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  Free Full Text References 17 Dec 2007


Free Full Text Article[Relationship between fluoride levels in the public water supply and dental f...
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[Relationship between fluoride levels in the public water supply and dental fluorosis.]

Rev Saude Publica. 2007 Oct;41(5):732-9

Authors: Catani DB, Hugo FN, Cypriano S, Sousa Mda L, Cury JA

OBJECTIVE: To assess the prevalence of dental fluorosis among schoolchildren subjected to different fluoride concentrations in the public water supply of their cities. METHODS: The sample comprised 386 seven-year-old schoolchildren living in two municipalities in the State of S&#xE3;o Paulo that practiced external control over the fluoridation of the water from 1998 to 2002: one with homogenous fluoride concentration and the other with oscillating concentration. Dental fluorosis was determined by dry examination of the upper permanent incisors using Dean's index. Scores classified as questionable were considered to represent fluorosis. Sociodemographic variables and questions regarding oral health were assessed using a structured questionnaire sent to the children's parents or the adults responsible for these children. Correlates of fluorosis were assessed using multivariate logistic regression (p<0.05). RESULTS: Both municipalities presented a mild degree of fluorosis. The prevalence of fluorosis in the municipality with oscillating fluoride content in the water was 31.4%, and it was 79.9% in the municipality with homogenous fluoride content. The prevalence of fluorosis was associated with the municipality with homogeneous fluoride levels in the water (OR=8.33, 95% CI: 5.15;13.45) and with not owning a car (OR=2.10, 95% CI: 1.27;3.49). CONCLUSIONS: The prevalence of dental fluorosis was higher in the city with better control of fluoride levels in the water supply, however, this higher prevalence was not related with children's satisfaction with the appearance of their teeth.

PMID: 17923894 [PubMed - in process]


Free Full Text ArticlePrevalence and severity of dental fluorosis among students from João Pessoa, ...
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Prevalence and severity of dental fluorosis among students from Jo&#xE3;o Pessoa, PB, Brazil.

Braz Oral Res. 2007 Jul-Sep;21(3):198-203

Authors: Carvalho TS, Kehrle HM, Sampaio FC

The aim of this study was to determine the prevalence and severity of dental fluorosis among 12-15-year-old students from João Pessoa, PB, Brazil before starting a program of artificial fluoridation of drinking water. The use of fluoridated dentifrice was also surveyed. A sample of 1,402 students was randomly selected. However, 31 students refused to participate and 257 were not permanent residents in João Pessoa, thus leaving a final sample of 1,114 students. Clinical exams were carried out by two calibrated dentists (Kappa = 0.78) under natural indirect light. Upper and lower front teeth were cleaned with gauze and dried, and then examined using the TF index for fluorosis. A questionnaire on dentifrice ingestion and oral hygiene habits was applied to the students. The results revealed that fluorosis prevalence in this age group was higher than expected (29.2%). Most fluorosis cases were TF = 1 (66.8%), and the most severe cases were TF = 4 (2.2%). The majority of the students reported that they had been using fluoridated dentifrices since childhood; 95% of the participants preferred brands with a 1,500 ppm F concentration, and 40% remembered that they usually ingested or still ingest dentifrice during brushing. It was concluded that dental fluorosis prevalence among students in João Pessoa is higher than expected for an area with non-fluoridated water. However, although most students use fluoridated dentifrices, and almost half ingest slurry while brushing, the majority of cases had little aesthetic relevance from the professionals' point of view, thus suggesting that fluorosis is not a public health problem in the locality.

PMID: 17710283 [PubMed - in process]


Free Full Text Article[Fifty years of fluoridation of public water supplies in Brazil: benefits for...
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[Fifty years of fluoridation of public water supplies in Brazil: benefits for the control of dental caries]

Cien Saude Colet. 2007 Jul-Aug;12(4):1057-65

Authors: Ramires I, Buzalaf MA

Fluoridation of public water supplies is among the most important public health measures for control of dental caries. Through a review of the literature, this study intends to reaffirm the importance and scope of fluoridation for caries control, as this is acknowledged as one of the most effective ways of ensuring the constant presence of fluoride in the oral cavity, which is vital for controlling caries. Water fluoridation is rated as an important factor for reducing caries, meaning that it should be maintained and also monitored, ensuring adequate fluoride levels for controlling caries while avoiding dental fluorosis.

PMID: 17680164 [PubMed - indexed for MEDLINE]


Free Full Text Article[A socioeconomic classification and the discussion related to prevalence of d...
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[A socioeconomic classification and the discussion related to prevalence of dental caries and dental fluorosis]

Cien Saude Colet. 2007 Mar-Apr;12(2):523-9

Authors: Meneghim Mde C, Kozlowski FC, Pereira AC, Ambrosano GM, Meneghim ZM

OBJECTIVE: The aim of this study was to evaluate the relationship between a socioeconomic classification model and prevalence of dental caries and dental fluorosis in Piracicaba, S&#xE2;o Paulo, Brazil. METHODS: For this classification five indicators were used (family monthly income, number of residents in the same household, parents' formal educational level, type of housing and occupation of person responsible for the family). A scoring system was used in order to arrange in a hierarchy, 812 12 year old school children distributed between six different social classes. Volunteers were examined in the school's back patio under natural light with a dental mirror, by two examiners calibrated for DMFT index (dental caries) and T-F (dental fluorosis). The qui-square test (p<0.01) was used in the statistical analysis for the association of DMFT and the dental fluorosis and between the socioeconomic variable and the proposed social classes. RESULTS: The DMFT average was 1.7, while 31.4%, of the children had dental fluorosis (T-Fe"1). CONCLUSION: With respect to socioeconomic class a statistically significant association was only verified with dental caries.

PMID: 17680106 [PubMed - indexed for MEDLINE]


Free Full Text Article[Fluoride concentrations in typical Brazilian foods and in infant foods]
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[Fluoride concentrations in typical Brazilian foods and in infant foods]

Rev Saude Publica. 2007 Aug;41(4):549-56

Authors: Casarin RC, Fernandes DR, Lima-Arsati YB, Cury JA

OBJECTIVE: To determine fluoride concentrations in the typical Brazilian meal (rice with beans) and in processed infant foods, and to estimate their contribution towards dental fluorosis. METHODS: The foods were purchased at supermarkets in the cities of Piracicaba and Campinas, Southeastern Brazil. The processed infant foods were bought in 2001 and the rice and beans in 2003, and they were analyzed immediately. Three brands of rice, three brands of beans and 36 samples of infant foods were analyzed, divided into five groups: ready-to-eat, porridges, formulated foods, powdered milk and others. For the rice and beans, fluoride concentrations were determined in the raw grains and after they were cooked with fluoridated (0.7 ppm) or distilled water. All the fluoride analyses were performed using a specific electrode. A dose of 0.07 mg/kg/day was considered to be the upper limit of fluoride exposure in terms of fluorosis risks. RESULTS: The fluoride concentrations found in the grains of rice and beans were low. However, they increased 100 to 200-fold after cooking in fluoridated water. Even so, they were lower than what is found in some processed foods. A meal of rice and beans prepared with fluoridated water would be responsible for 29% of the threshold dose for fluoride intake in terms of acceptable fluorosis; the contribution from some processed foods reaches 45%. CONCLUSIONS: The typical Brazilian food, even when prepared with fluoridated water, is safer in terms of the risk of dental fluorosis than are some processed infant foods.

PMID: 17589752 [PubMed - in process]


Free Full Text ArticleAssessment of periodontal status in dental fluorosis subjects using community...
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Assessment of periodontal status in dental fluorosis subjects using community periodontal index of treatment needs.

Indian J Dent Res. 2007 Apr-Jun;18(2):67-71

Authors: Vandana KL, Reddy MS

BACKGROUND: Periodontitis is multifactorial in nature. The various determinants of periodontal disease are age, sex, race, socioeconomic status and risk factors including tobacco usage and oral hygiene status. However, there is inconsistent epidemiological data on the periodontal status of subjects living in high-fluoride areas. The aim of the study was to investigate the effect of dental fluorosis on the periodontal status using community periodontal index of treatment needs (CPITN), as a clinical study. The purpose of this study is to determine the periodontal status using CPITN index in a population aged between 15 and 74 years residing in the high fluoride areas of Davangere district. The possible reasons for the susceptibility of this population to periodontal disease are discussed. MATERIALS AND METHODS: 1029 subjects, aged between 15 and 74 years suffering from dental fluorosis were assessed for their periodontal status. Clinical parameters recorded were OHI-S to assess the oral hygiene status, Jackson's fluorosis index to assess the degree of fluorosis and CPITN index to assess the periodontal status where treatment need was excluded. RESULTS: Gingivitis and periodontitis were more common in females (65.9% and 32.8%,respectively) than in males (75.1% and 24.2%, respectively). Periodontitis was significantly more common in females. As the age advanced from 15 to 55 years and above, gingivitis reduced from 81.0 to 42.9% and periodontitis increased steadily from 18.0 to 57.1%, which was significant. Periodontitis was high in subjects with poor oral hygiene (81.3%), compared to those with good oral hygiene (14.5%), which was significant. As the degree of fluorosis increased, severity of gingivitis reduced and periodontitis increased, i.e, with A degree fluorosis, gingivitis was 89.4% and periodontitis 8.5%, but with F degree fluorosis the former was 64% and the latter 35.8%, which was statistically significant. CONCLUSION: The results suggest that there is a strong association of occurrence of periodontal disease in high-fluoride areas. The role of plaque is well understood in contrast to the effect of fluorides on periodontal tissues. It goes a long way to reason out fluoride as an important etiological agent in periodontal disease.

