Abstract

OBJECTIVES: This study was designed to determine the optimal concentrations of fluoride for drinking water in Pakistan. Clinical dental examination of 1020 school children aged 12 years was carried out in 19 cities of Pakistan. Correlation between concentrations of water fluoride, caries and fluorosis was investigated by analyzing the data on fluoride concentrations in drinking water in the sampled population for which the caries and the fluorosis levels were also measured.

METHODS: The optimal level of fluoride in drinking water is universally calculated by applying the equation of Galagan and Vermillion, which permits the calculation of water intake as a function of temperature. The annual mean maximum temperatures (AMMT) recorded during the last 5 years were collected from the meteorological centres of the 28 divisional headquarter stations. The average AMMT of Pakistan is 29 degrees C at which the optimal fluoride in drinking water of Pakistan was calculated to be 0.7 ppm. As drinking habits differ in various parts of the world, determination of optimal concentration of fluoride for drinking water in Pakistan was performed using a modified Galagan and Vermillion equation, which applies a correction factor of 0.56 to the equation. The optimal fluoride in drinking water in Pakistan using this modified equation was determined to be 0.39 ppm.

RESULTS: Observation of the correlation showed that a fluoride concentration of 0.35 ppm in drinking water was associated with maximum reduction in dental  caries and a 10% prevalence of fluorosis.

CONCLUSIONS: Determining the most appropriate concentrations of fluoride in drinking water is crucial for communities. It is imperative that each country calculates its own optimal level of fluoride in drinking water based on the dose-response relationship of fluoride in drinking water with the levels of caries and fluorosis. Climatic conditions, dietary habits of the population and other possible fluoride exposures need to be considered in formulating these recommendations.

• Related Studies :

  • Drinking water fluoride levels, dental fluorosis, and caries experience in Brazil

    OBJECTIVES: The main aim of this study was to consider the association between water fluoride levels and caries prevalence in three Brazilian populations. METHODS: A total of 457 6-12-year-old lifetime residents from three economically deprived groups with 2-3, 0.7, and less than 0.01 ppm F in their water supplies were examined.

  • Fluoride And Caring for Children’s Teeth (FACCT): Clinical Fieldwork Protocol [version 1; peer review: 2 approved]

    Background: The reduction in dental caries seen between Irish national surveys of children’s oral health in 1984 and 2002 was accompanied by an increase in the prevalence of enamel fluorosis.  To minimise the risk of enamel fluorosis in Irish children, in 2007, the level of fluoride in drinking water was

  • Sulphur dioxide and fluoride co-exposure cause enamel damage by disrupting the Cl-/HCO3- ion transport

    Objective Although there is growing evidence linking the exposure to sulphur dioxide (SO2) and fluoride to human diseases, there is little data on the co-exposure of SO2 and fluoride. Moreover, literature on SO2 and fluoride co-exposure to enamel damage is insufficient. In this work, we concentrate on the concurrent environmental issues of excessive SO2 and fluoride in several

  • Dose-dependent effect of fluoride on clinical and subclinical indices of fluorosis in school going children and its mitigation by supply of safe drinking water for 5 years: An Indian study.

    Fluorosis is a public health problem in India; to know its prevalence and severity along with its mitigation measures is very important. The present study has been undertaken with the aim to assess the F dose-dependent clinical and subclinical symptoms of fluorosis and reversal of the disease by providing safe

  • Perceptions of adolescents and young people regarding endemic dental fluorosis in a rural area of Brazil: psychosocial suffering

    Severe dental fluorosis is endemic in some rural areas of Brazil. This paper describes the psychosocial consequences of this condition and how it has affected the self-esteem of adolescents and young people in a rural area in Brazil. Semi-structured, face-to-face interviews were carried out with 23 adolescents and young people

• Related FAN Content :

  • "Mild" Dental Fluorosis: Perceptions & Psychological Impact

    The vast majority of research has found that patients, parents, and the general public alike view mild fluorosis (TF score 3) as a significant blemish of the teeth, one that is likely to embarrass the affected child to a degree that cosmetic treatment would be warranted.

  • Dental Fluorosis: The "Cosmetic" Factor

    Any condition that can cause children to be embarrassed about their physical appearance can have significant consequences on their self-esteem and confidence.  Researchers have repeatedly found that "physical appearance [is] the best predictor of self-esteem" in adolescents, (Harter 2000) and that facial attractiveness, particularly the appearance of one's teeth, is a

  • Racial Disparities in Dental Fluorosis

    In 2005, the Centers for Disease Control published the results of a national survey of dental fluorosis conducted between 1999 and 2002. According to the CDC, black children in the United States have significantly higher rates of dental fluorosis than either white or Hispanic children. This was not the first time that black children were found to suffer higher rates of dental fluorosis. At least five other studies -- dating as far back as the 1960s -- have found black children in the United States are disproportionately impacted by dental fluorosis.

  • Dental Fluorosis Is a "Hypo-mineralization" of Enamel

    Teeth with fluorosis have an increase in porosity in the subsurface enamel ("hypomineralization"). The increased porosity of enamel found in fluorosis is a result of a fluoride-induced impairment in the clearance of proteins (amelogenins) from the developing teeth. Despite over 50 years of research, the exact mechanism by which fluoride impairs amelogin

  • Diagnostic Criteria for Dental Fluorosis: The Thylstrup-Fejerskov (TF) Index

    The traditional criteria (the "Dean Index") for diagnosing dental fluorosis was developed in the first half of the 20th century by H. Trendley Dean. While the Dean Index is still widely used in surveys of fluorosis -- including the CDC's national surveys of fluorosis in the United States -- dental