Enamel fluorosis related with fluoride-containing water ingestion and urinary excretion in schoolchildren

• Farith González-Martínez ^[2] ; Ruth Gómez-Scarpetta ^[3] ; Olga-Bibiana Salcedo ^[4] ; Patricia Bermúdez-Reyes ^[5] ; Patricia Castro-Villamizar ^[1] ; María del Pilar Cerezo ^[6] ; Carmen Martínez ^[7] ; Lesbia Tirado-Amador ^[8] ; Andrés Salas-Zambrano ^[9] ; Alexandra Saldarriaga ^[10] ; Marisol Sánchez-Molina ^[11] ; Luis-Armando Vila ^[12]
  1. [1] Corporación Universitaria Rafael Nuñez

     Corporación Universitaria Rafael Nuñez

     Colombia

     
  2. [2] DDS, MSPH, PhD. Public Health Research Group Universidad de Cartagena-Cartagena de Indias, Colombia; Asociación Colombiana de Facultades de Odontología-Bogotá-ACFO, Colombia; Latin American Network of Research on Fluorides and Dental Fluorosis, Cartagena 130014, Colombia
  3. [3] Latin American Network of Research on Fluorides and Dental Fluorosis, Cartagena 130014, Colombia; BAM, MSc. Universidad Cooperativa de Colombia-Villavicencio, Colombia
  4. [4] DDS, MSc. Universidad de Antioquia-Medellín, Colombia
  5. [5] DDS, MSc. Universidad Cooperativa de Colombia-Envigado, Colombia
  6. [6] DDS, MSc. Universidad Autónoma de Manizales-Manizales, Colombia
  7. [7] DDS, MSc. Universidad Santo Tomás-Bucaramanga, Colombia
  8. [8] 0DDS, MSc. Universidad del Sinú-Cartagena, Colombia
  9. [9] 1DDS, MSc. Universidad Cooperativa de Colombia-Pasto, Colombia
  10. [10] 2DDS, MSc, PhD. Universidad CES-Medellín, Colombia
  11. [11] 3DDS, MSc, PhDc Universidad Metropolitana-Barranquilla, Colombia
  12. [12] 4DDS, MSc, PhD. Universidad del Magdalena-Santa Marta, Colombia

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• Localización: Journal of Clinical and Experimental Dentistry, ISSN-e 1989-5488, Vol. 16, Nº. 1 (January), 2024, págs. 51-61
• Idioma: inglés
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• Resumen

  • Natural water sources are considered as the major environmental exposure of fluoride, resulting in increased prevalence of enamel fluorosis. This type of natural exposure should be permanently monitored to avoid the interactions with other non-natural fluoride sources. We evaluated the prevalence of enamel fluorosis in Colombian schoolchildren and its relationship with fluoride-containing water ingestion exposure dose and urinary fluoride excretion.

    We included 923 schoolchildren aged 7–12 years residing in eight municipalities in Colombia. Sampling of consumption water was performed in major aquifers used for daily supply. Samples were collected in 98 polyethylene containers and refrigerated until analysis. Water and urine fluoride concentrations were measured using the fluoride selective electrode method. Enamel fluorosis was evaluated using Thylstrup and Ferjerskov Index (TFI). Demographic and anthropometric characteristics were assessed. Besides, other exposures to non-natural fluoride were also evaluated. Logistic regression was applied for multiple analyses.

    The median fluoride concentration in water and urine samples was 10.5 mg/L and 0.63 mg/L respectively, with the highest value found in Algarrobo-Magdalena, and the lowest value found in Manzanares-Caldas. The overall prevalence of enamel fluorosis was 86.1%, being more frequent the mild codes with TFI-1 to TFI-2. The highest prevalence was found in Margarita-Bolívar and Manzanares-Caldas, and the most severe codes (TFI-5 to TFI-9) were detected in Manzanares-Caldas. The multiple analysis revealed water ingestion exposure dose, urinary excretion, involuntary intake of toothpaste, amount of table salt consumption and sex as significant factors (p< 0.001).

    The fluoride ingestion exposure dose and its subsequent urinary excretion could be used as estimators of past fluoride exposure, explaining the current prevalence of enamel fluorosis in Colombian schoolchildren.