PMID: 17502711 [PubMed - indexed for MEDLINE]


Free Full Text ArticleComparison of salivary fluoride levels following use of dentifrices containin...
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Comparison of salivary fluoride levels following use of dentifrices containing different concentrations of fluoride.

J Indian Soc Pedod Prev Dent. 2007 Mar;25(1):20-2

Authors: Nagpal DI, Damle SG

Many industrialized countries have reported a decline in caries prevalence over the past few decades. These reductions have been related to the regular use of fluoride dentifrices. Fluoride dentifrices are the most cost-effective and efficient means of caries prevention. However, there have been concerns regarding the risk of fluorosis in children due to the ingestion of dentifrices. This has led to the use of dentifrices with low concentration of fluoride. Salivary fluoride levels after tooth-brushing have been shown to be related to the anticaries efficacy of fluoride dentifrices. The present study was designed to evaluate the effect of the concentration of fluoride in the dentifrice, on the salivary fluoride level in children. Twenty children in the age group of five to six years were randomly selected and divided into two groups using, either 500ppm or 1000ppm fluoride dentifrice (sodium monofluorophosphate). Salivary fluoride levels at 0, 15, 30, 45, 60, minutes after brushing were estimated. The data collected was statistically evaluated using the unpaired t-test. The results showed that salivary fluoride levels following use of 500ppm fluoride dentifrice were significantly lower than 1000ppm fluoride dentifrice. The low salivary fluoride levels may thereby reduce the anticaries efficacy. Hence, the pros and cons of recommending a low fluoride concentration dentifrice must be judiciously considered.

PMID: 17456962 [PubMed - indexed for MEDLINE]


Free Full Text Article[Prevalence of enamel defects and the relationship to dental caries in decidu...
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[Prevalence of enamel defects and the relationship to dental caries in deciduous and permanent dentition in Indaiatuba, S&#xE3;o Paulo, Brazil]

Cad Saude Publica. 2007 Feb;23(2):435-44

Authors: Hoffmann RH, de Sousa Mda L, Cypriano S

The aim of this study was to determine the prevalence of hypoplasia, demarcated opacity and dental fluorosis among schoolchildren with deciduous and permanent dentition. The association between enamel defects and dental caries was also verified. The sample consisted of 624 schoolchildren aged 5 and 309 aged 12. The dmft and DMFT indexes were used to assess dental caries prevalence, DDE to assess enamel defects, and Dean to assess fluorosis. Chi-squared test was used to test significance (p < 0.05) and odds ratio to analyze prevalence of dental caries and enamel defects. A positive association between dental caries and enamel defects (hypoplasia, demarcated opacity and dental fluorosis) was observed for schoolchildren aged 5. However, only hypoplasia and demarcated opacity were associated with caries experience in permanent dentition. The results of this study indicated that children had increased odds of dental caries when enamel defect was present, both in deciduous and permanent dentition; further studies are needed to give evidence to this association.

PMID: 17221093 [PubMed - indexed for MEDLINE]


Free Full Text ArticleOne in a million: the first community trial of water fluoridation.
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One in a million: the first community trial of water fluoridation.

Bull World Health Organ. 2006 Sep;84(9):759-60

Authors: Lennon MA

PMID: 17128347 [PubMed - indexed for MEDLINE]


Free Full Text ArticleAnalysis of fluoride concentration in mother's milk substitutes.
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Analysis of fluoride concentration in mother's milk substitutes.

Braz Oral Res. 2006 Jul-Sep;20(3):269-74

Authors: Pagliari AV, Moimaz SA, Saliba O, Delbem AC, Sassaki KT

The aim of the present study was to determine the fluoride concentration in some brands of mother's milk substitutes and evaluate the possibility of developing dental fluorosis by consuming these products. The products, all powdered, were divided into 3 groups: infant formulae (group I, n = 7), milk-based (group M, n = 8) and soy-based (group S, n = 3). Samples from 3 cans of different batches of each brand were reconstituted in deionized water and analyzed using the specific electrode method, after hexamethyldisiloxane (HMDS) facilitated diffusion. The fluoride content (mg F/L) of the products ranged from 0.044 to 0.326 (I), 0.014 to 0.045 (M) and 0.253 to 0.702 (S). There was significant difference in the fluoride content of cans from distinct batches (p < 0.05) in most of the brands. The reconstitution of all products in water with optimal fluoride concentration for consumption during the mineralization phase of the primary teeth could result in daily fluoride intake above 0.07 mg F/kg body weight/day. Therefore, the consumption of these products, especially when reconstituted with optimally fluoridated water, could increase the risk of developing dental fluorosis.

PMID: 17119712 [PubMed - indexed for MEDLINE]


Free Full Text ArticleEffects of systemic fluoride and in vitro fluoride treatment on enamel crystals.
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Effects of systemic fluoride and in vitro fluoride treatment on enamel crystals.

J Dent Res. 2006 Nov;85(11):1042-5

Authors: Chen H, Czajka-Jakubowska A, Spencer NJ, Mansfield JF, Robinson C, Clarkson BH

Systemically administered fluoride at a concentration of 75 ppm increases the surface roughness of developing enamel crystals in rats, which may be significant in advancing our understanding of the biological mechanism of fluorosis. Thus, the aim of this study was to investigate whether the increased surface roughness may be a result of surface restructuring by the direct action of fluoride at the crystal surface. We examined the fluoride dose-dependent roughening of enamel crystal surfaces in vivo, in the rat, and whether this roughening could be mimicked by the in vitro treatment of rat enamel crystals with neutral pH fluoride solutions. Our results showed that enamel crystal surface roughness increased after treatment with increasing fluoride ion concentrations, whether applied in vitro or administered systemically. This suggests a mechanism, alongside others, for the increased surface roughness of crystals in fluorotic enamel.

PMID: 17062747 [PubMed - indexed for MEDLINE]


Free Full Text ArticleDental fluorosis in Brazil: a systematic review from 1993 to 2004.
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Dental fluorosis in Brazil: a systematic review from 1993 to 2004.

Cad Saude Publica. 2006 Sep;22(9):1809-16

Authors: da Cunha LF, Tomita NE

The current article proposes a reflection on several aspect pertaining to dental fluorosis in Brazil, based on a systematic review of epidemiological surveys. The authors assess the prevalence and degrees of severity found in different studies and show that in methodological terms, there is a need for progress in procedures for population-based studies on fluorosis. Despite the different data collection approaches, there is some consensus among the different studies as to the limited severity of fluorosis in Brazil, as well as its association with the independent variables age and socioeconomic status. The authors also highlight the importance of adding subjective aspects to the normative diagnosis as a contribution to public health policy decisions, since the use of exclusively clinical criteria gives dental fluorosis more space than society ascribes to it. There is a lack of empirical evidence to reassess the fluoride content in public water supplies, a method that is known to be necessary to improve dental caries epidemiological indicators.

PMID: 16917577 [PubMed - indexed for MEDLINE]


Free Full Text Article[Dental fluorosis in schoolchildren 12 and 15 years of age in Salvador, Bahia...
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[Dental fluorosis in schoolchildren 12 and 15 years of age in Salvador, Bahia, Brazil, in 2001 and 2004]

Cad Saude Publica. 2006 Jun;22(6):1201-6

Authors: Oliveira Junior SR, Cangussu MC, Lopes LS, Soares AP, Ribeiro Ade A, Fonseca Lde A

This article compares the results of two surveys in Salvador, Bahia State, Brazil, on prevalence and severity of dental fluorosis in 12 and 15-year-olds. The article discusses the survey methodologies in relation to their sampling process, calibration of examiners, and data collection procedures, comparing the resulting differences using chi-square and 95% confidence intervals obtained with the Dean index. A total of 3,313 adolescents 12 and 15 years of age were analyzed in 2001 and 1,032 in 2004. Both surveys used examiner calibration, and the samples were population-based. In the second survey there were a higher proportion of students from public schools for both ages, as compared to 2001 (p < 0.001). There was no significant difference in the fluorosis rate at 12 years, with a prevalence of 32.64% in 2004 and 31.4% in 2001. For 15-year-olds, the prevalence in 2004 (16.83%) was lower than in 2001 (27.6%). No increase was observed in the prevalence or severity of fluorosis in Salvador from 2001 to 2004.

