The relationships between fluoride intake levels and fluorosis of late-erupting permanent teeth
Corresponding Author
Pradeep Bhagavatula BDS, MPH, MS
Department of Clinical Services, Marquette University School of Dentistry, Milwaukee, WI, USA
Correspondence Pradeep Bhagavatula, Marquette University School of Dentistry, P.O. Box 1881, Milwaukee, WI 53201-1881. Tel.: 414-288-5694; Fax: 414-288-3586; e-mail: [email protected]. Alexandra Curtis is with the Department of Biostatistics, College of Public Health, University of Iowa. Barbara Broffitt and John Warren are with the Department of Preventive & Community Dentistry, College of Dentistry, University of Iowa. Karin Weber-Gasparoni is with the Department of Pediatric Dentistry, College of Dentistry, University of Iowa. Steven M. Levy is with the Department of Preventive & Community Dentistry, College of Dentistry and Department of Epidemiology, College of Public Health, University of Iowa.Search for more papers by this authorAlexandra Curtis MS
Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA
Search for more papers by this authorBarbara Broffitt MS
Department of Preventive & Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
Search for more papers by this authorKarin Weber-Gasparoni DDS, MS, PhD
Department of Pediatric Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
Search for more papers by this authorJohn Warren DDS, MS
Department of Preventive & Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
Search for more papers by this authorSteven M. Levy DDS, MPH
Department of Preventive & Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
Search for more papers by this authorCorresponding Author
Pradeep Bhagavatula BDS, MPH, MS
Department of Clinical Services, Marquette University School of Dentistry, Milwaukee, WI, USA
Correspondence Pradeep Bhagavatula, Marquette University School of Dentistry, P.O. Box 1881, Milwaukee, WI 53201-1881. Tel.: 414-288-5694; Fax: 414-288-3586; e-mail: [email protected]. Alexandra Curtis is with the Department of Biostatistics, College of Public Health, University of Iowa. Barbara Broffitt and John Warren are with the Department of Preventive & Community Dentistry, College of Dentistry, University of Iowa. Karin Weber-Gasparoni is with the Department of Pediatric Dentistry, College of Dentistry, University of Iowa. Steven M. Levy is with the Department of Preventive & Community Dentistry, College of Dentistry and Department of Epidemiology, College of Public Health, University of Iowa.Search for more papers by this authorAlexandra Curtis MS
Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA
Search for more papers by this authorBarbara Broffitt MS
Department of Preventive & Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
Search for more papers by this authorKarin Weber-Gasparoni DDS, MS, PhD
Department of Pediatric Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
Search for more papers by this authorJohn Warren DDS, MS
Department of Preventive & Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
Search for more papers by this authorSteven M. Levy DDS, MPH
Department of Preventive & Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
Search for more papers by this authorAbstract
Objectives
To examine the relationships between fluoride intake levels and fluorosis of late-erupting permanent teeth.
Methods
The current study used information collected from 437 children in the longitudinal Iowa Fluoride Study. Participants' fluoride intake information was collected using questionnaires from birth to age 10 years. Estimated mean daily fluoride intake was categorized into low, moderate, and high intake tertiles for each age interval (2-5, 5-8, and 2-8 years). Bivariate analyses were performed to study the relationships between self-reported fluoride intake levels during three age intervals and dental fluorosis.
Results
For canines and second molars, the prevalence of mostly mild fluorosis was less than 10% in the lowest fluoride intake tertile and more than 25% in the highest intake tertile. For both first and second premolars, the prevalence in the low and high intake tertiles was approximately 10-15% and 25-40%, respectively. When estimated total daily fluoride intake was 0.04 mg/kg BW during ages 2-8 years, the predicted probability of fluorosis was 16.0%, 20.5%, 21.8%, and 15.4% for canines, 1st and 2nd and premolars and 2nd molars, respectively. We found that an incremental increase in fluoride intake during the age 5- to 8-year interval led to greater odds for development of mostly mild dental fluorosis in late-erupting teeth compared to increases in fluoride intake during other age intervals.
Conclusions
Our results clearly show that dental fluorosis prevalence is closely related to fluoride intake levels and that teeth have greater susceptibility to fluoride intake during certain age intervals.
References
- 1 Burt BA. The changing patterns of systemic fluoride intake. J Dent Res. 1992; 71(5): 1228-37.
- 2 Pendrys DG, Stamm JW. Relationship of total fluoride intake to beneficial effects and enamel fluorosis. J Dent Res. 1990; 69: 529-38. discussion 56-7.
