Abstract
OBJECTIVE: The increased availability of fluoride and concern over the impact of fluorosis, have led to guidance suggesting a decrease or cease in the optimal concentration of fluoride in water fluoridation schemes. To date there have been no systematic reviews looking at both impact of fluoride reduction and total cessation. This review aimed to examine the impact of stopping or reducing the level of fluoride in public water supplies on dental fluorosis.
CONTENT: Multiple databases were searched (MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and the Web of Science). Two reviewers independently screened sources, extracted data and assessed study quality. Results were synthesised qualitatively and quantitatively. The main outcome measure was the prevalence of dental fluorosis.
SUMMARY: Six studies of cross-sectional design were included. Two studies were scored as evidence level B (moderate) and the remaining four publications were evidence level C (poor). Meta-analysis indicated fluorosis prevalence was significantly decreased following either a reduction in the concentration of fluoride or cessation of adding fluoride to the water supply (OR:6.68; 95% CI:2.48 to 18.00).
OUTLOOK: The evidence suggests a significant decrease in the prevalence of fluorosis post cessation or reduction in the concentration of fluoride added to the water supply. However, this work demonstrates that when studies are subject to current expectations of methodological and experimental rigour, there is limited evidence with low methodological quality to determine the effect of stopping or reducing the concentration of fluoride in the water supply on dental fluorosis.
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Dental fluorosis in populations from Chiang Mai, Thailand with different fluoride exposures - paper 1: assessing fluorosis risk, predictors of fluorosis and the potential role of food preparation.
BACKGROUND: To determine the severity of dental fluorosis in selected populations in Chiang Mai, Thailand with different exposures to fluoride and to explore possible risk indicators for dental fluorosis. METHODS: Subjects were male and female lifetime residents aged 8-13?years. For each child the fluoride content of drinking and cooking water samples
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Use of geochemical data banks in monitoring the natural environment — a case study from Sri Lanka.
A survey carried out on the incidence of dental diseases and the distribution of fluoride in drinking water wells and also copper in such waters in Sri Lanka showed the influence of the natural environmental factors on the prevalence of certain geographical diseases. In the case of the geographical variation
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Chronic Exposure to Bisphenol A exacerbates dental fluorosis in growing rats
Enamel defects resulting from environmental conditions and the way of life are public health concerns because of their high prevalence. As their etiology is unclear, the aim of this study was to analyze the various forms of enamel hypomineralization, and to characterize the genes involved in this process to determine
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Breastfeeding is protective against dental fluorosis in a nonfluoridated rural area of Ontario, Canada
To determine the relationship between early infant feeding and dental fluorosis in a non-fluoridated area, 1367 children were examined for fluorosis and given a water sample vial and questionnaire. 752 families responded (55%). Breastfeeding was reported by 69% of respondents, with 53.6% breastfed < 6 months, 35.3% 6-12 months, and
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Risk of fluorosis associated with infant formulas prepared with bottled water.
PURPOSE: The purpose of this study was to estimate fluoride (F) intake from infant formulas prepared with different brands of bottled water. METHODS: Fluoride concentrations in 4 samples of infant milk and soy-based formulas, commercially available in the United States, prepared with deionized water and 5 brands of bottled water, were
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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.
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Mechanisms by Which Fluoride Causes Dental Fluorosis Remain Unknown
When it comes to how fluoride impacts human health, no tissue in the body has been studied more than the teeth. Yet, despite over 50 years of research, the mechanism by which fluoride causes dental fluorosis (a hypo-mineralization of the enamel that results in significant staining of the teeth) is not
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Dental Fluorosis Impacts Dentin in Addition to Enamel
Dental fluorosis is a mineralization defect of tooth enamel marked by increased subsurface porosity. The enamel, however, is not the only component of teeth that is effected. As several studies have demonstrated, dental fluorosis can also impair the mineralization of dentin as well. As noted in one review: "The fact that
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Community Fluorosis Index (CFI)
The current Community Fluorosis Index for U.S. adolescents as a whole (from both fluoridated and non-fluoridated areas) is roughly 5 times higher than the CFI health authorities predicted for fluoridated areas when fluoridation first began. It is also higher than the CFI that the NIDR found in fluoridated areas back in the 1980s. It is readily apparent, therefore, that children are ingesting far more fluoride than was the case in the 1950s, and even as recently as the 1980s.
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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
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