PMID: 16751959 [PubMed - indexed for MEDLINE]


Free Full Text ArticleFluoride dentifrice ingestion and fluorosis of the permanent incisors.
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Fluoride dentifrice ingestion and fluorosis of the permanent incisors.

J Am Dent Assoc. 2006 May;137(5):645-52

Authors: Franzman MR, Levy SM, Warren JJ, Broffitt B

BACKGROUND: Fluoride dentifrice is a primary means of preventing childhood caries, but it is also an important risk factor for fluorosis. The authors examine the influence of fluoride dentifrice ingestion on fluorosis of the permanent incisors. METHODS: Participants in the Iowa Fluoride Study received questionnaires at regular intervals concerning fluoride sources. The authors assessed fluorosis using the fluorosis risk index. They estimated daily fluoride ingestion from dentifrice, diet and fluoride supplements and divided the amount by kilograms of body weight. The statistical analysis related fluoride ingestion to fluorosis in the permanent incisors. RESULTS: In bivariate analyses, mild fluorosis was significantly related to ingestion of fluoride dentifrice at ages 24 and 36 months (P = .02 for both). After the authors adjusted for fluoride ingested from dietary sources, logistic regression showed a significant association between fluorosis and dentifrice ingestion at age 24 months (P = .04). CONCLUSIONS: The study results suggest that fluorosis of the permanent incisors is influenced by ingestion of fluoride dentifrice during the first three years of life. Further research is needed to assess total intake of fluoride as a risk factor for fluorosis. CLINICAL IMPLICATIONS: These results support recommendations that young children use only a pea-sized amount of dentifrice. Parents should supervise young children as they brush their teeth with fluoride dentifrice.

PMID: 16739545 [PubMed - indexed for MEDLINE]


Free Full Text Article[Effect of overdose fluoride on expression of bone sialoprotein in developing...
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[Effect of overdose fluoride on expression of bone sialoprotein in developing dental tissues of rats]

Shanghai Kou Qiang Yi Xue. 2006 Apr;15(2):194-7

Authors: Xu ZL, Wang Q, Liu TL, Guo LY, Jing FQ, Liu H

PURPOSE: To investigate the changes of bone sialoprotein (BSP) in developing dental tissues of rats exposed to fluoride. METHODS: Twenty rats were randomly divided into two groups, one was with distilled water (control group), the other was with distilled water treated by fluoride (experimental group). When the fluorosis model was established, the changes of the expression of BSP were investigated and compared between the two groups. HE staining was used to observe the morphology of the cell, and immunohistochemisty assay was used to determine the expression of BSP in rat incisor. Student's t test was used for statistical analysis. RESULTS: The ameloblasts had normal morphology and arranged orderly. Immunoreactivitis of BSP was present in matured ameloblasts, dentinoblasts, cementoblasts, and the matrix in the control group. But in the experimental group the ameloblasts arranged in multiple layers, the enamel matrix was confused and the expression of BSP was significantly lower than that of the control group. Statistical analysis showed significant differences between the two groups (P<0.01). CONCLUSION: Fluoride can inhibit the expression of BSP in developing dental tissues of rats, and then inhibit differentiation of the tooth epithelial cells and secretion of matrix. This is a probable intracellular mechanism of dental fluorosis.

PMID: 16685365 [PubMed - in process]


Free Full Text ArticleFluoride kinetics in saliva after the use of a fluoride-containing chewing gum.
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Fluoride kinetics in saliva after the use of a fluoride-containing chewing gum.

Braz Oral Res. 2005 Oct-Dec;19(4):256-60

Authors: Bijella MF, Brighenti FL, Bijella MF, Buzalaf MA

There is a relationship between the use of fluoride, the reduction of dental caries and the increase of dental fluorosis. The purpose of this study was to analyze the fluoride kinetics in saliva after using the Happydent chewing gum, which contains 3.38 mg of fluoride as monofluorophosphate. Fifteen 7-9-year-old volunteers were instructed to chew the gum Trident (control) and Happydent on different days. Total saliva was collected for 3 minutes, at 0, 3, 6, 9, 15, 30 and 45 minutes after starting chewing. Salivary fluoride was analyzed with a fluoride-specific electrode (Orion 96-09) after acid hydrolysis. The data were analyzed by two-way analysis of variance and by Tukeys post hoc test (p < 0.05). The mean amounts +/- sd (mg) of fluoride released in saliva were 0.276 +/- 0.126 and 0.024 +/- 0.014 for Happydent and Trident respectively. The fluoride amount in the saliva samples after the use of Happydent was significantly higher than after the use of Trident in all experimental periods, except after 30 and 45 minutes. The high fluoride presence in saliva after the use of Happydent may be significant to prevent dental caries and this should be evaluated in clinical researches. On the other hand, children at an age of risk for dental fluorosis should avoid the use of Happydent.

PMID: 16491252 [PubMed - indexed for MEDLINE]


Free Full Text ArticleLow-fluoride dentifrice and gastrointestinal fluoride absorption after meals.
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Low-fluoride dentifrice and gastrointestinal fluoride absorption after meals.

J Dent Res. 2005 Dec;84(12):1133-7

Authors: Cury JA, Del Fiol FS, Tenuta LM, Rosalen PL

A low-fluoride (F) dentifrice has been recommended to reduce the risk of dental fluorosis, but its anti-caries efficacy is questionable compared with that of conventional dentrifices (1000-1100 microg F/g). The tested hypothesis was that conventional dentifrices might be safe if used soon after meals, since food interferes with F absorption. In a crossover, double-blind study, 11 volunteers ingested a dentifrice slurry containing 0 (placebo), 550 (low F), or 1100 microg F/g in 3 gastric content situations: on fasting, or 15 min after breakfast or lunch. F was analyzed in saliva and 24-hour urine samples. The conventional dentifrice ingested after lunch resulted in only 10% higher F absorption than the low-F ingested on fasting. Analysis of the data suggests that the risk of fluorosis could be reduced by the use of either a low-F dentifrice or a conventional dentifrice, if toothbrushing occurred soon after meals.

PMID: 16304442 [PubMed - indexed for MEDLINE]


Free Full Text ArticleRelationship between dental fluorosis and quality of life: a population based...
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Relationship between dental fluorosis and quality of life: a population based study.

Braz Oral Res. 2005 Apr-Jun;19(2):150-5

Authors: Michel-Crosato E, Biazevic MG, Crosato E

The aim of this study was to verify the prevalence of dental fluorosis in schoolchildren aged 6 to 15 and its possible association with the impacts on their daily activities. This study is observational, cross-sectional and analytical. A total of 513 schoolchildren from the city of Pinheiro Preto, SC, took part in this study. The children were examined by three calibrated dentists, after obtaining a kappa > 0.80. To assess the prevalence of fluorosis, clinical examinations were performed according to the methodology set forth by the 4th edition of the WHO. To assess the impact of fluorosis on their daily activities, a modified OIDP (Oral Impacts on Daily Performance) was adopted. The statistical analysis used was the Chi-squared test with a 5% significance level. Of the total number of children examined, 262 (51.1%) were of the female gender and 251 (48.9%) were of the male gender. In regard to the prevalence of fluorosis, 94 (18.3%) of the children presented this condition, while 419 children (81.7%) presented a normal condition. In regard to the severity of fluorosis, few children presented severe alterations. No association was found between dental fluorosis and gender (p = 0.646), between fluorosis and socioeconomic status (p = 0.848) or between fluorosis and access to public water supply system (p = 0.198). The activities that most affected children's daily performance were: oral hygiene (40.9%) and food intake or enjoying food (40.4%). None of the daily activities could be associated with the occurrence of dental fluorosis. The prevalence of dental fluorosis was consonant with the standards found for locations with optimum fluoride content in the water supply. The questionable and very slight levels of fluorosis were the most frequently found, without influence in the quality of life of the schoolchildren participating in the study.

PMID: 16292450 [PubMed - indexed for MEDLINE]


Free Full Text ArticlePrevalence of oral diseases/conditions in Uganda.
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Prevalence of oral diseases/conditions in Uganda.

