fluoride concentration using their own methods. The group then reviewed existing analytical techniques for fluoride analysis, identified inconsistencies in the use of these techniques and conducted testing to resolve differences. Based on the results of the testing undertaken to define the best approaches for the analysis, the group developed recommendations for direct and microdiffusion methods using the fluoride ion-selective electrode. RESULTS Initial results demonstrated that there was no consensus regarding the choice of analytical techniques for different types of samples. Although for several types of samples, the results of the fluoride analyses were similar among some laboratories, greater differences were observed for saliva, food and beverage samples. In spite of these initial differences, precise and true values of fluoride concentration, as well as smaller differences between laboratories, were obtained once the standardized methodologies were used. Intraclass correlation coefficients ranged from 0.90 to 0.93, for the analysis of a certified reference material, using the standardized methodologies. CONCLUSION The results of this study demonstrate that the development and use of standardized protocols for F analysis significantly decreased differences among laboratories and resulted in more precise and true values.
Collapse
Affiliation(s)
- E A Martínez-Mier
- Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis, Ind. 46202, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Martínez-Mier EA, Soto-Rojas AE, Buckley CM, Margineda J, Zero DT. Evaluation of the direct and diffusion methods for the determination of fluoride content in table salt. Community Dent Health 2009; 26:204-210. [PMID: 20088217 PMCID: PMC2870713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE The aim of this study was to assess methods currently used for analyzing fluoridated salt in order to identify the most useful method for this type of analysis. BASIC RESEARCH DESIGN Seventy-five fluoridated salt samples were obtained. Samples were analyzed for fluoride content, with and without pretreatment, using direct and diffusion methods. Element analysis was also conducted in selected samples. Fluoride was added to ultra pure NaCl and non-fluoridated commercial salt samples and Ca and Mg were added to fluoride samples in order to assess fluoride recoveries using modifications to the methods. RESULTS Larger amounts of fluoride were found and recovered using diffusion than direct methods (96%-100% for diffusion vs. 67%-90% for direct). Statistically significant differences were obtained between direct and diffusion methods using different ion strength adjusters. Pretreatment methods reduced the amount of recovered fluoride. Determination of fluoride content was influenced both by the presence of NaCl and other ions in the salt. CONCLUSION Direct and diffusion techniques for analysis of fluoridated salt are suitable methods for fluoride analysis. The choice of method should depend on the purpose of the analysis.
Collapse
Affiliation(s)
- E A Martínez-Mier
- Department of Preventive and Community, Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis 46202, USA.
| | | | | | | | | |
Collapse
|
9
|
Soto-Rojas AE, Martínez-Mier EA, Ureña-Cirett J, Jackson RD, Stookey GK. Development of a standardisation device for photographic assessment of dental fluorosis in field studies. Oral Health Prev Dent 2008; 6:29-36. [PMID: 18399305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE This study evaluated the agreement between clinical and photographic assessment of dental fluorosis (DF) in 73 children during a field study, using portable equipment and a standardising device. MATERIALS AND METHODS A dental exam was performed using the Tooth Surface Index of Fluorosis (TSIF). Photographs of the facial aspects of front teeth and from the occlusal aspect of the mandibular posterior teeth were taken. All photographs were taken following a standard operating procedure. Photographs of anterior and posterior teeth were coded and assigned a random study number. Examiners scored photographs as fluorosis cases or non-cases. RESULTS Agreement among the clinical examiners ranged from good to excellent. Agreement was also good for the repeated photographic evaluations. In total, 22% of the children were diagnosed with DF during a clinical exam, and 19% were diagnosed with DF using the photographs. CONCLUSIONS Development of this method aided in the photographic assessment of DF. The photographs obtained were a useful tool for documenting DF, to re-train examiners, and to determine intra- and inter-examiner agreement.
