Impact of socio-demographic, socioeconomic, and water variables on dental fluorosis in adolescents growing up during the implementation of a fluoridated domestic salt program

Abstract

The objective of this study is to determine the impact of socio-demographic, socioeconomic, and other risk indicators on dental fluorosis (DF) among Mexican adolescents. A cross-sectional study was carried out in 1,538 adolescents 12 and 15 years of age in semi-rural communities located at high altitude (>2,000 m) and with high concentration of fluoride in water (1.38-3.07 ppm) in Hidalgo, Mexico. DF was determined by means of Dean's Index and all teeth were examined. Remaining variables were collected using a questionnaire. The adjusted final model was performed using ordered logistic regression. After adjusting for sex, the variables associated with DF were (p< 0.05): being 12 years old (OR = 1.10) versus 15 years old; having lived the first 6 years of life in El Llano (3.07 F ppm) (OR = 3.19) or San Marcos (1.38 F ppm) (OR = 1.63) versus Tula (1.42 F ppm); having public (OR = 1.35) or private health insurance (OR = 1.36) versus those without insurance; belonging to the lower quartiles of socioeconomic position (SEP) [1st quartile (OR = 2.48), 2nd quartile (OR = 1.81), 3rd quartile (OR = 1.49)] versus the highest quartile; having drunk tap water (OR = 1.83) or from a well or spring (OR = 2.30) versus those who drank water purchased in large containers or bottles. Demographic and socioeconomic variables were associated with DF. While better SEP appeared to play an important role in DF, a pattern of water intake associated with water purchased in large containers or bottles (which have different connotations to the use of bottled water in industrialized Western countries) did reduce DF risk in these high fluoride content, high altitude communities.

Dental fluorosis, fluoride in urine, and nutritional status in adolescent students living in the rural areas of Guanajuato, Mexico

“…Pontigo-Loyola et al . [22] also reported similar results showing that children aged 12 years had greater chance to have fluorosis compared to those aged 15 years. The epidemiology system for oral diseases (SIVEPAB)[23] in 2010 also proposed an increase in DF prevalence, especially in the younger age groups (under 25 years).…”

Dental fluorosis: prevalence and associated factors in 12-year-old schoolchildren in Goiânia, Goiás

“…REV BRAS EPIDEMIOL JUL-SEP 2015; 18(3): 568-577 conducted in Brazil and Latin America have shown an association between higher socioeconomic status and lower prevalence of fluorosis 9,10 , others have reported no association 3,[11][12][13] . Some studies have also reported association between better socioeconomic status and higher incidence of fluorosis [14][15][16] .…”

Dental Fluorosis in Children from Aguascalientes, Mexico: A Persistent Public Health Problem

“…For example, it is well-established in the literature that the consumption of tap water with fluoride levels above 1.5 mg/L increases the likelihood of suffering more severe dental fluorosis [28]. This relationship has been found in studies in different states of Mexico (see [50][51][52][53]) and around the world (see [54][55][56]). Therefore, it is essential to provide information to affected households about the increased risk of developing dental fluorosis associated with tap-water consumption.…”