Spatial correlation between the prevalence of dental fluorosis and the chemical elemental composition of drinking water sources in a typical coal-fired pollution fluorosis area / 中华流行病学杂志

Objective: To investigate the spatial distribution characteristics and correlation between the prevalence of dental fluorosis and the chemical elemental composition of drinking water sources in coal-fired fluorosis areas. Methods: Based on the survey data on the prevalence of dental fluorosis at CDC in Guizhou Province in 2022, 274 original surface drinking water sources were collected in typical coal-fired fluorosis areas, and fluoride (F), calcium (Ca), magnesium (Mg), aluminum (Al), titanium (Ti), chromium (Cr), manganese (Mn), iron (Fe), nickel (Ni), copper (Cu), zinc (Zn), arsenic (As), selenium (Se), molybdenum (Mo), cadmium (Cd), barium (Ba), lead (Pb) 17 elements; apply Moran's I index, Getis-Ord Gi* hotspot analysis of the global spatial autocorrelation of chemical elements in drinking water and the degree of aggregation of each element on the local area, and correlation analysis with the prevalence of dental fluorosis in the region. Results: Except for Cu, Zn, and Cd, global spatial autocorrelation Moran's I was negative, and all other elements were positive. F, Ca, Al, Ti, As, Mo, Cd, and Cu elements showed high values of aggregation in the southeastern low-altitude area; Mg, Ba, Pb, Cr, Mn, and Fe elements were mainly aggregated in the central altitude terrain transition area, Zn and Se elements in water sources are significantly positively correlated with the prevalence of dental fluorosis (P<0.05). In contrast, F, Mg, Al, Ti, As, Mo, Cd, Ba, and Pb elements negatively correlate (P<0.05). Elements in the central region were high-high aggregation, as a hot spot aggregation area with high disease incidence, while F, Al, Mn, Mo, Cd, and Ba elements in the western region were low-low aggregation, as a cold spot aggregation area with a low incidence of fluorosis. Conclusions: The risk of population fluoride exposure in surface drinking water sources is shallow. However, the chemical element content of drinking water sources in coal-fired polluted endemic fluorosis areas has prominent spatial geographical distribution characteristics. There is a significant spatial aggregation effect with the prevalence of dental fluorosis, which may play a synergistic or antagonistic effect on the occurrence and prevalence of dental fluorosis.

Correlation analysis and benchmark dose study on bone metabolic biochemical index of low doses of exposed hydrogen fluoride workers / 中华劳动卫生职业病杂志

Objective: To analyze correlation of occupational hydrogen fluoride exposure to low doses of bone metabolism index through occupational epidemiological investigation and benchmark dose calculation. Methods: In May 2021, using cluster sampling method, 237 workers exposed to hydrogen fluoride in a company were selected as the contact group, and 83 workers not exposed to hydrogen fluoride in an electronics production company were selected as the control group. The external exposure dose and urinary fluoride concentration, blood and urine biochemical indicators of the workers was measured.The relationship between external dose and internal dose of hydrogen fluoride was analyzed. The external dose, urinary fluoride was used as exposure biomarkers, while serum osteocalcin (BGP), serum alkaline phosphatase (AKP) and urinary hydroxyproline (HYP) were used as effect biomarkers for bone metabolism of hydrogen fluoride exposure. The benchmark dose calculation software (BMDS1.3.2) was used to calculate benchmark dose (BMD) . Results: Urine fluoride concentration in the contact group was correlated with creatinine-adjusted urine fluoride concentration (r=0.69, P=0.001). There was no significant correlation between the external dose of hydrogen fluoride and urine fluoride in the contact group (r=0.03, P=0.132). The concentrations of urine fluoride in the contact group and the control group were (0.81±0.61) and (0.45±0.14) mg/L, respectively, and the difference between the two groups was statistically significant (t=5.01, P=0.025). Using BGP, AKP and HYP as effect indexes, the urinary BMDL-05 values were 1.28, 1.47 and 1.08 mg/L, respectively. Conclusion: Urinary fluoride can sensitively reflect the changes in the effect indexes of biochemical indexes of bone metabolism. BGP and HYP can be used as early sensitive effect indexes of occupational hydrogen fluoride exposure.