Collapse
Affiliation(s)
- Armando E Soto-Rojas
- Oral Health Research Institute, Indiana University School of Dentistry, 415 Lansing Street, Indianapolis, Indiana 46202, USA.
| | | | | | | | | |
Collapse
|
10
|
Martínez-Mier EA, Soto-Rojas AE, Buckley CM, Zero DT, Margineda J. Fluoride concentration of bottled water, tap water, and fluoridated salt from two communities in Mexico. Int Dent J 2005; 55:93-9. [PMID: 15880964 DOI: 10.1111/j.1875-595x.2005.tb00040.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
AIM To determine fluoride levels in bottled water, tap water, and fluoridated salt from two communities in Mexico. DESIGN Stratified random collection of water and salt samples from Mexico City and Veracruz, Mexico for fluoride analysis. METHODS Samples were analysed using a combination fluoride ion-specific electrode. Results were compared using Student's t-test and mixed-model ANOVA. Water fluoride values were compared by type, community and collection area; salt fluoride values were compared by community and collection area. RESULTS 197 tap water samples, 133 bottled water samples and 20 fluoridated salt samples were collected. The mean (+/- SD) fluoride content for all tap water was 0.20 +/- 0.17 microg F/g (ranging from 0.01 to 0.88 microg F/g) and 0.24 +/- 0.24 microg F/g for all bottled water (ranging from 0.01 to 2.80 microg F/g). This difference was not statistically significant. When results were analysed by city, the difference between tap water samples was statistically significant. Ten bottled water samples contained more than negligible fluoride (ranging from 0.7-2.8 microg F/g). Mean salt fluoride content was 230.0 +/- 49.8 microg F/g, which was within governmental regulation levels. CONCLUSION Some water samples had amounts of fluoride exceeding the maximum recommended levels. Salt fluoride levels were within regulation limits. Monitoring of fluoride content of both bottled and tap water is strongly advised.
Collapse
Affiliation(s)
- E Angeles Martínez-Mier
- Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis, IN 46202, USA.
| | | | | | | | | |
Collapse
|
11
|
Franco AM, Martignon S, Saldarriaga A, González MC, Arbeláez MI, Ocampo A, Luna LM, Martínez-Mier EA, Villa AE. Total fluoride intake in children aged 22-35 months in four Colombian cities. Community Dent Oral Epidemiol 2005; 33:1-8. [PMID: 15642041 DOI: 10.1111/j.1600-0528.2004.00164.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To obtain information on the level of total fluoride intake from food, beverages and toothpaste by children at the age of 22-25 months of low and high socioeconomic status (SES) in major Colombian cities. METHODS Daily fluoride intake was assessed by the duplicate plate method and by recovered toothpaste solution during a 3-day period and afterwards analysed by the microdiffusion method. RESULTS Mean daily fluoride intake was 0.11 (+/-0.10), 0.14 (+/-0.12), 0.10 (+/-0.07) and 0.07 (+/-0.06) mg/kg body weight (bw)/day in Bogota, Medellin, Manizales and Cartagena, respectively. The total fluoride intake was higher in low-SES subjects in the cities of Medellin and Bogota. In the high-SES children of the four cities, the average intakes ranged from 0.06 to 0.09 mg F/kg bw, whereas, the low-SES children in three cities had intakes between 0.11 and 0.21 mg F/kg bw (Cartagena, 0.07). Toothpaste (containing 1000-1500 ppm F, with 1500 ppm F being more common) accounted for approximately 70% of total fluoride intake, followed by food (24%) and beverages (<6%). More than half the children had their teeth brushed by an adult, on average twice a day, using 0.22-0.65 g of toothpaste. CONCLUSION Children from three Colombian cities have a mean total daily fluoride intake above the 'optimal range'. Health authorities should promote an appropriate use of fluoridated dentifrices discouraging the use of dentifrices containing 1500 ppm F in children younger than 6 years of age and promoting a campaign of education of parents and oral health professionals on adequate toothbrushing practices.
Collapse
Affiliation(s)
- Angela M Franco
- Research Center, CES University School of Dentistry, Calle 10 A No. 22-4, Medellín, Columbia.
| | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Martínez-Mier EA, Maupomé G, Soto-Rojas AE, Ureña-Cirett JL, Katz BP, Stookey GK. Development of a questionnaire to measure perceptions of, and concerns derived from, dental fluorosis. Community Dent Health 2004; 21:299-305. [PMID: 15617415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
OBJECTIVE To develop a questionnaire in English and Spanish to measure concerns caused by children's (and their parents') perceptions of dental appearance. MATERIALS AND METHODS The questionnaire addressed concerns in the physical, mental, and social domains, perceptions about discolourations and other oral conditions including tooth colour. Test-retest and internal reliability, and construct and criterion validity, were assessed as part of the development process. Children in Mexico City, Mexico and Indianapolis, Indiana answered the questionnaire and were examined for fluorosis using the TSIF index. Data were analysed using Cronbach's alpha, Pearson's, Spearman's and intraclass correlations, and percentage agreement tests. RESULTS Ninety-five children and 28 parents participated in Mexico City; fluorosis was diagnosed in 66% of children. Seventy-one children and 65 parents participated in Indianapolis; fluorosis was diagnosed in 63% of children. English and Spanish questionnaires had acceptable test-retest performance, and moderate internal reliability. Criterion validity was acceptable, and the translated versions retained acceptable construct validity. Perceptions of discolourations were associated with concerns of the participants. Level of concern was higher in Indianapolis than in Mexico City, generally. Many participants reported that they were at least occasionally distressed or worried over the appearance of the children's teeth, that it hindered children from smiling freely, and that it was an unsatisfactory appearance. CONCLUSION The developed questionnaire allowed children and parents to report perceived dental appearance problems and concerns.
