Abstract
Fluoride is recommended for its cariostatic effect, but excessive fluoride intake may have health risks. Increased prevalence of dental fluorosis in areas with low fluoride content in drinking water has been attributed to the inappropriate excessive intake of fluoride supplements (tablets and drops) and toothpaste ingestion. The aim of the present study was to estimate the fluoride intake and the risk of fluorosis in children (6 months–6 years) in the Castelli Romani area (province of Rome, Italy), which is volcanic, therefore with a higher concentration of fluorine. Measurements of the fluoride content in drinking water, mineral waters, vegetables and commercial toothpaste for children were performed. The fluoride concentrations of all samples were determined using a Fluoride Ion Selective Electrode (GLP 22, Crison, Esp). Data were analyzed by descriptive statistics. Differences between samples were determined by Student’s t-test. The fluoride content in tap water samples collected from public sources averaged from 0.35 to 1.11 ppm. The Pavona area showed the highest content of fluoride with respect to the others (p ≤ 0.05). The fluoride content in mineral water samples averaged from 0.07 to 1.50 ppm. The fluoride content of some vegetables showed increased mean values when compared to control vegetables (p ≤ 0.05). Within the limitations of the present study, considerations should be made when prescribing fluoride toothpaste for infants (6 months–4 years) in the areas with high fluoride content, because involuntary ingestion is consistent.
Highlights
If the average water consumed by age group is multiplied by the content of fluoride detected in tap water from the areas studied in 2016, it is possible to estimate the amount of fluoride ingested by children in those areas (Table 7)
Excessive fluoride ingestion during tooth formation is the cause of dental fluorosis, which results in hypoplasia or hypomineralization of tooth enamel and dentine
It is clear that the main sources of fluoride associated with increased dental fluorosis are fluoridated supplements, dentifrices, water and processed baby foods consumed before six years of age [38,39]
Summary
The cariostatic effect of fluoride has been studied since the 1930s [1]. Health Organization (WHO) approved fluoride as a preventive measure against dental caries in 1969 [2] and recommended its appropriate use in 1994 and 2010 [3,4]. This has led to increased development of fluoride-releasing materials as a strategy in the prevention or inhibition of caries development and progression, in addition to the wellestablished curing and finishing procedures aimed at reducing biofilm formation [5,6,7]
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