Glutathione S-transferase genetic polymorphisms and fluoride-induced reproductive toxicity in men with idiopathic infertility / 亚洲男科学杂志(英文版)

Male infertility caused by idiopathic oligoasthenospermia (OAT) is known as idiopathic male infertility. Glutathione S-transferase (GST) and fluoride may play important roles in idiopathic male infertility, but their effects are still unknown. Our study examined the relationship between GST polymorphisms and fluoride-induced toxicity in idiopathic male infertility and determined the underlying mechanism. Sperm, blood, and urine samples were collected from 560 males. Fluoride levels were measured by a highly selective electrode method, and GST genotypes were identified using polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism (PCR-RFLP). Semen parameters, DNA fragmentation index (DFI), mitochondrial membrane potential (MMP), and oxidative stress (OS) biomarkers were statistically assessed at the P < 0.05 level. Compared with healthy fertile group, semen parameters, fluoride levels, OS biomarkers, sex hormone levels, and MMP and DFI levels were lower in the idiopathic male infertility group. For glutathione S-transferase M1 (GSTM1[-]) and glutathione S-transferase T1 (GSTT1[-]) or glutathione S-transferase P1 (GSTP1) mutant genotypes, levels of semen fluoride, OS, MMP, and DFI were considerably higher, and the mean levels of sperm parameters and testosterone were statistically significant in GSTM1(+), GSTT1(+), and GSTP1 wild-type genotypes. Both semen and blood fluoride levels were associated with oxidative stress in idiopathic male infertility patients. Elevated fluoride in semen with the genotypes listed above was linked to reproductive quality in idiopathic male infertility patients. In conclusion, GST polymorphisms and fluorine may have an indicative relationship between reproductive quality and sex hormone levels, and OS participates in the development of idiopathic male infertility.

Fluoruros en agua de consumo al norte y occidente de México / Fluorides in water for consumption in northern and western Mexico

La cantidad de fluoruros en el agua en algunas regiones de México representa un problema de salud pública. El objetivo de este trabajo fue realizar una revisión sistemática de estudios originales que reportaran niveles de fluoruros en agua corriente y embotellada de la región norte y occidente de México. Esta revisión sistemática se elaboró utilizando el sistema PRISMA en las bases de datos de PubMed, Scopus, Medigraphic y Scielo. Se implementaron las palabras clave de fluoride OR fluorosis AND water AND Mexico, y se incluyeron y excluyeron registros de acuerdo con los criterios previamente establecidos. Fueron revisados aquellos artículos publicados entre el 1 de enero del 2010 y el 30 de marzo del 2021. Se identificaron 36 registros en total. La mayoría mostraban datos encontrados en la región occidente del país (n = 23) mientras que los restantes fueron realizados al norte. Ambas regiones se mostraron con rangos máximos y medias muestrales por encima de lo sugerido por la Organización Mundial de la Salud y los organismos reguladores nacionales. De acuerdo con los estudios aquí analizados en México, las regiones Norte y Occidente del país muestran una situación preocupante por los elevados niveles de fluoruros que reportan los autores en agua corriente y embotellada, los niveles se encuentran casi en su totalidad por encima de los recomendados a nivel nacional e internacional lo cual significa un problema de salud pública que requiere de atención.

