Abstract
Fluoride continues to be the cornerstone of dental caries prevention in North America and throughout the world, and there are a variety of sources of fluoride that may contribute to the dietary intakes of fluoride. Although the severe effect of chronic exposures to high levels of fluoride–skeletal fluorosis–is extremely rare in North America, dental fluorosis has become more prevalent. To address the increase in dental fluorosis prevalence, recommendations have been made to reduce fluoride ingestion early in life. These recommendations have included the introduction of lower concentration fluoride dentifrice for use by young children, labeling of the fluoride concentration of bottled water, and revised fluoride supplement guidelines to reduce or eliminate their use. Because our knowledge is incomplete regarding the amount, duration, and timing of fluoride ingestion that can result in dental fluorosis, however, further research is clearly needed before definitive recommendations can be made regarding the use of fluorides, including recommended intakes of fluoride in the diet.
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Assessing Fluorosis Incidence in Areas with Low Fluoride Content in the Drinking Water, Fluorotic Enamel Architecture, and Composition Alterations.
There is currently no consensus among researchers on the optimal level of fluoride for human growth and health. As drinking water is not the sole source of fluoride for humans, and fluoride can be found in many food sources, this work aimed to determine the incidence and severity of dental
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Evaluation of a fluorosis prevention educational program: A randomized field trial.
Background: A 2-group randomized field trial was conducted to evaluate the impact of a fluorosis educational preventive program in mother´s knowledge and practices, and on the urine fluoride concentration of their preschool children. Material and Methods: A group of 139 mother-child pairs participated in the study. Randomly, children were assigned to an intervention
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Effects of fluoride supplementation from birth on human deciduous and permanent teeth.
A group (I) of 7–12-yr-old children from non-fluoridated communities who had ingested 0.5 mg F supplement/day from shortly after birth to the age of 3 yr. and 1 mg/day thereafter was compared with a control group (II) from the same communities and with a group (III) with lifetime exposure to
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Risk of enamel fluorosis in nonfluoridated and optimally fluoridated populations: considerations for the dental professional.
BACKGROUND: Few studies have evaluated the impact of specific fluoride sources on the prevalence of enamel fluorosis in the population. The author conducted research to determine attributable risk percent estimates for mild-to-moderate enamel fluorosis in two populations of middle-school-aged children. METHODS: The author recruited two groups of children 10 to 14
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Potential fluoride exposure from selected food crops grown in high fluoride soils in the Makueni County, south-eastern Kenya.
Makueni County, located in south-eastern Kenya, faces challenges such as limited potable water and restricted food supplies as the result of semi-aridity. High fluoride (F) concentrations have been reported in drinking water with resultant dental fluorosis affecting the local population. To determine the potential F exposure through the consumption of
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Diagnostic Criteria for Dental Fluorosis: The TSIF ("Total Surface Index of Fluorosis")
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
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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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Nutrient Deficiencies Enhance Fluoride Toxicity
It has been known since the 1930s that poor nutrition enhances the toxicity of fluoride. As discussed below, nutrient deficiencies have been specifically linked to increased susceptibility to fluoride-induced tooth damage (dental fluorosis), bone damage (osteomalacia), neurotoxicity (reduced intelligence), and mutagenicity. The nutrients of primary importance appear to be calcium,
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Fluoridation of drinking water and chronic kidney disease: Absence of evidence is not evidence of absence
A fairly substantial body of research indicates that patients with chronic renal insufficiency are at an increased risk of chronic fluoride toxicity. Patients with reduced glomerular filtration rates have a decreased ability to excrete fluoride in the urine. These patients may develop skeletal fluorosis even at 1 ppm fluoride in the drinking water.
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Moderate/Severe Dental Fluorosis
In its "moderate" and severe forms, fluoride causes a marked increase in the porosity of the enamel. After eruption into mouth, the porous enamel of moderate to severe fluorosis readily takes up stain, creating permanent brown and black discolorations of the teeth. In addition to extensive staining, teeth with moderate to severe fluorosis are more prone to attrition and wear - leading to pitting, chipping, and decay.
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