Abstract
Background: A relationship between fluoride and osteosarcoma has been hypothesized but not validated. To the authors’ knowledge, there are no published studies examining topical fluoride or dietary fluoride supplements and osteosarcoma risk. The purpose of this study was to examine the association between ever or never use of topical and dietary fluoride supplements and osteosarcoma.
Methods: The authors performed a secondary data analysis on data from 2 separate but linked studies. Patients for Phase 1 and Phase 2 were selected from US hospitals using a hospital-based matched case-control study design. Case patients were those who had received diagnoses of osteosarcoma, and control patients were those who had received diagnoses of other bone tumors or nonneoplastic conditions. In Phase 1, case patients (N = 209) and control patients (N = 440) were those seeking treatment at orthopedic departments from 1989 through 1993. In Phase 2, incident case patients (N = 108) and control patients (N = 296) were identified and treated by physicians from 1994 through 2000. This analysis included all patients who met eligibility criteria and on whom the authors had complete data on exposure, outcome, and covariates. The authors used conditional logistic regression to estimate odds ratios and 95% confidence intervals (CIs) for the association of topical fluoride use and supplemental fluoride use with osteosarcoma.
Results: The adjusted odds ratios were 0.94 (95% CI, 0.60 to 1.46) and 0.78 (95% CI, 0.46 to 1.33) for topical fluoride and supplemental fluoride, respectively.
Conclusions: Neither topical nor dietary fluoride supplements are associated with an increased risk of developing osteosarcoma.
Practical Implications: Supplemental and topical fluorides used in the dental office and in over-the-counter products are not related to an increased risk of developing osteosarcoma.
Excerpt:
Dr. Hayes is the director of Dental Services, Division of Commonwealth Medicine, Office of Clinical Affairs, University of Massachusetts Medical School, Worcester, MA; a clinical professor, Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA; and a lecturer, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA.
Dr. Douglass is a professor emeritus, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA.
Dr. Kim is a dental public health consultant, San Antonio, TX.
Ms. Burgard is a senior biostatistician, Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Dr. Couper is a professor, Department of Biostatistics, University of North Carolina at Chapel Hill, NC.
-
The National Osteosarcoma Etiology Group is represented by MA Simon (University of Chicago, Chicago, IL), MC Gebhardt (Massachusetts General Hospital, Boston, MA), MT Scarborough (Shands Medical Center, University of Florida, Gainesville, FL), S Gitelis (Rush Presbyterian and St. Luke’s Medical Center, Chicago IL), JJ Eckardt (UCLA School of Medicine, Los Angeles, CA), JR Neff (Nebraska Health System, Omaha, NE), MJ Joyce (Cleveland Clinic Foundation, Cleveland, OH), M McGuire (Creighton University, Omaha, NE), and HC Anderson (University of Kansas Medical Center, Kansas City, KS).
-
Disclosures. Dr. Douglass has written reviews of the literature for a number of companies that sell, reimburse, or do research on preventive dentistry products, most notably GlaxoSmithKline, Colgate-Palmolive, Henry Schein, Dentsply, Quintiles, and Delta Dental Plans, as well as the US Public Health Service. Dr. Hayes has done limited consulting with Proctor & Gamble. None of the other authors reported any disclosures.
-
Statistical analysis for this study was conducted by the Collaborative Studies Coordinating Center, University of North Carolina at Chapel Hill, with funding from CDI Research. Data collection for this study was conducted by Westat, with Dr. Robert Hoover as principal investigator.
-
The authors acknowledge the participation of the patients, hospitals, and surgeons in this study.
-
Phase 1 of this study was funded by grant 5R01ESO6000 from the National Institute of Environmental Health Sciences, National Institutes of Health. Data collection was conducted by the New England Research Institute. Phase 2 was funded by grant T32DE07151 from the National Cancer Institute and the National Institute of Dental and Craniofacial Research, National Institutes of Health.
Print 
PDF