The amount of fluoride in water in some regions of Mexico represents a public health problem. The aim of this study was to conduct a systematic review of original studies that report fluoride levels in tap and bottled water from the northern and western regions of Mexico. A systematic review was conducted using the PRISMA method in PubMed, Scopus, Medigraphic and Scielo databases. The keywords fluoride OR fluorosis AND water AND Mexico were used for the search and the records found were included and excluded according to the previous established criteria. We reviewed data in articles published between January 1st, 2010 and March 30th, 2021. We identified a total of 36 records. Most showed data found in the western region (n = 23), while the rest reported data found in the north. Both regions reported maximum and mean sample ranges above those suggested by the World Health Organization and national regulations. According to the analyzed data, in Mexico, the northern and western regions of the country show a concerning situation due to the high levels of fluoride reported by many authors in tap and bottled water. Almost all authors reported data above those recommended for national and international regulations, which represent an important public health problem that requires attention.

Does fluoride cause neurotoxic effects in humans? The importance of critically analyzing the scientific evidence / O fluoreto tem efeito neurotóxico? A importância da análise crítica da informação

The lack of critical interpretation of scientific information resulting from foundational data and evidence can jeopardize the shared decision between a clinical practitioner and the patient. This commentary analyzes the scientific evidence of a systematic review about the neurotoxic effect of fluoride in humans. The systematic review included observational studies from Chinese and Iranian populations exposed to a high-fluoridated water supply. The meta-analysis indicated that these populations had lower scores of the intelligence coefficient (IQ). However, the review is limited by the lack of methodological quality and the certainty of the scientific evidence. To critically analyze the evidence, we should avoid the "wireless phone effect" that considers the information without checking the original data source. Moreover, we should always base our analysis on the full text and never on the abstract alone.

Dental fluorosis and its influence on children’s life

This study verified the prevalence of dental fluorosis in 12-year-old children and its association with different fluoride levels in the public water supply, and evaluated the level of perception of dental fluorosis by the studied children. To assess fluorosis prevalence, clinical examinations were performed and a structured instrument was used to evaluate the self-perception of fluorosis. The water supply source in the children’s area of residence since birth was used as the study criterion. In total, 496 children were included in the study. Fluorosis was diagnosed in 292 (58.9%) children; from these, 220 (44.4%) children were diagnosed with very mild fluorosis, 59 (11.9%) with mild fluorosis, 12 (2.4%) with moderate fluorosis, and 1 (0.2%) child with severe fluorosis. A significant association (p = 0.0004) was observed between the presence of fluorosis and areas with excessive fluoride in the water supply. Among the 292 children that showed fluorosis, 40% perceived the presence of spots in their teeth. The prevalence of fluorosis was slightly high, and the mildest levels were the most frequently observed. Although most of the children showed fluorosis to various degrees, the majority did not perceive these spots, suggesting that this alteration did not affect their quality of life.

Co-relation of body mass index, dental caries and periodontal status with fluorosis in different high fluoridated areas of Haryana state, India.

Background and Aim: The aim of the present study is to compare the effect of corticotomy versus prostaglandin E1 injection in human subjects on rate of tooth movement, anchorage loss and their effect on crest bone height and root length. Settings and Design: Clinical interventional study. Split mouth design was used. Materials and Methods: Study was done on 32 regular orthodontic patients. A volume of 100 mcg of prostaglandin E1 was injected on the right side once in 2 weeks and on the left side corticotomy was performed, and canine retraction was started on both sides simultaneously. The rate of space closure and anchorage loss was assessed with casts. The root length and crestal bone height changes were assed with IOPAs. The comparison of rate of tooth movement, anchorage loss, crestal bone height and root length changes between the sides were statistically analyzed using paired t-test. Results: The average rate of space closure on right side was 0.36 mm/week with a standard deviation of 0.05 mm/week and on the left side average rate of space closure was 0.40 mm/week with a standard deviation of 0.04 mm/week. The difference between the rate of closure between the right side and left where found to be statistically significant (P = 0.003). The anchorage loss, the crestal bone height changes and root length changes were not statistically significant. Conclusion: The rate of tooth movement was significantly more with corticotomies when compared with given dose of prostaglandin injection.