- 3 Kumar JV, Green EL, Wallace W, Carnahan T. Trends in dental fluorosis and dental caries prevalences in Newburgh and Kingston, NY. Am J Public Health. 1989; 79(5): 565-9.
- 4 Beltran-Aguilar ED, Griffin SO, Lockwood SA. Prevalence and trends in enamel fluorosis in the United States from the 1930s to the 1980s. J Am Dent Assoc. 2002; 133(2): 157-65.
- 5
Dean HT,
Dixon RM,
Cohen C. Mottled enamel in Texas. Public Health Rep. 1935; 50(13): 424-42.
10.2307/4581503 Google Scholar
- 6 McClure FJ, Likins RC. Fluorine in human teeth studied in relation to fluorine in the drinking water. J Dent Res. 1951; 30(2): 172-6.
- 7 Singh KA, Spencer AJ. Relative effects of pre- and post-eruption water fluoride on caries experience by surface type of permanent first molars. Community Dent Oral Epidemiol. 2004; 32(6): 435-46.
- 8 DenBesten PK, Thariani H. Biological mechanisms of fluorosis and level and timing of systemic exposure to fluoride with respect to fluorosis. J Dent Res. 1992; 71(5): 1238-43.
- 9 Hong L, Levy SM, Warren JJ, Broffitt B, Cavanaugh J. Fluoride intake levels in relation to fluorosis development in permanent maxillary central incisors and first molars. Caries Res. 2006; 40(6): 494-500.
- 10 Hong L, Levy SM, Broffitt B, Warren JJ, Kanellis MJ, Wefel JS, Dawson DV. Timing of fluoride intake in relation to development of fluorosis on maxillary central incisors. Community Dent Oral Epidemiol 2006; 34(4): 299-309.
- 11 Bhagavatula P, Levy SM, Broffitt B, Weber-Gasparoni K, Warren JJ. Timing of fluoride intake and dental fluorosis on late-erupting permanent teeth. Community Dent Oral Epidemiol. 2016; 44(1): 32-45.
- 12 Pendrys DG, Katz RV, Morse DE. Risk factors for enamel fluorosis in a fluoridated population. Am J Epidemiol. 1994; 140(5): 461-71.
- 13 Pendrys DG, Katz RV, Morse DE. Risk factors for enamel fluorosis in a nonfluoridated population. Am J Epidemiol. 1996; 143(8): 808-15.
- 14 Ishii T, Suckling G. The severity of dental fluorosis in children exposed to water with a high fluoride content for various periods of time. J Dent Res. 1991; 70(6): 952-6.
- 15 Pendrys DG, Katz RV. Risk of enamel fluorosis associated with fluoride supplementation, infant formula, and fluoride dentifrice use. Am J Epidemiol. 1989; 130(6): 1199-208.
- 16 Kroon J. The relation between toothpaste usage and fluorosis: a cause for concern? SADJ. 2001; 56(1): 20-7.
- 17 Larsen MJ, Kirkegaard E, Poulsen S. Patterns of dental fluorosis in a European country in relation to the fluoride concentration of drinking water. J Dent Res. 1987; 66(1): 10-2.
- 18 Larsen MJ, Richards A, Fejerskov O. Development of dental fluorosis according to age at start of fluoride administration. Caries Res. 1985; 19(6): 519-27.
- 19 Sudhir KM, Suresh S, Prashant GM, Reddy VV, Shafiulla M, Chandu GN. Distribution patterns of enamel fluorosis in permanent dentition. Oral Health Prev Dent. 2012; 10(2): 167-74.
- 20 van Palenstein Helderman WH, Mabelya L, Van't Hof MA, Konig KG. Two types of intraoral distribution of fluorotic enamel. Community Dent Oral Epidemiol. 1997; 25(3): 251-5.
- 21 Manji F, Baelum V, Fejerskov O, Gemert W. Enamel changes in two low-fluoride areas of Kenya. Caries Res. 1986; 20(4): 371-80.
- 22 Baelum V, Fejerskov O, Manji F, Larsen MJ. Daily dose of fluoride and dental fluorosis. Tandlaegebladet. 1987; 91(10): 452-6.
- 23 Ramires I, Pessan JP, Levy FM, Rodrigues MH, de Almeida BS, Kato MT, Peres SH, Buzalaf MA. Prevalence of dental fluorosis in Bauru, São Paulo, Brazil. J Appl Oral Sci. 2007; 15(2): 140-3.
- 24 Levy SM, Kiritsy MC, Slager SL, Warren JJ, Kohout FJ. Patterns of fluoride dentifrice use among infants. Pediatr Dent. 1997; 19(1): 50-5.
