A smile with beautiful teeth makes a first and lasting impression – but for children living in Phayao province, smiling is bringing unhappiness and depression.
Their teeth have telltale chalky white spots and mottled brown staining caused by fluoride poisoning.
“I am waiting for medication from a doctor,” said unhappy 15-year-old schoolboy Suppakij Tipkham, who suffers from chronic fluorosis- a dental health condition caused by a child receiving too much fluoride during tooth development. The critical period of exposure is between 1 and 4 years of age.
Of geological origin
Fluoride in water is mostly of geological origin. Water with high levels of fluoride content is found mostly at the foot of high mountains and in areas where the sea has left geological deposits.
The north of Thailand is part of a fluoride belt stretching from Syria through Jordan, Egypt, Libya, Algeria, Sudan, and Kenya.
In Thailand, the Public Health Ministry estimates about 8,500 villages in 12 provinces including Mae Hong Son, Tak, Uthai Thani, Phichit, Kanchanaburi, Nakhon Pa-thom, Ratchaburi, Phetchaburi, Prachuap Khiri Khan, and Chon Buri are contaminated with unsafe levels of fluoride in drinking water.
The World Health Organisa-tion suggests a level of fluoride from 0.5 to 1.5 milligrams per litre, depending on climate; while Thailand’s Public Health Department recommends the level should not exceed 0.7mg per litre as safe for drinking.
The severity of dental fluorosis depends on the amount of exposure to water that is naturally fluoridated to well above recommended levels.
In Phayao province’s Phukamyoa district, where the water supply is fluoridated at the excessive level of 2.9mg per litre, 20.4 per cent of children suffer from dental fluorosis.
Most have drunk a lot of underground water tainted with the fluoride since they were born.
They are embarrassed and do not feel confident when they talk with other people as they have mottled teeth, caused by the effects of high fluoride intake, making for an ugly smile.
“Dental fluorosis steals smiles and ruins lives. It forces [young people] to separate from society because of their unattractive smiles,” said Public Health Department deputy director Dr Sophon Mekthon
Dental fluorosis can be cosmetically treated with dental crowns- but the cost of treatment is expensive, ranging from Bt 8,000 to Bt 16,000.
Meanwhile, the National Health Security Office does not list treatment under the universal health care scheme as fluorosis is recognised as a cosmetic condition, not a disease.