Enamel crystals of mice susceptible or resistant to dental fluorosis: an AFM study

Objective: This study aimed to assess the overall apatite crystals profile in the enamel matrix of mice susceptible (A/J strain) or resistant (129P3/J strain) to dental fluorosis through analyses by atomic force microscopy (AFM). Material and Methods: Samples from the enamel matrix in the early stages of secretion and maturation were obtained from the incisors of mice from both strains. All detectable traces of matrix protein were removed from the samples by a sequential extraction procedure. The purified crystals (n=13 per strain) were analyzed qualitatively in the AFM. Surface roughness profile (Ra) was measured. Results: The mean (±SD) Ra of the crystals of A/J strain (0.58±0.15 nm) was lower than the one found for the 129P3/J strain (0.66±0.21 nm) but the difference did not reach statistical significance (t=1.187, p=0.247). Crystals of the 129P3/J strain (70.42±6.79 nm) were found to be significantly narrower (t=4.013, p=0.0013) than the same parameter measured for the A/J strain (90.42±15.86 nm). Conclusion: enamel crystals of the 129P3/J strain are narrower, which is indicative of slower crystal growth and could interfere in the occurrence of dental fluorosis. .

Evidence-based recommendation on toothpaste use

Toothpaste can be used as a vehicle for substances to improve the oral health of individuals and populations. Therefore, it should be recommended based on the best scientific evidence available, and not on the opinion of authorities or specialists. Fluoride is the most important therapeutic substance used in toothpastes, adding to the effect of mechanical toothbrushing on dental caries control. The use of fluoride toothpaste to reduce caries in children and adults is strongly based on evidence, and is dependent on the concentration (minimum of 1000 ppm F) and frequency of fluoride toothpaste use (2'/day or higher). The risk of dental fluorosis due to toothpaste ingestion by children has been overestimated, since there is no evidence that: 1) fluoride toothpaste use should be postponed until the age of 3-4 or older, 2) low-fluoride toothpaste avoids fluorosis and 3) fluorosis has a detrimental effect on the quality of life of individuals exposed to fluoridated water and toothpaste. Among other therapeutic substances used in toothpastes, there is evidence that triclosan/copolymer reduce dental biofilm, gingivitis, periodontitis, calculus and halitosis, and that toothpastes containing stannous fluoride reduce biofilm and gingivitis.

Influence of fluoride-containing acidic artificial saliva on the mechanical properties of Nickel-Titanium orthodontics wires.

Objective: This study aimed to investigate the influence of fluoride and an acidic environment on the mechanical properties of NiTi orthodontic wires (NiTiW) in artificial saliva. Design: A prospective laboratory investigation. Setting: Department of Stomatology, First Affiliated Hospital, Zhejiang University, Hangzhou, China. Materials and Methods: Commercial, round 0.016-inch NiTiW were immersed in 0% or 0.05% Natrium-Fluoride-containing artificial saliva at a pH of 4 or 6 for one or three days, respectively. NiTiW were examined with a three-point bending test, Vickers' microhardness tests and surface morphology observation (SEM). Results: A pH of 4 increased microhardness and decreased the three-point bending strength significantly (P≤0.05), whereas immersion time and fluoride concentration had no significant influence on the microhardness or on the three-point bending strength (P>0.05). When examining the test group NiTiWs after three days of immersion at a pH of 4 the SEM revealed a rough surface morphology, a damaged oxide layer and signs of corrosion. Conclusions: The most influential factor for decreasing the unloading force and increasing the hardness seems to be the pH value, whereas immersion time and NaF addition do not have a major influence.