- 25 Levy SM, Warren JJ, Davis CS, Kirchner HL, Kanellis MJ, Wefel JS. Patterns of fluoride intake from birth to 36 months. J Public Health Dent. 2001; 61(2): 70-7.
- 26 Levy SM, Warren JJ, Broffitt B. Patterns of fluoride intake from 36 to 72 months of age. J Public Health Dent. 2003; 63(4): 211-20.
- 27 Tai MM. A mathematical model for the determination of total area under glucose tolerance and other metabolic curves. Diab Care. 1994; 17(2): 152-4.
- 28 Cruz-Orcutt N, Warren JJ, Broffitt B, Levy SM, Weber-Gasparoni K. Examiner reliability of fluorosis scoring: a comparison of photographic and clinical examination findings. J Public Health Dent. 2012; 72(2): 172-5.
- 29 McClure FJ. Ingestion of fluoride and dental caries: quantitative relations based on food and water requirements of children one to twelve years old. Am J Dis Children. 1943; 66(4): 362-9.
- 30 Maguire A, Zohouri FV, Hindmarch PN, Hatts J, Moynihan PJ. Fluoride intake and urinary excretion in 6- to 7-year-old children living in optimally, sub-optimally and non-fluoridated areas. Community Dent Oral Epidemiol. 2007; 35(6): 479-88.
- 31 Levy SM, Eichenberger-Gilmore J, Warren JJ, Letuchy E, Broffitt B, Marshall TA, Burns T, Willing M, Janz K, Torner JC. Associations of fluoride intake with children's bone measures at age 11. Community Dent Oral Epidemiol. 2009; 37(5): 416-26.
- 32 Whitford GM. Fluoride metabolism and excretion in children. J Public Health Dent. 1999; 59(4): 224-8.
- 33 Aasenden R, Peebles TC. Effects of fluoride supplementation from birth on human deciduous and permanent teeth. Arch Oral Biol. 1974; 19(4): 321-6.
- 34 Institute of Medicine (US) Panel on Micronutrients. Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. Washington, DC: National Academies Press (US); 2001. [cited 2017 Oct 24]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK222310/
- 35 Warren JJ, Levy SM, Broffitt B, Cavanaugh JE, Kanellis MJ, Weber-Gasparoni K. Considerations on optimal fluoride intake using dental fluorosis and dental caries outcomes—a longitudinal study. J Public Health Dent. 2009; 69(2): 111-5.
- 36 Pendrys DG. The fluorosis risk index: a method for investigating risk factors. J Public Health Dent. 1990; 50(5): 291-8.
- 37 Slayton RL, Warren JJ, Kanellis MJ, Levy SM, Islam M. Prevalence of enamel hypoplasia and isolated opacities in the primary dentition. Pediatr Dent. 2001; 23(1): 32-6.
- 38
Russell AL. The differential diagnosis of fluoride and nonfluoride enamel opacities. J Public Health Dent. 1961; 21(4): 143-6.
10.1111/j.1752-7325.1961.tb00373.x Google Scholar
- 39 Dean HT, Elvove E. Some epidemiological aspects of chronic endemic dental fluorosis. Am J Public Health Nations Health. 1936; 26(6): 567-75.
- 40 Thylstrup A, Fejerskov O. Clinical appearance of dental fluorosis in permanent teeth in relation to histologic changes. Community Dent Oral Epidemiol. 1978; 6(6): 315-28.
- 41 Nelson SJ. Wheeler's dental anatomy, physiology and occlusion. 9th ed. St. Louis: Saunders Elsevier; 2010.
- 42 Haavikko K. The formation and the alveolar and clinical eruption of the permanent teeth. An orthopantomographic study. Suom Hammaslaak Toim. 1970; 66(3): 103-70.
- 43 Rwenyonyi CM, Birkeland JM, Haugejorden O, Bjorvatn K. Dental variables associated with differences in severity of fluorosis within the permanent dentition. Clin Oral Investig. 2000; 4(1): 57-63.
- 44 Shillingburg HT, Grace CS. Thickness of enamel and dentin. J South Calif Dent Assoc. 1973; 41(1): 33-6 passim.
- 45 United States Department of Health and Human Services. Fluoridation census, 1992. Atlanta, GA: Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention; 1993.
- 46 United States Department of Health and Human Services. Reports and Recommendations: U.S. Public health service recommendation for fluoride concentration in drinking water for the prevention of dental caries. Public Health Rep. 2015; 130(4): 318-31.