Afr Health Sci. 2005 Sep;5(3):227-33

Authors: Muwazi LM, Rwenyonyi CM, Tirwomwe FJ, Ssali C, Kasangaki A, Nkamba ME, Ekwaru P

Objectives: The aim was to report the prevalence of oral diseases/conditions among a Ugandan population. Methods: Subjects aged 12 (n=696) and 35-44 years (n=396) were chosen from randomly selected urban and peri-urban areas of Arua, Mbale, Kampala and Mbarara districts. They were clinically examined by 4 trained and calibrated dentists for oral diseases/conditions using criteria described by World Health Organisation. Results: Dental caries (DMFT >/=1) was recorded in 40% and 62.5% of the children and adults, respectively. The overall mean DMFT score was 0.9 for children and 3.4 for adults. Caries was significantly more severe in females as compared to males in children (p<0.05), whereas in adults, there was no significant gender difference. Kampala had a significantly higher mean DMFT score compared to other districts in all age groups (p>0.05). Culculus deposits were generally, more prevalent in adults as compare to children except in Mbarara district. Gum bleeding was also significantly more prevalent among children as compared to adults (p<0.05). Significantly higher prevalence of gum bleeding in both children and adults was recorded in Arua district as compared to other areas (p<0.05). Each of the age groups had a prevalence of malocclusion of 61%. However, the severity of malocclusion varied between age groups and districts. The prevalence of dental fluorosis was 3% and 4% for children and adults, respectively. All subjects in Arua district were fluorosis-free. Tetracycline enamel staining was less than 1% in both age groups. Enamel attrition was more prevalent in adults as compared to children: 19% versus 1%. Conclusion: The prevalence of oral diseases/conditions was generally low among the study population. Caries experience was significantly higher in the Kampala (urban) district as compared to rural districts in all age groups; the D - component being the major contributor.

PMID: 16245993 [PubMed - in process]


Free Full Text ArticleThe effective use of fluorides in public health.
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The effective use of fluorides in public health.

Bull World Health Organ. 2005 Sep;83(9):670-6

Authors: Jones S, Burt BA, Petersen PE, Lennon MA

Dental caries remain a public health problem for many developing countries and for underprivileged populations in developed countries. This paper outlines the historical development of public health approaches to the use of fluoride and comments on their effectiveness. Early research and development was concerned with waterborne fluorides, both naturally occurring and added, and their effects on the prevalence and incidence of dental caries and dental fluorosis. In the latter half of the 20th century, the focus of research was on fluoride toothpastes and mouth rinses. More recently, systematic reviews summarizing these extensive databases have indicated that water fluoridation and fluoride toothpastes both substantially reduce the prevalence and incidence of dental caries. We present four case studies that illustrate the use of fluoride in modern public health practice, focusing on: recent water fluoridation schemes in California, USA; salt fluoridation in Jamaica; milk fluoridation in Chile; and the development of "affordable" fluoride toothpastes in Indonesia. Common themes are the concern to reduce demands for compliance with fluoride regimes that rely upon action by individuals and their families, and the issue of cost. We recommend that a community should use no more than one systemic fluoride (i.e. water or salt or milk fluoridation) combined with the use of fluoride toothpastes, and that the prevalence of dental fluorosis should be monitored in order to detect increases in or higher-than-acceptable levels.

PMID: 16211158 [PubMed - indexed for MEDLINE]


Free Full Text ArticleAssociation of amoxicillin use during early childhood with developmental toot...
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Association of amoxicillin use during early childhood with developmental tooth enamel defects.

Arch Pediatr Adolesc Med. 2005 Oct;159(10):943-8

Authors: Hong L, Levy SM, Warren JJ, Dawson DV, Bergus GR, Wefel JS

BACKGROUND: It has been speculated that amoxicillin use could be associated with dental enamel defects. OBJECTIVE: To assess the association between dental fluorosis, one of the most common developmental tooth enamel defects, and amoxicillin use during early childhood. DESIGN, SETTING, AND PARTICIPANTS: As participants in the Iowa Fluoride Study, subjects were followed up from birth to 32 months using questionnaires every 3 to 4 months to gather information on fluoride intake and amoxicillin use. METHODS: Early-erupting permanent teeth of 579 subjects were assessed for fluorosis using the Fluorosis Risk Index at approximately the age of 9 years. Relationships between fluorosis and amoxicillin use were assessed using relative risk (RR), Mantel-Haenszel stratified analyses, and multivariable logistic regression. RESULTS: Amoxicillin use was reported by 75% of subjects by 12 months and 91% by 32 months. Overall, 24% had fluorosis on both maxillary central incisors. Amoxicillin use from 3 to 6 months significantly increased the risk of fluorosis on the maxillary central incisors (RR = 2.04; 95% confidence interval [CI], 1.49-2.78). After adjusting for fluoride intake and otitis media, the risk of fluorosis on the maxillary central incisors from amoxicillin use during 3 to 6 months (Mantel-Haenszel RR = 1.85; 95% CI, 1.20-2.78) was still statistically significant. Multivariable logistic regression analyses confirmed the increased risk of fluorosis from amoxicillin use during 3 to 6 months (odds ratio = 2.50; 95% CI, 1.21-5.15); fluoride intake was also statistically significant. CONCLUSION: The findings from this study suggest a link between amoxicillin use during infancy and developmental enamel defects of permanent teeth; however, further research is needed.

PMID: 16203939 [PubMed - indexed for MEDLINE]


Free Full Text ArticleHow does fluoride affect dentin microhardness and mineralization?
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How does fluoride affect dentin microhardness and mineralization?

J Dent Res. 2005 Oct;84(10):951-7

Authors: Vieira A, Hancock R, Dumitriu M, Schwartz M, Limeback H, Grynpas M

Fluoride (F) has been a useful instrument in caries prevention. However, only limited data exist on the effect of its long-term use on dentin mineralization patterns and microhardness. The objective of this study was to evaluate the influence of tooth F concentration ([F]) and dental fluorosis (DF) severity on dentin microhardness and mineralization. We collected 137 teeth in Montreal and Toronto, Canada, and Fortaleza, Brazil, where optimum or suboptimum levels of water F were 0.2 ppm, 1 ppm, and 0.7 ppm, respectively. Teeth were analyzed for DF severity, dentin [F], enamel [F], dentin microhardness, and dentin mineralization. Dentin [F] correlated with DF severity; enamel [F] correlated with dentin microhardness and dentin mineralization; DF severity correlated with dentin microhardness. Genetic factors (e.g., DF severity) and environmental factors (e.g., tooth [F]) influenced the mechanical properties (microhardness) of the teeth, while only the environmental factors influenced their material properties (e.g., mineralization). Fortaleza teeth were harder and less mineralized and presented higher dentin [F] values. Montreal teeth presented lower levels of DF when compared with both Toronto and Fortaleza teeth.

PMID: 16183797 [PubMed - indexed for MEDLINE]


Free Full Text ArticleSurveillance for dental caries, dental sealants, tooth retention, edentulism,...
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Surveillance for dental caries, dental sealants, tooth retention, edentulism, and enamel fluorosis--United States, 1988-1994 and 1999-2002.

MMWR Surveill Summ. 2005 Aug 26;54(3):1-43

Authors: Beltr&#xE1;n-Aguilar ED, Barker LK, Canto MT, Dye BA, Gooch BF, Griffin SO, Hyman J, Jaramillo F, Kingman A, Nowjack-Raymer R, Selwitz RH, Wu T,

PROBLEM/CONDITION: Dental caries is a common chronic disease that causes pain and disability across all age groups. If left untreated, dental caries can lead to pain and infection, tooth loss, and edentulism (total tooth loss). Dental sealants are effective in preventing dental caries in the occlusal (chewing) and other pitted and fissured surfaces of the teeth. Enamel fluorosis is a hypomineralization of enamel related to fluoride exposure during tooth formation (first 6 years for most permanent teeth). Exposure to fluoride throughout life is effective in preventing dental caries. This is the first CDC Surveillance Summary that addresses these conditions and practices. REPORTING PERIOD: 1988-1994 and 1999-2002. SYSTEM DESCRIPTION: The National Health and Nutrition Examination Survey (NHANES) is an ongoing survey of representative samples of the civilian, noninstitutionalized U.S. population aged >/=2 months in NHANES 1988-1994 and all ages during 1999-2002. The dental component gathered information on persons aged >/=2 years. RESULTS: During 1999-2002, among children aged 2-11 years, 41% had dental caries in their primary teeth. Forty-two percent of children and adolescents aged 6-19 years and approximately 90% of adults had dental caries in their permanent teeth. Among children aged 6-19 years, 32% had received dental sealants. Adults aged >/=20 years retained a mean of 24 of 28 natural teeth and 8% were edentulous. Among persons aged 6-39 years, 23% had very mild or greater enamel fluorosis. Disparities were noticed across all age groups, among racial/ethnic groups, persons with lower education and income, and by smoking status. From 1988-1994 to 1999-2002, four trends were observed: 1) no change in the prevalence of dental caries in primary teeth among children aged 2-11 years, 2) a reduction in prevalence of caries in permanent teeth of up to 10 percentage points among persons aged 6-19 years and up to six percentage points among dentate adults aged >/=20 years, 3) an increase of 13 percentage points in dental sealants among persons aged 6-19 years, and 4) a six percentage point reduction in total tooth loss (edentulism) among persons aged >/=60 years. INTERPRETATION: The findings of this report indicate that the dental caries status of permanent teeth has improved since the 1988-1994 survey. Despite the decrease in caries prevalence and severity in the permanent dentition and the increase in the proportion of children and adolescents who benefit from dental sealants, disparities remain. PUBLIC HEALTH ACTION: These data provide information for public health professionals in designing interventions to improve oral health and to reduce disparities in oral health, for researchers in assessing factors associated with disparities and dental caries in primary teeth, and in designing timely surveillance tools to monitor total fluoride exposure.