Collapse
Affiliation(s)
- E Angeles Martínez-Mier
- Oral Health Research Institute, Indiana University School of Dentistry, 415 Lansing Street, Indianapolis IN 46202, USA.
| | | | | | | | | | | |
Collapse
|
13
|
Martínez-Mier EA, Soto-Rojas AE, Ureña-Cirett JL, Katz BP, Stookey GK, Dunipace AJ. Dental fluorosis and altitude: a preliminary study. Oral Health Prev Dent 2004; 2:39-48. [PMID: 15641764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
PURPOSE Previous studies have reported higher dental fluorosis prevalence in high-altitude communities than in low-altitude communities. This investigation determined and compared dental fluorosis prevalence in populations of children living at high and low altitudes in Mexico. MATERIALS AND METHODS Fluorosis prevalence was determined in 7 to 10-year-old children: 67 in Mexico City (2,240 m) and 71 in Veracruz (sea level). Previous fluoride exposure of those children was surveyed by retrospective, questionnaire data. The fluoride content of water and salt from those communities was also documented. RESULTS Fluorosis prevalence in Mexico City (53.0%) was significantly higher than in Veracruz (24.3%) (p < 0.0001). While there were statistical differences in one of the fluorosis risk factors between the two communities, the observed difference in fluorosis prevalence was still significant when data were analyzed after adjusting for the reported differences in that factor. CONCLUSION Our results led to the conclusion that the difference in fluorosis prevalence in Mexico City and Veracruz could not be explained by differences in fluoride content of the salt or water samples, self-reported exposure to fluorosis risk factors or estimated fluoride intake.
Collapse
Affiliation(s)
- E Angeles Martínez-Mier
- Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis 46202, USA.
| | | | | | | | | | | |
Collapse
|
14
|
Martínez-Mier EA, Soto-Rojas AE, Ureña-Cirett JL, Stookey GK, Dunipace AJ. Fluoride intake from foods, beverages and dentifrice by children in Mexico. Community Dent Oral Epidemiol 2003; 31:221-30. [PMID: 12752549 DOI: 10.1034/j.1600-0528.2003.00043.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This investigation monitored fluoride ingestion in Mexican children who were susceptible to developing dental fluorosis. METHODS Total fluoride intake, from dietary and toothpaste samples, was determined in 15-36-month-old children from Mexico City and Veracruz, Mexico. A duplicate plate technique was used. Plasma fluoride levels were also determined in this group of children. RESULTS The children ingested a mean (+/-SD) of 0.20 +/- 0.08 and 0.18 +/- 0.07 mg fluoride/kg/day, in Mexico City and Veracruz, respectively. There was no statistically significant difference between the fluoride ingested by children in the two cities (P > 0.9). Plasma from children in Mexico City and Veracruz contained a mean of 1.30 +/- 0.81 and 0.87 +/- 0.72 micro mol fluoride/l, respectively, and these values were not significantly different. CONCLUSIONS Our results lead to the conclusion that mean fluoride ingested from the combination of foods and beverages was within the proposed safe threshold for fluoride intake of 0.05-0.07 mg F/kg/day. Most of the fluoride intake by these children was derived from the ingestion of fluoridated toothpaste. When all sources of ingested fluoride were added and total fluoride intake was calculated, the children, both in Mexico City and Veracruz, were ingesting amounts of fluoride well above the upper limits of the proposed safe threshold for fluoride intake.
Collapse
Affiliation(s)
- E Angeles Martínez-Mier
- Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis, IN 46202, USA.
| | | | | | | | | |
Collapse
|