Distribution pattern of enamel fluorosis severity: What is it telling us about local fluoride exposure?

Authors

DOI:

https://doi.org/10.21615/cesodon.5615

Keywords:

epidemiology, dental fluorosis, fluoridation, fluoride exposure

Abstract

Introduction and objective: dental fluorosis severity reflects fluoride exposure during dental enamel development. Recently, prenatal and postnatal exposure to fluoride has been associated with negative neurodevelopmental outcomes. The aim of this study was to describe and compare the severity and distribution pattern of dental fluorosis in the primary and permanent dentition, as a basis to discuss the timing and extent of fluoride exposure of children living in endemic areas of fluorosis in the department of Huila. Materials and methods: 840 children (preschoolers and schoolchildren) from four municipalities of the Huila Department were examined by trained dentists for dental fluorosis using the Thylstrup & Fejerskov Index. To estimate the prevalence of severities of fluorosis, each child was classified according to the most severe score. The distribution of the prevalence of enamel fluorosis severity by age-group  and type of dentition were reported as prevalence rates (%). Results: Prevalence of dental fluorosis in preschoolers was of 97.2% and in schoolers of 99.9%. For both preschoolers and schoolers moderate fluorosis was the most prevalent (75.6% and 63.5%, respectively). For both primary and permanent teeth, mild fluorosis was more prevalent in anterior teeth than in posterior teeth. Moderate and severe fluorosis were more prevalent in posterior teeth than in anterior teeth. Conclusions: the distribution pattern of the severity of dental fluorosis suggests both prenatal and postnatal exposure to fluoride above recommended levels. This study raises the importance of the validation of dental fluorosis as a potential historical biomarker of fluoride exposure at moments that are critical for neurodevelopment.

Downloads

Download data is not yet available.

Author Biographies

Gina Alejandra Castiblanco, Universidad El Bosque

Doctor in Dental Surgery, Master’s degree in Biomedical Sciences, PhD in Dental Sciences, Department of Cariology, Preventive Dentistry and Dental Public Health, Indiana University School of Dentistry (Indianapolis, Indiana, USA) and Unidad de Investigación en Caries (UNICA), Research Vice rectory, Universidad El Bosque (Bogotá, Colombia).

Blanca Cecilia Silva-Hermida, Independiente

Pediatric Dentist, Private Practice. Neiva (Huila, Colombia). 

Mario Opazo G, Universidad El Bosque

Sanitary Engineer. MS Environmental Sanitation, School of Engineering, Department of Environmental Engineering, Grupo de Investigacion en Agua, Salud y Ambiente, Universidad El Bosque (Bogotá, Colombia).

Maria Clara Gonzalez-Carrera, Universidad El Bosque

Doctor in Dental Surgery, Pediatric Dentist, Unidad de Manejo integral de Malformaciones craneofaciales (UMIMC), Facultad de Odontología Universidad El Bosque, (Bogotá, Colombia). 

Viviana Avila, Universidad El Bosque

Doctor in Dental Surgery, Master’s degree in microbiology, PhD Candidate in Biomedical Sciences, Unidad de Investigacion en Caries (UNICA), Research Vice rectory, Universidad El Bosque (Bogotá, Colombia)

Luis Fernando Gamboa, Universidad El Bosque

Doctor in Dental Surgery, Master’s degree in Clinical Epidemiology, Unidad de Investigacion en Caries (UNICA), Universidad El Bosque (Bogotá, Colombia). 

Lina Maria Marin, University of Saskatchewan

Doctor in Dental Surgery, Master’s degree in Biomedical Sciences, PhD in Dentistry, PhD in Biomedical Engineering, Salivary Proteomics Research Laboratory, College of Dentistry, University of Saskatchewan (Saskatoon SK, Canada). 

Margarita Usuga-Vacca, Universidad El Bosque

Doctor in Dental Surgery, Pediatric Dentist, Master’s degree in Dentistry, PhD Candidate in Biomedical Sciences, Unidad de Investigacion en Caries (UNICA), Research Vice rectory, Universidad El Bosque (Bogotá, Colombia)

Andrea Cortes, Universidad El Bosque

Doctor in Dental Surgery, Pediatric Dentist, PhD in Cariology, Unidad de Investigacion en Caries (UNICA), Research Vice rectory, Universidad El Bosque (Bogotá, Colombia)

Fabián Cortés-Muñoz, Universidad El Bosque

Nurse. Master´s Degree in Clinical Epidemiology. PhD in Statistics. Research Vice Rectory, Universidad El Bosque. Clinical Research Director at Fundación Clínica Shaio (Bogotá, Colombia).

Jaime Alberto Ruiz-Carrizosa, Universidad El Bosque

Doctor in Dental Surgery, Master´s degree in Public Health, Caries Research Unit (UNICA) Research Vice rectory, Universidad El Bosque (Bogotá, Colombia). 

Stefania Martignon, Universidad El Bosque

Doctor in Dental Surgery, Pediatric Dentist, PhD in Cariology, Caries Research Unit (UNICA), Research Vice rectory, Universidad El Bosque (Bogotá, Colombia)

References

DenBesten P, Li W. Chronic fluoride toxicity: dental fluorosis. In: Buzalaf M, editor. Fluoride and the oral environment. Monogr Oral Sci. Basel: Karger; 2011, vol 22, p. 81–96.

Buzalaf M. Fluoride Metabolism. In: Buzalaf M, editor. Fluoride and the oral environment. Monogr Oral Sci. Basel: Karger; 2011, vol 22, p. 20–36.