PMID: 16121123 [PubMed - indexed for MEDLINE]


Free Full Text ArticleFluorosis: a new model and new insights.
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Fluorosis: a new model and new insights.

J Dent Res. 2005 Sep;84(9):832-6

Authors: Bartlett JD, Dwyer SE, Beniash E, Skobe Z, Payne-Ferreira TL

Fluoride is an effective agent for the prevention of dental caries. However, the mechanism of how excessive fluoride exposure causes fluorosis remains uncertain. Zebrafish (Danio rerio) exhibit periodic tooth replacement throughout their lives, thereby providing continuous access to teeth at developmental stages susceptible to fluoride exposure. Zebrafish teeth do not contain true enamel, but consist of a hard enameloid surface. Therefore, we asked whether zebrafish could be used as a model organism for the study of dental fluorosis. Scanning electron microscopy of fluoride-treated teeth demonstrated that the enameloid was pitted and rough, and FTIR analysis demonstrated that the teeth also contained a significantly higher organic content when compared with untreated controls. Furthermore, we demonstrate for the first time that decreased expression of an important signaling molecule (Alk8) in tooth development may contribute to the observed fluorotic phenotype, and that increased cell apoptosis may also play a role in the mechanism of fluorosis.

PMID: 16109993 [PubMed - indexed for MEDLINE]


Free Full Text ArticleGlobal Voices of Science. Of stones and health: medical geology in Sri Lanka.
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Global Voices of Science. Of stones and health: medical geology in Sri Lanka.

Science. 2005 Aug 5;309(5736):883-5

Authors: Dissanayake C

PMID: 16081722 [PubMed - indexed for MEDLINE]


Free Full Text ArticleA visual analog scale for measuring dental fluorosis severity.
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A visual analog scale for measuring dental fluorosis severity.

J Am Dent Assoc. 2005 Jul;136(7):895-901

Authors: Vieira AP, Lawrence HP, Limeback H, Sampaio FC, Grynpas M

BACKGROUND: To date, no continuous scale exists for measuring the severity of dental fluorosis (DF). OBJECTIVES: The authors developed and validated a visual analog scale (VAS) for DF. They tested the scale in clinical (DF-endemic area) and laboratory settings. METHODS: Dentists and nondentists (23 per group) were asked to grade the DF severity in photographs of 23 anterior teeth with different DF levels (using a 100-millimeter VAS) to create a VAS for DF. Statistical analysis was performed to validate the new scale. The authors used clinical and laboratory (unerupted third molars) analyses to assess the usefulness of the VAS. RESULTS: The authors used an intraclass correlation coefficient (ICC) to assess the interexaminer (ICC = .79: good agreement) and intraexaminer (.88 < ICC < .97: excellent agreement) reliability during creation of the scale. They used the Spearman rank correlation (r(s)) to validate the VAS against the gold standards (that is, the Thylstrup-Fejerskov index [TFI] and Dean's index [DI]) (the results showed excellent or good correlation for 45 examiners). Two dentist examiners clinically tested the new VAS, and the results showed excellent (r(s) = .922, P < .001) correlation and excellent ICC between the examiners (ICC = .96), as well as good ICC between the TFI and the VAS for DF (ICC = .6). The laboratory study showed better correlation between fluoride concentration and the VAS for DF than between fluoride concentration and the TFI. CONCLUSION: Because of its simplicity, precision and utility in statistical applications, the VAS for DF can be useful in DF studies.

PMID: 16060470 [PubMed - indexed for MEDLINE]


Free Full Text ArticleDrug-induced disorders of teeth.
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Drug-induced disorders of teeth.

J Dent Res. 2005 Jul;84(7):596-602

Authors: Tredwin CJ, Scully C, Bagan-Sebastian JV

It is essential that every health care professional who is involved with the prescription or recommendation of drugs be fully aware of any resultant disorders that may arise as a side-effect. A range of drugs can affect the teeth. In this review article, drugs that have the potential to induce changes in teeth have been classified as those leading to tooth discoloration (intrinsic and extrinsic), physical damage to tooth structure (enamel, dentin, and cementum), and alteration in tooth sensitivity.

PMID: 15972585 [PubMed - indexed for MEDLINE]


Free Full Text Article[Dental fluorosis in schoolchildren in a county in the mountainous region of ...
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[Dental fluorosis in schoolchildren in a county in the mountainous region of Rio Grande do Sul State, Brazil]

Cad Saude Publica. 2005 Mar-Apr;21(2):652-5

Authors: Toassi RF, Abegg C

The aim of the present study was to determine the prevalence and severity of dental fluorosis in all schoolchildren (ages 4 to 18 years, n = 259) from the town of Santa Tereza, Rio Grande do Sul, Brazil, and to investigate associated factors. Data were obtained through a questionnaire and by means of clinical tests. Dean's index was used to determine fluorosis occurrence. Prevalence of fluorosis was 63.7%. The predominant category was very mild (43.6%), followed by mild (12.0%), moderate (7.7%), borderline (7.3%), and severe (0.4%). Approximately 85.0% of the schoolchildren currently have, or have had, access to other topical sources of fluoride. Significant associations were found between place of residence and previous or ongoing fluoride mouth rinsing and prevalence and severity of fluorosis (p < 0.05). There was also a significant association between dental fluorosis and parents' level of schooling, frequency of brushing teeth, fluoride rinsing, and use of fluoride gel (p < 0.05).

PMID: 15905927 [PubMed - indexed for MEDLINE]


Free Full Text ArticleEsthetic perception and psychosocial impact of developmental enamel defects a...
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Esthetic perception and psychosocial impact of developmental enamel defects among Malaysian adolescents.

J Oral Sci. 2004 Dec;46(4):221-6

Authors: Sujak SL, Abdul Kadir R, Dom TN

The aim of this study was to investigate the prevalence and psychosocial impact of enamel defects among 16-year-old school children on the island of Penang. The data were collected through a self-administered questionnaire survey and an oral examination, using the Modified Developmental Defects of Enamel Index (FDI, 1992). In all, 1024 subjects were selected using a multistage random sampling technique. About two-thirds of the sample (67.1%) had at least one tooth affected by enamel defects. Enamel opacities accounted for 85.6% of the total condition. Diffuse-type opacity predominated (63.5%). Among subjects who expressed dissatisfaction, 18.8% reported covering their mouths when smiling, 8.7% avoided going out with friends and 39.1% had consulted their dentists. About 17% of the subjects reported that their parents had complained about the color of their front teeth but only 5.7% had experienced being teased by their friends about the problem. Two-thirds of the subjects were affected by enamel defects involving at least one tooth; however, the esthetic perception and psychosocial impact of those affected were minor.

PMID: 15901066 [PubMed - indexed for MEDLINE]


Free Full Text ArticleFluoride induces endoplasmic reticulum stress in ameloblasts responsible for ...
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Fluoride induces endoplasmic reticulum stress in ameloblasts responsible for dental enamel formation.

J Biol Chem. 2005 Jun 17;280(24):23194-202

Authors: Kubota K, Lee DH, Tsuchiya M, Young CS, Everett ET, Martinez-Mier EA, Snead ML, Nguyen L, Urano F, Bartlett JD

The mechanism of how fluoride causes fluorosis remains unknown. Exposure to fluoride can inhibit protein synthesis, and this may also occur by agents that cause endoplasmic reticulum (ER) stress. When translated proteins fail to fold properly or become misfolded, ER stress response genes are induced that together comprise the unfolded protein response. Because ameloblasts are responsible for dental enamel formation, we used an ameloblast-derived cell line (LS8) to characterize specific responses to fluoride treatment. LS8 cells were growth-inhibited by as little as 1.9-3.8 ppm fluoride, whereas higher doses induced ER stress and caspase-mediated DNA fragmentation. Growth arrest and DNA damage-inducible proteins (GADD153/CHOP, GADD45alpha), binding protein (BiP/glucose-responsive protein 78 (GRP78), the non-secreted form of carbonic anhydrase VI (CA-VI), and active X-box-binding protein-1 (Xbp-1) were all induced significantly after exposure to 38 ppm fluoride. Unexpectedly, DNA fragmentation increased when GADD153 expression was inhibited by short interfering RNA treatment but remained unaffected by transient GADD153 overexpression. Analysis of control and GADD153(-/-) embryonic fibroblasts demonstrated that caspase-3 mediated the increased DNA fragmentation observed in the GADD153 null cells. We also demonstrate that mouse incisor ameloblasts are sensitive to the toxic effects of high dose fluoride in drinking water. Activated Ire1 initiates an ER stress response pathway, and mouse ameloblasts were shown to express activated Ire1. Ire1 levels appeared induced by fluoride treatment, indicating that ER stress may play a role in dental fluorosis. Low dose fluoride, such as that present in fluoridated drinking water, did not induce ER stress.