Percepção da fluorose dentária e avaliação da concordância entre pais e filhos: validação de um instrumento / Perceptions of dental fluorosis and evaluation of agreement between parents and children: validation of a questionnaire

Objetivou-se validar o Child's and Parent's Questionnaire about Teeth Appearance, avaliando as preocupações relacionadas à fluorose em 213 pares de pais/crianças (12 anos) de duas regiões brasileiras. A confiabilidade foi avaliada pelo alfa de Cronbach e pelo coeficiente de correlação intraclasse; e a validade de constructo e de critério, pela correlação de Spearman. Para comparar as duas regiões e avaliar a concordância pais/filhos, foi utilizado o teste t de Student. A consistência interna foi aceitável, e a confiabilidade teste-reteste, moderada a excelente. Houve correlação significativa entre percepção da fluorose moderada e severa e os dados clínicos e entre percepção da fluorose e preocupações dos indivíduos. Embora os pais de Rafael Arruda, Ceará, Brasil, tenham tido maior percepção da fluorose, o incômodo e a preocupação com a aparência foram maiores em Piracicaba, São Paulo. Os pais se mostraram mais incomodados, preocupados e insatisfeitos com a aparência dentária das crianças do que elas mesmas. Essa versão é válida e confiável para avaliar a percepção da estética dentária em crianças e em seus pais.

This study aimed to validate the Child's and Parent's Questionnaire about Teeth Appearance and to evaluate concerns relative to fluorosis among 213 pairs of parents and 12-year-old children from two regions of Brazil. Reliability was assessed by Cronbach's alpha and intraclass correlation coefficient, and construct and criterion validity by Spearman's correlations. Student t-test was used to compare the two regions and to assess parent/child agreement. Internal consistency was acceptable, and test-retest reliability was moderate to excellent. Perception of moderate to severe fluorosis and clinical data were significantly correlated, as were perception of fluorosis and subjects' concerns. Although parents from Rafael Arruda, Ceará State, showed a higher perception of fluorosis, parental concern was greater in Piracicaba, São Paulo State. Parents were more worried and dissatisfied with their children's dental appearance than the children themselves. This version of the questionnaire proved to be valid and reliable for assessing children's and parents' perceptions of dental fluorosis.

Qualidade da água para consumo humano e concentração de fluoreto / Drinking water quality and fluoride concentration / Calidad del agua para consumo humano y concentración de fluoruro

O artigo visa analisar a concentração de fluoreto na água para consumo humano, considerando o balanço entre benefícios e riscos à saúde, e produzir subsídios para atualização da legislação brasileira. Estudos de revisão sistemática, documentos oficiais e dados meteorológicos foram examinados. As temperaturas nas capitais brasileiras indicam que o fluoreto deveria variar de 0,6 a 0,9 mg/L para prevenir cárie dentária. Concentração de fluoreto natural de 1,5 mg/L é tolerável para consumo no Brasil se não houver tecnologia de custo-benefício aceitável para ajuste/remoção do seu excesso. A ingestão diária de água com fluoreto em concentração > 0,9 mg/L representa risco à dentição em menores de oito anos de idade e os consumidores deveriam ser expressamente informados desse risco. Considerando a expansão do programa nacional de fluoretação da água para regiões de clima tipicamente tropical, deve-se revisar a Portaria 635/75, relacionada ao fluoreto adicionado às águas de abastecimento público.

This paper aimed to analyze the fluoride concentration in drinking water, taking into account the balance between the benefits and risks to health, in order to produce scientific backing for the updating of the Brazilian legislation. Systematic reviews studies, official documents and meteorological data were examined. The temperatures in Brazilian state capitals indicate that fluoride levels should be between 0.6 and 0.9 mg F/l in order to prevent dental caries. Natural fluoride concentration of 1.5 mg F/l is tolerated for consumption in Brazil if there is no technology with an acceptable cost-benefit ratio for adjusting/removing the excess. Daily intake of water with a fluoride concentration > 0.9 mg F/l presents a risk to the dentition among children under the age of eight years, and consumers should be explicitly informed of this risk. In view of the expansion of the Brazilian water fluoridation program to regions with a typically tropical climate, Ordinance 635/75 relating to fluoride added to the public water supply should be revised.

