Fluoride Action Network


Objectives: Due to increased consumption of pre-packaged drinks, tap water may no longer be the principal source of water intake and consequently fluoride intake. Little is known about the importance of solid foods as fluoride sources and how the relative contribution of foods/drinks to fluoride intake is affected by residing in fluoridated or non-fluoridated areas. This study investigated the relative contributions of different dietary sources to dietary fluoride intake and compared this in children residing in optimally artificially fluoridated, sub-optimally artificially fluoridated, and non-fluoridated areas.

Methods: Thirty-three healthy children aged 6 years were recruited from fluoridated and non-fluoridated communities and categorised into three groups based on fluoride content of home tap water: optimally fluoridated (< or =0.7 mgF/L), sub-optimally fluoridated (> or =0.3 to < or =0.7 mgF/L) and non-fluoridated (50.3 mgF/L) drinking water. A 3-day dietary diary collected dietary information. Samples of foods/drinks consumed were collected and analyzed for fluoride content.

Results: Drinks provided 59%, 55% and 32% of dietary fluoride intake in optimally, sub-optimally and non-fluoridated areas respectively. Tap water, fruit squashes and cordials (extremely sweet non-alcoholic fruit flavoured drink concentrates) prepared with tap water, as well as cooked rice, pasta and vegetables were important sources of fluoride in optimally and sub-optimally fluoridated areas. Carbonated soft drinks and bread were the most important contributors to dietary fluoride intake in the non-fluoridated area.

Conclusion: The main contributory sources to dietary fluoride differ between fluoridated and non-fluoridated areas. Estimating total fluoride intake from levels of fluoride in tap water alone is unlikely to provide a reliable quantitative measure of intake. Studies monitoring dietary fluoride exposure should consider intake from all foods and drinks.

*Original abstract online at https://onlinelibrary.wiley.com/doi/10.1111/j.1752-7325.2006.tb04074.x

Source of support: The Borrow Foundation.

Citing Literature

Use of public water supply fluoride concentration as an indicator of population exposure to fluoride in England 1995–2015, Environmental Monitoring and Assessment, 10.1007/s10661-020-08304-3, 192, 8, (2020). Crossref

Fluoride, Molecular, Genetic, and Nutritional Aspects of Major and Trace Minerals, 10.1016/B978-0-12-802168-2.00044-0, (539-550), (2017). vCrossref

Total daily fluoride intake and fractional urinary fluoride excretion in 4? to 6?year?old children living in a fluoridated area: weekly variation?, Community Dentistry and Oral Epidemiology, 10.1111/cdoe.12254, 45, 1, (12-19), (2016). vWiley Online Library

Estimation of daily dietary fluoride intake: 3-d food diary v . 2-d duplicate plate , British Journal of Nutrition, 10.1017/S0007114515003906, 114, 12, (2103-2109), (2015). Crossref

Total daily fluoride intake and the relative contributions of foods, drinks and toothpaste by 3? to 4?year?old children in the Gaza Strip – Palestine, International Journal of Paediatric Dentistry, 10.1111/ipd.12108, 25, 2, (127-135), (2014). Wiley Online Library

Dental Fluorosis: Concentration of Fluoride in Drinking Water and Consumption of Bottled Beverages in School Children, Journal of Clinical Pediatric Dentistry, 10.17796/jcpd.38.4.e77h557k0005077n, 38, 4, (338-344), (2014). Crossref

Fluoride balance in infants and young children in the UK and its clinical relevance for the dental team, British Dental Journal, 10.1038/sj.bdj.2013.531, 214, 11, (587-593), (2013). Crossref

Total fluoride intake and excretion in children up to 4 years of age living in fluoridated and non?fluoridated areas, European Journal of Oral Sciences, 10.1111/eos.12070, 121, 5, (457-464), (2013). Wiley Online Library

The association between social deprivation and the prevalence and severity of dental caries and fluorosis in populations with and without water fluoridation, BMC Public Health, 10.1186/1471-2458-12-1122, 12, 1, (2012). Crossref

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, BMC Oral Health, 10.1186/1472-6831-12-16, 12, 1, (2012). Crossref

Dental fluorosis in populations from Chiang Mai, Thailand with different fluoride exposures – Paper 2: The ability of fluorescence imaging to detect differences in fluorosis prevalence and severity for different fluoride intakes from water, BMC Oral Health, 10.1186/1472-6831-12-33, 12, 1, (2012). Crossref

Fluoride content of Ready?to?Feed (RTF) infant food and drinks in the UK, Community Dentistry and Oral Epidemiology, 10.1111/j.1600-0528.2011.00632.x, 40, 1, (26-36), (2011). Wiley Online Library

Fluoride content of solid foods impacts daily intake, Journal of Public Health Dentistry, 10.1111/j.1752-7325.2011.00292.x, 72, 2, (128-134), (2011). Wiley Online Library

Fluoride Ingestion Is Related to Fluid Consumption Patterns, Journal of Public Health Dentistry, 10.1111/j.1752-7325.2009.00133.x, 69, 4, (267-275), (2009). Wiley Online Library