Estimated Dietary Fluoride Intake by 24-Month-Olds from Chocolate Bars, Cookies, Infant Cereals, and Chocolate Drinks in Brazil

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.