El artículo busca analizar la concentración de fluoruro en el agua para consumo humano considerando el balance entre beneficios y riesgos a la salud y producir subsidios para actualización de la legislación brasileña. Estudios de revisión sistemática, documentos oficiales y datos meteorológicos fueron examinados. Las temperaturas en las capitales brasileñas indican que el fluoruro debería variar de 0,6 a 0,9 mg/L para prevenir caries dentaria. Concentración de fluoruro natural de 1,5 mg/L es tolerable para consumo en Brasil si no hay tecnología de costo-beneficio aceptable para ajuste/remoción de su exceso. La ingestión diaria de agua con fluoruro en concentración > 0,9mg/L representa riesgo para la dentición en menores de ocho años de edad y los consumidores deberían ser expresamente informados de este riesgo. Considerando la expansión del programa nacional de fluorificación del agua para regiones de clima típicamente tropical se debe revisar el Documento Público 635/75, relacionado con el fluoruro adicionado a las aguas de abastecimiento público.

Exploración del riesgo para fluorosis dental en niños de las clínicas odontológicas universidad de Cartagena / Exploring the risk of dental fluorosis in children at the Universidad of Cartagena's odontology clinics

Objetivo Describir la prevalencia de fluorosis dental y su relación con factores asociados en niños que acuden a las clínicas de Odontopediatría Universidad de Cartagena. Métodos Estudio de corte transversal, realizado en la Universidad de Cartagena durante el 2009. Se seleccionó una muestra probabilística aleatoria simple con remplazo. Se examinaron 230 niños utilizando el índice de Thylstrup y Fejerskov y se aplicó una encuesta a las madres de los participantes, que indagaba sobre los factores asociados a la Fluorosis dental. Los datos fueron analizados a partir de proporciones, asumiendo intervalos de confianza del 95 %, razones de disparidad (odds ratio) y regresión logística, utilizando el programa STATA 10.0®. Resultados La prevalencia de la Fluorosis dental fue 66,5 %, presentándose un 88,3 % de casos leve y 11,7 % de moderado. No se observaron lesiones severas. Los factores que explican la presencia de Fluorosis dental fueron: cantidad de sal utilizada para preparar los alimentos entre media y una cucharada sopera, primera aplicación de flúor antes de los cuatro años, cantidad de dentífrico usado entre la mitad y la totalidad del cepillo, ingesta de dentífrico durante el cepillado y la ingesta de dentífrico en momentos diferentes al cepillado (p=0.000; x² =48,2). Conclusiones La prevalencia de Fluorosis en la población de estudio se considera alta, aunque la mayoría de los casos corresponden al estadio leve. Se puede afirmar que esta alteración está influida probablemente por la exposición al mismo tiempo de diferentes fuentes de fluoruros utilizadas para la prevención de la Caries dental.(AU)

Objective Describing the prevalence of dental fluorosis and its relationship with associated factors in children attending the University of Cartagena's Odontopaediatrics clinics. Methods A cross-sectional study was carried out at the University of Cartagena during 2009; patients were selected by simple random sampling with replacement (SRSWR). A group of 230 children were examined using the Thylstrup and Ferjerskov index and the participants' mothers were surveyed regarding factors associated with dental fluorosis. STATA 10.0 software was used for analysing the information by percentages, assuming 95 % confidence intervals, disparity ratios and logistic retrogression. Results There was 66.5 % dental fluorosis prevalence; 88.3 % of cases were mild and 11.7 % moderate. No severe lesions were observed. The factors explaining the presence of dental fluorosis were: the quantity of salt used in preparing food, the first application of fluorine before age 4, the quantity of toothpaste used when brushing, ingestion of toothpaste during brushing and ingestion of toothpaste different to that at brushing time (p=0.000; x²=48.2). Conclusions The prevalence of fluorosis in the study group was considered to be significantly high, although most cases were very moderate. It can be stated that such alteration was probably influenced by exposure to varied sources of fluoride used in preventing dental caries.(AU)

Dental fluorosis and its association with the use of fluoridated toothpaste among middle school students of Delhi.

