Caries Research
2012;47:229-308
Fluorosis and Dental Caries in Mexican Schoolchildren Residing in Areas with Different Water Fluoride Concentrations and Receiving Fluoridated Salt by García-Pérez A. · Irigoyen-Camacho M.E. · Borges-Yáñez A.
Abstract
Objective: To
explore the association between fluoride in drinking water and the prevalence
and severity of fluorosis and dental caries in children living in communities
receiving fluoridated salt.
Material and
Methods: Participants were schoolchildren (n = 457) living in two rural
areas of the State of Morelos, Mexico, where the water fluoride concentration
was 0.70 or 1.50 ppm. Dental caries status was assessed using Pitts’ criteria.
Lesions that were classified as D3 (decayed) were identified to
determine the decayed, missing, and filled teeth index (D3MFT).
Fluorosis was assessed using the Thylstrup-Fejerskov Index (TFI). Information
regarding drinking water source and oral hygiene practices (tooth brushing
frequency, dentifrice use, and oral hygiene index) was obtained.
Results: The
prevalence of fluorosis (TFI ≥1) in communities with 0.70 and 1.50 ppm water
fluoride was 39.4 and 60.5% (p = 0.014), respectively, while the prevalence of
more severe forms (TFI ≥4) was 7.9 and 25.5% (p < 0.001), respectively. The
mean D3MFT was 0.49 (±1.01) in the 0.70 ppm community and 0.61
(±1.47) in the 1.50 ppm community (p = 0.349). A logistic regression model for
caries (D3 >1) showed that higher fluorosis categories (TFI 5–6 OR
= 6.81, p = 0.001) were associated with higher caries experience, adjusted by
age, number of teeth present, tooth brushing frequency, bottled water use, and
natural water fluoride concentration.
Conclusions:
The prevalence of fluorosis was associated with the water fluoride
concentration. Fluorosis at moderate and severe levels was associated with a
higher prevalence of dental caries, compared with lesser degrees of fluorosis.
The impact of dental fluorosis should be considered in dental public health
programs.
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