Effect of fluoridated water on dental caries and fluorosis in schoolchildren who use fluoridated dentifrice

Abstract

This cross-sectional study evaluated the prevalence and severity of dental caries and fluorosis in children and adolescents using fluoridated toothpaste, from areas with and without fluoridated water. Parents of 5-year-old children and 12-year-old adolescents from neighbourhoods that are supplied with and without fluoridated water answered questionnaires for determining socio-economic and demographic characteristics and habits related to oral health. The individuals were examined, and dental caries and fluorosis were measured by dmft/DMFT and TF indexes, respectively. Descriptive, bivariate and logistic regression analyses were performed (p < 0.05). Of 692 participants, 47.7% were 5-year-olds and 52.3% were 12-year-olds. The mean dmft/DMFT in the 5-year-olds/ 12-year-olds from Exposed and Not Exposed fluoridated water groups was 1.53 (± 2.47) and 3.54 (± 4.10) / 1.53 (± 1.81) and 3.54 (± 3.82), respectively. Children (OR = 2.86, 95% CI = 1.71-4.75) and adolescents (OR = 1.95, 95% CI = 1.24-3.05), who did not consume fluoridated water, had greater caries experience. Among adolescents, there was an association between fluoridated water and the prevalence of very mild/mild fluorosis (OR = 5.45, 95% CI: 3.23-9.19) and moderate fluorosis (OR = 11.11, 95% CI = 4.43-27.87). Children and adolescents, who consumed fluoridated water, presented lower prevalence and severity of dental caries compared to those who used only fluoridated toothpaste as the source of fluoride. There is an association between water fluoridation and very mild/mild and moderate fluorosis in adolescents.

Fluorosis dental en relación con el tipo de pastas dentales utilizadas por niños de una clínica odontológica de Jaén, Perú

“…La segunda pasta sí que está indicado en niños (22) , por tanto se evidencia que es la de mayor uso por parte de los padres como recomendación de su dentista o por avisos publicitarios, o porque son entregados en sus atenciones a nivel del Minsa o EsSalud. El mal uso de las pastas dentales en niños, principalmente debido a la concentración de flúor es uno de los principales factores de riesgo para contraer fluorosis dental en este grupo etario, así como ha sido también informado por estudios previos (23,24) .…”

A Systematic Review on Water Fluoride Levels Causing Dental Fluorosis

“…The prevalence of dental fluorosis reported in the past five years agrees with the prevalence reported before the past five years. As shown in Tables 4 and 5, the studies included in this systematic review from the past five years were [32,[44][45][46][47][48][49][50][51][52][53][54][55][56]. In comparison, the studies included in this review before the past five years were [34][35][36][37][38][39][40][41][42][43].…”

“…However, the impact of fluorosis on dental caries when fluoride levels are beyond this limit is unknown. Some authors [55,56] conclude that a lower incidence of dental caries may be predicted in regions where fluorosis is frequent, suggesting that higher fluoride dosages are useful. Some people with severe dental fluorosis also have increased caries, which may be attributed to the loss of protective enamel due to the pitting that occurs in severe fluorosis.…”

Biphasic Functions of Sodium Fluoride (NaF) in Soft and in Hard Periodontal Tissues

“…These macroscopic presentations were soon deciphered in the form of microscopic and molecular mechanisms and pathways [117]. The major application of low concentrations of fluoride in dentistry have been related to the prevention of dental caries by fluoridation of systemic water, milk, and salt [118]. There is a plethora of literature on this topic with high-quality evidence supporting the efficacy of this paradigm [117,118].…”

“…The major application of low concentrations of fluoride in dentistry have been related to the prevention of dental caries by fluoridation of systemic water, milk, and salt [118]. There is a plethora of literature on this topic with high-quality evidence supporting the efficacy of this paradigm [117,118]. Fluoride in sodium and stannous and acidulated phosphate forms has found utility in topical applications [119], which have evolved as solutions, gels, varnishes, and pastes [119].…”