PMID: 15849362 [PubMed - indexed for MEDLINE]


Free Full Text ArticleDoes school-based dental screening for children increase follow-up treatment ...
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Does school-based dental screening for children increase follow-up treatment at dental school clinics?

J Dent Educ. 2005 Mar;69(3):382-6

Authors: Hebbal M, Nagarajappa R

The purpose of this study was to evaluate the effectiveness of a screening program and referral system in stimulating dental attendance of children in need of treatment at Bapuji Dental College and Hospital of Davangere, India. A total of fourteen schools in the Davangere area were selected randomly and divided into two groups: seven schools that had a dental screening program (study group, n=2100 children), and seven schools that did not have one (control group, n=2400 children). The attendance rate by members of the study group was determined during the three-month period from the date of initiating the school screening program. During this same period the students who visited the college from the control group underwent a dental examination. Chi-square tests were used to test the difference between different variables. The response rate for seeking treatment was 31 percent for the study group (34.2 percent for males; 26.2 percent for females) and 10 percent for the control group (9.6 percent for males; 10.5 percent for females). In both the groups, the treatment need was highest for dental caries (study group=36.3 percent, control group=11.1 percent) and least for fluorosis (study group=21.2 percent, control group=1.2 percent). The study demonstrated that screening and motivation significantly improved the percentage of school children who sought dental care.

PMID: 15749950 [PubMed - indexed for MEDLINE]


Free Full Text ArticleA quantitative look at fluorosis, fluoride exposure, and intake in children u...
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A quantitative look at fluorosis, fluoride exposure, and intake in children using a health risk assessment approach.

Environ Health Perspect. 2005 Jan;113(1):111-7

Authors: Erdal S, Buchanan SN

The prevalence of dental fluorosis in the United States has increased during the last 30 years. In this study, we used a mathematical model commonly employed by the U.S. Environmental Protection Agency to estimate average daily intake of fluoride via all applicable exposure pathways contributing to fluorosis risk for infants and children living in hypothetical fluoridated and nonfluoridated communities. We also estimated hazard quotients for each exposure pathway and hazard indices for exposure conditions representative of central tendency exposure (CTE) and reasonable maximum exposure (RME) conditions. The exposure pathways considered were uptake of fluoride via fluoridated drinking water, beverages, cow's milk, foods, and fluoride supplements for both age groups. Additionally, consumption of infant formula for infants and inadvertent swallowing of toothpaste while brushing and incidental ingestion of soil for children were also considered. The cumulative daily fluoride intake in fluoridated areas was estimated as 0.20 and 0.11 mg/kg-day for RME and CTE scenarios, respectively, for infants. On the other hand, the RME and CTE estimates for children were 0.23 and 0.06 mg/kg-day, respectively. In areas where municipal water is not fluoridated, our RME and CTE estimates for cumulative daily average intake were, respectively, 0.11 and 0.08 mg/kg-day for infants and 0.21 and 0.06 mg/kg-day for children. Our theoretical estimates are in good agreement with measurement-based estimates reported in the literature. Although CTE estimates were within the optimum range for dental caries prevention, the RME estimates were above the upper tolerable intake limit. This suggests that some children may be at risk for fluorosis.

PMID: 15626657 [PubMed - indexed for MEDLINE]


Free Full Text Article[Dental fluorosis: comparison of two prevalence studies]
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[Dental fluorosis: comparison of two prevalence studies]

Cad Saude Publica. 2004 Jul-Aug;20(4):1050-8

Authors: Fraz&#xE3;o P, Peverari AC, Forni TI, Mota AG, Costa LR

Dental fluorosis is an enamel opacity resulting from the ingestion of excessive amounts of fluoride (chronic exposure) during tooth formation. Estimation of this problem among populations exposed to fluoride sources is necessary and should be performed periodically to monitor changes in levels and patterns in the disorder. This research aimed to describe and compare two prevalence studies to estimate the occurrence of dental fluorosis in a population of schoolchildren in Ribeirão Pires, São Paulo State, Brazil, conducted in 1997 and 2000. The methods used in each study are described briefly and the results compared. Methodological aspects and implications for public health are discussed.

PMID: 15300298 [PubMed - indexed for MEDLINE]


Free Full Text Article[Dental caries in Paulínia, São Paulo State, Brazil, and WHO goals for 2000 a...
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[Dental caries in Paulínia, São Paulo State, Brazil, and WHO goals for 2000 and 2010]

Cad Saude Publica. 2004 May-Jun;20(3):866-70

Authors: Gomes PR, Costa SC, Cypriano S, de Sousa Mda L

An epidemiological survey was conducted in Paulínia, São Paulo State, Brazil, in 2000, aimed at verifying the prevalence of principal oral health problems, using the DMFT index and WHO diagnostic criteria. The sample (1,151) was randomly selected. The dmft was 1.90 in 5-year-olds, with 54.2% caries-free. DMFT was 1.00 in 12-year-olds, with 46.4% caries-free in the permanent dentition. Fluorosis prevalence in 7 to 12-year-olds was 30.5%, mostly the very mild form (22.9%). Prevalence of opacities and hypoplasias was 9.1%. In adults, the dental care index was 55.4% and an average of 21.30 teeth presented caries experience. In the elderly, DMFT was 29.50, consisting predominantly of extracted teeth (93.0%).

PMID: 15263998 [PubMed - indexed for MEDLINE]


Free Full Text Article[Evaluation of the fluoride concentration and consumption of mineral water]
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[Evaluation of the fluoride concentration and consumption of mineral water]

Rev Saude Publica. 2004 Jun;38(3):459-65

Authors: Ramires I, Grec RH, Cattan L, Moura PG, Lauris JR, Buzalaf MA

OBJECTIVE: Considering that water is an importance source of fluoride intake, and that the consumption of mineral water and prevalence of dental fluorosis have been increasing, the aim of this study was to evaluate the consumption of mineral water and its fluoride concentration. METHODS: The study was performed in residential districts of the municipality of Bauru, State of São Paulo, by means of stratified sampling via clusters. Each cluster corresponded to one residential block. For randomization purposes, the residential blocks were numbered within the 17 districts established by the city plan. One thousand homes were thus visited. Mineral water samples were collected using previously labeled 50 ml plastic flasks. Fluoride analysis was done using an ion-sensitive electrode (Orion 9609), after buffering using TISAB II. Information on the consumption of mineral water was obtained by means of applying a questionnaire. RESULTS: Around 29.72% of the city's population was consuming mineral water. In the 260 samples analyzed from 29 different brands of water, the fluoride concentration ranged from 0.045 to 1.515 mg/l. For one brand, the label stated that the fluoride concentration was 0.220 mg/l, but analysis revealed a concentration of 1.515 mg/l. Moreover, some brands did not specify the fluoride concentration on the label and, for these, the analysis showed concentrations ranging from 0.049 to 0.924 mg/l. CONCLUSIONS: The results demonstrated wide variation in fluoride concentrations and reinforce the importance of the control of such waters by the sanitary surveillance agency.

PMID: 15243678 [PubMed - indexed for MEDLINE]


Free Full Text ArticleA comparison of mesio-distal crown dimensions of the permanent teeth in subje...
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A comparison of mesio-distal crown dimensions of the permanent teeth in subjects with and without fluorosis.

Eur J Orthod. 2004 Jun;26(3):279-81

Authors: Sa&#x11F;lam AM, Ozbaran HM, Sağlam AA

This investigation was undertaken to compare the mesio-distal crown dimensions of the permanent teeth in subjects with and without fluorosis. For this study, 25 pairs of study models cast immediately from alginate impressions of children from each of the two groups were evaluated. Their mean ages were 13.9 +/- 1.6 and 13.9 +/- 1.4 years, respectively. A dental vernier calliper was used to record the maximum mesio-distal dimensions. Analysis of the study models showed that there were no statistically significant differences between the left and right sides (P > 0.05). The results indicated that the mesio-distal crown diameters were consistently larger in the subjects with non-fluorotic permanent teeth. With the exception of the mandibular first premolars, there were no statistically significant differences in the mesio-distal crown diameters of the two groups.

PMID: 15222712 [PubMed - indexed for MEDLINE]


Free Full Text ArticlePerceptions of desirable tooth color among parents, dentists and children.
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Perceptions of desirable tooth color among parents, dentists and children.