Introduction: Fluorosis can manifest as dental fluorosis (seen mostly in secondary dentition), skeletal fluorosis, and systemic fluorosis. Groundwater with high fluoride concentrations, diet rich in fish and tea, indoor air-pollution, and use of fluoride toothpastes may contribute considerably to total exposure. Objective: To assess the prevalence of dental fluorosis and associated factors particularly fluoridated toothpastes, among middle school children of a resettlement colony in Delhi. Materials and Methods: This survey was conducted among the middle school students (VI th -VIII th ) studying in three government schools of Sangam Vihar, South Delhi. Students were examined for dental fluorosis by experts. A pre-structured questionnaire was used to obtain data regarding age, source of drinking water, toothpaste used, etc. Height, weight, and hemoglobin were recorded. Two repeat visits were made. Out of 432 students enrolled in these schools, 413 students were examined. Statistics: Descriptive and chi-square statistics were used. Results: Dental fluorosis was prevalent in 121 (29.3%) study subjects. It was significantly more in children of age 13 years or above, in those who used fluoridated toothpaste for dental cleaning (P=0.033) and in anemic children (P<0.001). However, there was no significant association of disease with gender (P=0.02), source of drinking water (P=0.417), and with BMI (P=0.826). Conclusion: As dental fluorosis is very common (in about one-fourth) among the middle school children, in this resettlement colony of Delhi, various control measures e.g. discouraging the fluoridated toothpastes, educating parents about fluorosis, de-fluoridation of water in the high risk areas, etc may help to tackle this situation.

Fluoride: its role in dentistry

In spite of decades of research on fluoride and the recognition of its role as the cornerstone of dental caries reduction in the last fifty years, questions still arise on its use at community, self-applied and professional application levels. Which method of fluoride delivery should be used? How and when should it be used? How can its benefits be maximized and still reduce the risks associated with its use? These are only some of the challenging questions facing us daily. The aim of this paper is to present scientific background to understand the importance of each method of fluoride use considering the current caries epidemiological scenario, and to discuss how individual or combined methods can be used based on the best evidence available.

Fingernail may not be a reliable biomarker of fluoride body burden from dentifrice

Fingernail has been suggested as a biomarker of fluoride (F) body burden, but there is no consensus if it would be a reliable indicator of F exposure from dentifrice. Therefore, the present study was conducted to investigate if fingernails would have sensitivity to detect F exposure from dentifrice in young children. Twenty-three 1-3-year-old children living in the city of Piracicaba (0.72 ppm F in water), Brazil, were enrolled in two phases of different F exposure: in phase A (1st to 11th week), they were exposed to the combination of F from diet (solids and liquids) and dentifrice (1,500 µg F/g as MFP), and in phase B (12th to 29th week), only to F from diet (the use of F dentifrice was interrupted). Fingernails were weekly clipped during 35 weeks for F determination. F intake from diet and dentifrice in each phase was also determined. Both analyses were made with ion-specific electrode. F intake (Mean ± SD) was significantly higher (p<0.01) when the children were exposed to F from diet+dentifrice than only to F from diet (0.086 ± 0.032 and 0.040 ± 0.009 mg F/day/kg body weight, respectively). However, F concentrations in nails collected during the whole experimental period of 35 weeks presented great variation with no trend of decreasing after F dentifrice intake interruption. The findings suggest that fingernail may not be a reliable F biomarker of body burden from dentifrice.