Tovar S, Misnaza S. Documento técnico perspectiva del uso del flúor vs caries y fluorosis dental en Colombia. Bogotá, Colombia: Ministerio de Salud y Protección Social; 2016, Feb. Versión 3. Available from: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/PP/ENT/perspectiva-uso-fluor.pdf

República de Colombia. Estudio Nacional de Salud Bucal ENSAB IV: Situación en Salud Bucal. Bogotá, Colombia: Ministerio de Salud y Protección Social; 2015. Available from: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/PP/ENSAB-IVSituacion-Bucal-Actual.pdf

Martignon S, Opazo-Gutiérrez MO, Velásquez-Riaño M, Orjuela-Osorio IR, Avila V, Martinez-Mier EA, et al. Geochemical characterization of fluoride in water, table salt, active sediment, rock and soil samples, and its possible relationship with the prevalence of enamel fluorosis in children in four municipalities of the department of Huila (Colombia). Environ Monit Assess. 2017;189(6):264.

Pessan JP, Buzalaf M. Historical and recent biological markers of exposure to fluoride. In: Buzalaf M, editor. Fluoride and the oral environment. Monogr Oral Sci. Basel: Karger; 2011, vol 22, p. 52–65.

Bashash M, Thomas D, Hu H, Martinez-Mier EA, Sanchez BN, Basu N, et al. Prenatal fluoride exposure and cognitive outcomes in children at 4 and 6–12 years of age in Mexico. Environ Health Perspect. 2017; 97017:1.

Bashash M, Marchand M, Hu H, Till C, Martinez-Mier EA, Sanchez BN, et al. Prenatal fluoride exposure and attention deficit hyperactivity disorder (ADHD) symptoms in children at 6–12 years of age in Mexico City. Environ Int. 2018 Dec;121:658–66.

Castiblanco GA, Silva-Hermida BC, Opazo G M, González-Carrera MC, Avila V, Gamboa LF, et al. Julio – diciembre de 2021

Green R, Lanphear B, Hornung R, Flora D, Martinez-Mier EA, Neufeld R, et al. Association between maternal fluoride exposure during pregnancy and IQ scores in offspring in Canada. JAMA Pediatr. 2019;173(10):940–8.

AlQahtani SJ, Hector MP, Liversidge HM. Brief communication: the London atlas of human tooth development and eruption. Am J Phys Anthropol. 2010;142(3):481–90.

Misnaza Castrillón S P, Tovar Valencia S. Áreas de riesgo por exposición a flúor, Colombia 2012 – 2015. IQEN. 2017; 22(15):229 - 244. Available from: http://www.ins.gov.co/iqen/IQUEN/IQEN%20vol%2022%202017%20num%2015.pdf

Lemeshow S, Hosmer DW, Klar J, Lwanga SK, World Health Organization. Adequacy of sample size in health studies. Chichester: Wiley; 1990.

Dean HT. Post-war implications of fluorine and dental health: epidemiological aspects. Am J Public Heal Nations Heal. 1944;34(2):133–43.

Levy SM, Hillis SL, Warren JJ, Broffitt BA, Mahbubul Islam AKM, Wefel JS, et al. Primary tooth fluorosis and fluoride intake during the first year of life. Community Dent Oral Epidemiol. 2002;30(4):286–95.

Hong L, Levy SM, Broffitt B, Warren JJ, Kanellis MJ, Wefel JS, et al. Timing of fluoride intake in relation to development of fluorosis on maxillary central incisors. Community Dent Oral Epidemiol. 2006;34(4):299–309.

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.

Institute of Medicine (US). Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington: National Academy Press; 1997.

República de Colombia. Guía de práctica clínica No. 24. Bogotá, Colombia: Ministerio de Salud y Protección Social; 2015. Available from: http://gpc.minsalud.gov.co/gpc_sites/Repositorio/Conv_563/GPC_crecimiento/Guia_Completa_C_D.pdf

Poureslami H, Khazaeli P, Mahvi AH, Poureslami K, Poureslami P, Haghani J, et al. Fluoride level in the breast milk in Koohbanan, a city with endemic dental fluorosis. Fluoride. 2016;49(4 Pt 2):485–94.

Martínez-Mier EA, Cury JA, Heilman JR, Katz BP, Levy SM, Li Y, et al. Development of Gold Standard Ion-Selective Electrode-Based Methods for Fluoride Analysis. Caries Res [Internet]. 2011;45(1):3–12. Available from: https://www.karger.com/Article/FullText/321657

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.

Franco ÁM, Martignon S, Saldarriaga A, González MC, Arbeláez MI, Ocampo A, et al. Total fluoride intake in children aged 22–35 months in four Colombian cities. Community Dent Oral Epidemiol. 2005;33(1):1–8.

Soto-Rojas AE, Ureña-Cirett JL, Martínez-Mier EA. A review of the prevalence of dental fluorosis in Mexico. Rev Panam Salud Pública. 2004;15:9–17.

Canada. Report on the Findings of the Oral Health Component of the Canadian Health Measures Survey, 2007-2009. Otawa, Ontario: Health Canada; 2010. Available from: http://www.caphd.ca/sites/default/files/CHMS-E-summ.pdf

Published

2021-12-17

How to Cite

1.
Castiblanco GA, Silva-Hermida BC, Opazo G M, Gonzalez-Carrera MC, Avila V, Gamboa LF, et al. Distribution pattern of enamel fluorosis severity: What is it telling us about local fluoride exposure?. CES odontol. [Internet]. 2021 Dec. 17 [cited 2024 May 17];34(2):15-29. Available from: https://revistas.ces.edu.co/index.php/odontologia/article/view/5615

Issue

Section

Artículo de Investigación Científica y Tecnológica
Article metrics
Abstract views
Galley vies
PDF Views
HTML views
Other views