J Am Dent Assoc. 2004 May;135(5):595-604; quiz 654-5

Authors: Shulman JD, Maupome G, Clark DC, Levy SM

BACKGROUND: As part of a large-scale fluoridation cessation study, standardized examiners assessed 8,281 school-aged children for dental fluorosis using the Thylstrup Fejerskov index, or TFI, in which scores range from 0 (no fluorosis) to 9 (severe loss of enamel with change of anatomical appearance). METHODS: Dentists, parents and children were asked to respond to a statement, "The color of these teeth (mine or my child's) is pleasing and looks nice." Agreement or disagreement with the statement was indicated on a five-level scale, with a rating of 1 representing total agreement with the reference statement. The authors used repeated-measures analysis of variance to ascertain differences in satisfaction with the esthetic appearance of the subject's tooth color across dentists', parents' and subjects' perceptions. RESULTS: Girls were more critical of their tooth color than were boys; however, parents and dentists were more critical of boys' tooth color than of girls'. While younger subjects were more critical than older subjects, parents of younger subjects were less critical than those of older subjects. Dentists' ratings were not significantly associated with subjects' age group. Subjects with a TFI score of 1 or 2 were not significantly more critical than subjects with a TFI score of 0, while those with a TFI score of 3 of higher were. Similarly, only parents of subjects with a TFI score of 3 of higher had significantly different ratings. CONCLUSIONS: The three stakeholders in the esthetic treatment of children-parents, dentists and patients-appear to see the potential outcome of such treatment differently. CLINICAL IMPLICATIONS: Dentists should ensure that parents and children agree about the course of treatment, the rationale for undertaking it and the results that could reasonably be expected.

PMID: 15202751 [PubMed - indexed for MEDLINE]


Free Full Text ArticleHenry Klein--a forgotten icon?
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Henry Klein--a forgotten icon?

J Dent Res. 2004 May;83(5):365-7

Authors: Bowen WH

PMID: 15111625 [PubMed - indexed for MEDLINE]


Free Full Text Article[Survey of children dental fluorosis in severely epidemic area]
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[Survey of children dental fluorosis in severely epidemic area]

Shanghai Kou Qiang Yi Xue. 1998 Jun;7(2):123-4

Authors: Dai XJ, Chen E, Zhang J, Chen ZS

PMID: 15071687 [PubMed - as supplied by publisher]


Free Full Text ArticleTeeth.
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Teeth.

Pediatrics. 2004 Apr;113(4 Suppl):1120-7

Authors: Billings RJ, Berkowitz RJ, Watson G

Common environmental chemicals, drugs, or physical agents can adversely affect human teeth during their embryonic development and after their eruption into the oral cavity. One of the more common elemental toxicants is lead. Teeth are known to accumulate lead during their development. Both animal and human studies have shown that teeth with high lead levels are generally more susceptible to dental caries. Similarly, although inorganic fluorides have long been recognized for their potential to prevent dental caries, exposure to excessive amounts of fluoride when enamel is forming often leads to a type of enamel hypoplasia referred to as dental fluorosis or mottled enamel. Teratogenic agents, such as tetracyclines, a class of antibiotic drugs commonly administered to infants and children, will often result in the discoloration of tooth enamel when prescribed during tooth development. It has recently been suggested that childhood exposure to passive smoking increases the risk for dental caries. Environmental tobacco smoke has previously been linked to periodontal disease in adults. However, this is the first report of an association between passive tobacco smoke and increased susceptibility to dental caries. Last, an often-overlooked source of damage to teeth among all age groups after their eruption into the oral cavity is physical trauma from a variety of sources, especially sports-related injuries. Epidemiologic data suggest that up to one third of all dental injuries are sports related.

PMID: 15060208 [PubMed - indexed for MEDLINE]


Free Full Text ArticleUsing microabrasive material to remove fluorosis stains.
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Using microabrasive material to remove fluorosis stains.

J Am Dent Assoc. 2004 Mar;135(3):319-23

Authors: Allen K, Agosta C, Estafan D

BACKGROUND: Increased public access to fluoride has decreased the prevalence of caries and increased the prevalence of fluorosis staining. This article provides a case report involving a conservative method of removing fluorosis stain, as well as describes an in vitro test of the method. CASE DESCRIPTION: A healthy man sought treatment at New York University College of Dentistry for removal of severe, dark brown fluorosis staining on his anterior teeth. To remove the stain, the treating clinician used a microabrasive material, which leaves enamel intact, instead of a tooth-whitening agent, which requires removal of all affected enamel. METHODS: To demonstrate that enamel structure is not disturbed by the microabrasive material, the authors performed a study using scanning electron microscopy, or SEM. They viewed enamel structure under SEM at x1,000 magnification. They viewed untreated microabraded enamel and compared it with enamel that had been treated for 20 seconds with 37 percent phosphoric acid. RESULTS: An etch pattern was not discernible on the tooth treated with the microabrasive material. The enamel prisms remained intact and the cores were not exposed. CLINICAL IMPLICATIONS: Microabrasion removes intrinsic fluorosis stain effectively while protecting enamel. In this case, an enamel shade of brown not in the range of any tooth color shade guide was reduced.

PMID: 15058619 [PubMed - indexed for MEDLINE]


Free Full Text ArticleAssociations between Intakes of fluoride from beverages during infancy and de...
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Associations between Intakes of fluoride from beverages during infancy and dental fluorosis of primary teeth.

J Am Coll Nutr. 2004 Apr;23(2):108-16

Authors: Marshall TA, Levy SM, Warren JJ, Broffitt B, Eichenberger-Gilmore JM, Stumbo PJ

OBJECTIVE: We describe associations between primary tooth fluorosis status and intakes of beverages and fluoride from these beverages during infancy. METHODS: Subjects (n = 677) are members of the Iowa Fluoride Study, a cohort of young children followed from birth. Food and nutrient intakes were obtained from 3-day diet records. Diets were analyzed at 6 weeks, 3, 6, 9, 12 and 16 months and cumulatively for 6 weeks through 16 months of age. Primary tooth fluorosis was assessed at 4.5-6.9 years of age and defined as present or absent. Multiple logistic regression analyses were used to develop models to predict fluorosis status. RESULTS: Water-based beverage intakes were higher in subjects with fluorosis than in those without. Specifically, higher intakes of water used to reconstitute formulas at 3, 6 and 9 months; any intake of water as a beverage at 16 months; and higher intakes of combined 100% juice and miscellaneous beverages at 16 months were positively associated with fluorosis (p < 0.05). Fluoride intakes from water sources were also higher in subjects with fluorosis than in those without. Specifically, higher intakes of fluoride from water used to reconstitute formulas at 3, 6, 9 and 12 months and for 6 weeks through 16 months, and higher intakes of fluoride from water as a beverage at 16 months and for 6 weeks through 16 months were positively associated with fluorosis (p < 0.05). CONCLUSION: Infant beverages, particularly infant formulas prepared with fluoridated water, can increase the risk of fluorosis in primary teeth.

PMID: 15047676 [PubMed - indexed for MEDLINE]


Free Full Text Article[Prevalence of dental fluorosis in 12 and 15 years old schoolchildren in Salv...
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[Prevalence of dental fluorosis in 12 and 15 years old schoolchildren in Salvador, Bahia, Brazil, 2001]

Cad Saude Publica. 2004 Jan-Feb;20(1):129-35

Authors: Cangussu MC, Castellanos Fernandez RA, Rivas CC, Ferreira Jr C, Santos LC

This study aimed to determine the prevalence of dental fluorosis in a sample of 3,313 schoolchildren (ages 12 and 15) in a health district in Salvador, Bahia, Brazil. A cross-sectional study was developed, and data were collected by seven examiners (kappa = 0.69) according to WHO criteria (the Dean index). Additional information such as participation in programs, access to a dentist, place of residence from 0-5 years of age, sex, and ethnicity were obtained through a questionnaire. A descriptive analysis was performed for the municipality as a whole and for each district. According to the results, 31.4% of the 12-year-olds and 27.6% of the 15-year-olds presented fluorosis, predominantly of the "very mild" type. Differences were found between the districts (p<0.05). The districts of Pau da Lima and Brotas had the highest percentages of healthy individuals at 12 years of age (81.8% and 81.6%). At 15 years, Sub&#xFA;rbio Ferroviário, Pau da Lima, and Cajazeiras were the districts with the lowest prevalence rates (13.0%, 14.6%, and 13.5%). The district of Liberdade had the highest prevalence (72.4% and 57.3%) at 12 and 15 years, respectively, attributed to differences in calibration. Differences were found between the health districts, thus emphasizing the need for health surveillance.