As unhas têm sido consideradas um biomarcador para a exposição ao flúor (F), mas não há consenso se é um indicador confiável para exposição ao F a partir do dentifrício. Vinte e três crianças, com idade entre 1 a 3 anos, moradoras de Piracicaba (0,72 ppm F na água), Brasil, foram submetidas a duas fases de diferentes exposição ao F: fase A (1a a 11a semanas), as crianças foram expostas à combinação de F a partir da dieta (sólidos e líquidos) e dentifrício (1500 µg F/g como MFP); e na fase B (12ª a 29ª semanas), apenas ao F da dieta, uma vez que usaram dentifrício não fluoretado. As unhas das mãos foram coletadas semanalmente durante 35 semanas para determinação de F. A exposição ao F a partir da dieta e dentifrício foi também determinada. Ambas análises foram feitas com eletrodo específico para F. A exposição ao F foi significativamente maior (p<0,001) quando as crianças foram expostas ao F da dieta + dentifrício que ao F da dieta (0,086 ± 0,032 e 0,040 ± 0,009 mg F/kg corpóreo/dia, respectivamente). Entretanto, a concentração de F nas unhas coletadas durante todo o período experimental não diminuiu após a interrupção da ingestão do F a partir do dentifrício. Os resultados sugerem que as unhas das mãos não são um biomarcador confiável para refletir a exposição ao F pelo dentifrício.

Is there a need of extra fluoride in children.

The issues related to fluoridation of water or fortification of tooth paste with compounds of fluorides are controversial. Fluoride is stored mainly in the bones, where it increases the density and changes the internal architecture, makes it osteoporotic and more prone to fractures. Fluoride consumption by human beings increases the general cancer death rate, disrupts the synthesis of collagen and leads to the breakdown of collagen in bone, tendon, muscle, skin, cartilage, lungs, kidney and trachea, causing disruptive effect on various tissues in the body. It inhibits antibody formation, disturbs immune system and makes the child prone to malignancy. Fluoride has been categorized as a protoplasmic poison and any additional ingestion of fluoride by children is undesirable.

Estudio de fluorosis dental en escolares de Mórrope / A study on dental fluorosis in Morrope schoolchildren

La fluorosis dental es un defecto en la formación del esmalte por altas concentraciones de flúor, que se puede dar desde la gestación e infancia. Objetivos: determinar la prevalencia de fluorosis en escolares, el grado de la misma según sexo, colegio y lugar en el distrito de Mórrope, provincia de Lambayeque. Población y muestra: 444 estudiantes de 7 colegios y procedentes de 28 localidades del distrito de Mórrope, realizándose el examen dental con la clasificación de Dean. Resultados: alta prevalencia de fluorosis del 97.5 por ciento en los escolares de Mórrope, siendo la más alta reportada en estudios latinoamericanos; no existe asociación estadística según sexo, es más predominante en las edades de 13 a 16 años con proporciones de 44 a 49 por ciento de grado moderado/severo y existen localidades como Cruz del Médano donde 53 por ciento tienen fluorosis moderada/severa, mientras que en la ciudad de Mórrope el grado predominante es fluorosis leve. Conclusiones: existe una alta prevalencia de fluorosis en el distrito de Mórrope, siendo necesarios estudios de agua de pozos y determinar la existencia de fluorosis ósea en la población.

Conceitos atuais sobre utilização de suplementos fluoretados no período gestacional / Actual concepts about the use of fluoride supplements during pregnancy

A utilização de fluoretos tem levado à redução na incidência e na prevalência da doença cárie. As formas de emprego desse composto têm sido bastante discutidas, principalmente no que se refere à suplementação fluoretada pré-natal. Apesar de a ingestão de fluoreto no período gestacional não ter tido o seu poder preventivo contra cárie cientificamente comprovado, estes suplementos são, ainda, amplamente utilizados e prescritos por profissionais da saúde. Assim, este trabalho visa a discutir os benefícios e os riscos do uso de suplemento fluoretado durante a fase pré-natal.

The use of fluoride has reduced the incidence and prevalence of caries. The substance ways of administration have been discussed, especially as prenatal supplements. Although the ingestion of fluoride during the pregnancy is not universally accepted, these supplements are widely used and prescribed by health care professionals. Thus, this work aims to review benefits and risks of using fluoride supplements during pregnancy.