Methods: The study used randomly collected (6107) groundwater samples from Sri Lanka and categorized them as “dentally optimal” and “unsafe” based on their F content. The minimum distance from an identified high F source (above dentally optimal level) to a safe groundwater source was determined using geospatial analysis.
Results: Dentally optimal F sources (<1 and <1.5 mg/L) were identified among the high F groundwater sources (>2 mg/L), some even within a walking distance of 500 m. Results indicated that 26% of dentally unsafe groundwater sources (2.0 mg/L+ wells) had a low F source (<1.0 mg/L) available within a distance of 500 m. It was also evident that 39% of high F wells (2.0 mg/L+ wells) had a low F well (<1.5 mg/L) within a distance of 500 m, if the WHO guideline value for optimal F levels (1.5 mg/L) was assigned as the safe F limit.
Conclusion: The spatial approach demonstrated a reasonable access to alternative water sources with low or safe F limit in endemic fluorosis areas. Optimizing the use of accessible low F sources is highly recommended as the first-line option to mitigate dental fluorosis in Sri Lanka since the defluoridation methods introduced in past did not provide sustainable oral health solutions for the inhabitants in high-risk areas.
*Original article online at https://onlinelibrary.wiley.com/doi/10.1111/cdoe.12449
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