PMID: 15029313 [PubMed - indexed for MEDLINE]


Free Full Text Article[Epidemiologic survey of dental fluorosis and caries in school students in We...
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[Epidemiologic survey of dental fluorosis and caries in school students in Wensu county in Xinjiang]

Shanghai Kou Qiang Yi Xue. 2000 Dec;9(4):232-4

Authors: Cheng H, Liang AX, Elly A, Ling ZQ, Li CR

OBJECTIVE: To assess the relationship between the dental fluorosis and caries,and their prevalence features in school students in Wensu country in Xinjiang. METHODS: The study groups consisted of 1527 Weuer and Han students at the age of 6 to 16.Dental fluorosis and caries disease were assessed strictly by Dean's Classification Standard and WHO "Oral Health Surveys Basic Methods" (the 3rd ed). The concentration of fluorine in water and urine was measured by using selective electrode. RESULTS: The prevalence and index of dental fluorosis in Weuer and Han students were 73.70%, 64.67%, 1.647, 1.303,respectively.The prevalence of dental caries and DMFT were 61.19%, 42.66%, 1.648, 1.023 respectively. The corresponding values were 51.94%, 52.99%, 1.305, 1.449 for students of fluorosis group and non-fluorosis group, respectively. The fluorine degree of water was 2-5mg/L,the average value of fluorine in urine was 3.64 mg/L in Han students, and 5.28 mg/L in Weuer students. CONCLUSION: The prevalence of dental caries didn't decrease, even though the grevalence of fluorosis was high in Weuer country. The prevalence of fluorosis dental caries in Weuer students were significantly higher than those in Han students. It showed no significant different between the group of fluorosis and the group of non-fluorosis in the prevalence of dental caries, perhaps due to the high fluorine intake, poor oral hygiene, and unqualified medical service.

PMID: 15014770 [PubMed]


Free Full Text ArticleFluoride and aluminum in teas and tea-based beverages.
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Fluoride and aluminum in teas and tea-based beverages.

Rev Saude Publica. 2004 Feb;38(1):100-5

Authors: Hayacibara MF, Queiroz CS, Tabchoury CP, Cury JA

OBJECTIVE: To evaluate fluoride and aluminum concentration in herbal, black, ready-to-drink, and imported teas available in Brazil considering the risks fluoride and aluminum pose to oral and general health, respectively. METHODS: One-hundred and seventy-seven samples of herbal and black tea, 11 types of imported tea and 21 samples of ready-to-drink tea were divided into four groups: I-herbal tea; II-Brazilian black tea (Camellia sinensis); III-imported tea (Camellia sinensis); IV-ready-to-drink tea-based beverages. Fluoride and aluminum were analyzed using ion-selective electrode and atomic absorption, respectively. RESULTS: Fluoride and aluminum levels in herbal teas were very low, but high amounts were found in black and ready-to-drink teas. Aluminum found in all samples analyzed can be considered safe to general health. However, considering 0.07 mg F/kg/day as the upper limit of fluoride intake with regard to undesirable dental fluorosis, some teas exceed the daily intake limit for children. CONCLUSIONS: Brazilian and imported teas made from Camellia sinensis as well as some tea-based beverages are sources of significant amounts of fluoride, and their intake may increase the risk of developing dental fluorosis.

PMID: 14963548 [PubMed - indexed for MEDLINE]


Free Full Text ArticleFluorine content of several brands of chocolate bars and chocolate cookies fo...
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Fluorine content of several brands of chocolate bars and chocolate cookies found in Brazil.

Pesqui Odontol Bras. 2003 Jul-Sep;17(3):223-7

Authors: Buzalaf MA, Granjeiro JM, Cardoso VE, da Silva TL, Olympio KP

Chocolate bars and chocolate cookies are foodstuffs highly appreciated by children. The possibility of having fluorine (F) among their components, associated with an excessive consumption, may make them decisive contributors to the total daily F intake. Thus, they could participate in the establishment of dental fluorosis. The aim of this study was to analyze the fluorine concentration [F] of the chocolates bars (CB) Baton, Confeti, Garoto Ball, Kinder Ovo, M&M s, Milkybar, Nescau, Nescau Ball, Surpresa, Surpresa Bichos, Tortuguita; and of the chocolate cookies (CC) Danyt s, Hipop , Nescau, Passatempo, Pok&#xE9;mon, S tio do Pica-Pau Amarelo and Trakinas. Samples were purchased in Bauru, São Paulo, Brazil. Three grams of each product were previously ashed at 525 C (CB and cookies fillings) and at 550 C (cookies dough), during 4 hours. Fluorine was separated from the ash by hexamethyldisiloxane (HMDS)-facilitated diffusion. Fluorine analysis was carried out with the specific electrode. Mean [F]s SD and amplitude (unit mg/g) were: CB = 0.30 0.45 (0.07 - 1.60, n = 12) and CC = 1.08 2.64 (0.04 - 7.10, n = 7). It was concluded that some of the analyzed foods may be important contributors to the total daily F intake. As for the product that had the highest [F] (Danyt s), when only 3 units are consumed just once a day, they may supply up to 40% of the maximum recommended daily F intake (0.07 mg/kg body weight) for a 2-year-old child (12 kg). The [F] in these products should be informed on their labels.

PMID: 14762499 [PubMed - indexed for MEDLINE]


Free Full Text Article[Drinking water in infants]
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[Drinking water in infants]

An Pediatr (Barc). 2004 Feb;60(2):161-9

Authors: Vitoria Miñana I

We review types of public drinking water and bottled water and provide recommendations on the composition of water for infants. Water used with any of the commercial infant formulas in Spain should contain less than 25 mg/l of sodium. Drinking water must be boiled for a maximum of one minute (at sea level) to avoid excessive salt concentration. Bottled water need not be boiled. Fluoride content in drinking water should be less than 0.3 mg/l in first year of life to prevent dental fluorosis. Nitrate content in water should be less than 25 mg/l to prevent methemoglobinemia. Water with a calcium concentration of between 50 and 100 mg/l is a dietary source of calcium since it provides 24-56 % of the required daily intake in infancy.

PMID: 14757021 [PubMed - indexed for MEDLINE]


Free Full Text ArticleGuestimates.
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Guestimates.

J R Soc Med. 2004 Jan;97(1):49

Authors: Sarll DW

PMID: 14702377 [PubMed - indexed for MEDLINE]


Free Full Text ArticleIs fluoride concentration in dentin and enamel a good indicator of dental flu...
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Is fluoride concentration in dentin and enamel a good indicator of dental fluorosis?

J Dent Res. 2004 Jan;83(1):76-80

Authors: Vieira AP, Hancock R, Limeback H, Maia R, Grynpas MD

Despite some studies correlating dental fluorosis (DF) and fluoride (F) concentration in dental enamel, no information is available about DF and dentin F concentration. Our objective was to determine the correlation between teeth F concentration and DF severity in unerupted human 3rd molars, and the correlation between dentin and enamel F concentrations in the same tooth. Ninety-nine 3rd molars were studied-53 from Fortaleza, Brazil (F water, 0.7 ppm), 22 from Toronto (1.0 ppm), and 24 from Montreal (0.2 ppm). DF severity was evaluated according to the Thylstrup-Fejerskov Index, while F concentration was analyzed by Instrumental Neutron Activation Analysis. DF severity varied between TF0 and TF4, while F concentration ranged between 39 and 550 ppm in enamel and 101 and 860 ppm in dentin. Our results showed correlation between dentin F concentration and DF (r(S) = 0.316, p = 0.001), but no correlation between enamel F concentration and DF (r(S) = 0.154, p = 0.133). No correlation was observed between dentin and enamel F concentrations in the same tooth (r(S) = 0.064, p = 0.536).

PMID: 14691118 [PubMed - indexed for MEDLINE]


Free Full Text ArticleUrinary fluoride levels and prevalence of dental fluorosis in children of Jha...
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Urinary fluoride levels and prevalence of dental fluorosis in children of Jhajjar District, Haryana.

Indian J Med Sci. 2003 Sep;57(9):394-9

Authors: Yadav JP, Lata S

A study was conducted in the Jhajjar district of Haryana to assess the fluoride excretion in the population exposed to environmental fluoride and efforts were being made to correlate the results with dental fluorosis. The mean fluoride concentration in drinking water samples of Bahadurgarh, Beri, Jhajjar, Matanhail and Sahalawas blocks of Jhajjar district were 2.05 mg/L, 2.14 mg/L, 2.05 mg/L, 2.14 mg/L and 1.93 mg/L respectively. The mean urinary fluoride concentration was 1.58 mg/L in Bahadurgarh, 1.48 in Beri, 1.50 in Jhajjar, 1.51 in Matanhail and 1.56 in Sahalawas. The mean prevalence of fluorosis on the basis of stage of dental fluorosis was highest of yellowish brown type and on the basis of TSIF score, score 4 type fluorosis was highest in most of the blocks of Jhajjar district. The study revealed that more than 50% of the individuals were found to be affected with flurosis in this district.

PMID: 14515029 [PubMed - indexed for MEDLINE]



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