Abstract
The purpose of this study was to assess exposure to drinking water fluoride and evaluate the risk of dental fluorosis among the Estonian population. The study covered all 15 counties in Estonia and 93.7% of population that has access to public water supplies. In Estonia groundwater is the main source for public water supply systems in most towns and rural settlements. The content of natural fluoride in water ranges from 0.01 to 7.20 mg/L. The exposure to different fluoride levels was assessed by linking data from previous studies on drinking water quality with databases of the Health Protection Inspectorate on water suppliers and the number of water consumers in water supply systems. Exposure assessment showed that 4% of the study population had excessive exposure to fluoride, mainly in small public water supplies in western and central Estonia, where the Silurian-Ordovician aquifer system is the only source of drinking water. There is a strong correlation between natural fluoride levels and the prevalence of dental fluorosis. Risk of dental fluorosis was calculated to different fluoride exposure levels over 1.5 mg/L.
Highlights
Fluoride is known to have both beneficial and adverse effects on humans, depending on the total intake
Exposure assessment showed that 4% of the study population had excessive exposure to fluoride, mainly in small public water supplies in western and central Estonia, where the Silurian-Ordovician aquifer system is the only source of drinking water
The results of this study provide a first assessment of human exposure to fluorides by drinking water and risk of dental fluorosis
Summary
Fluoride is known to have both beneficial and adverse effects on humans, depending on the total intake. But not always, the main source of fluoride and fluoride is sometimes added to public water supplies to help prevent dental caries. This paper considers exposure to natural fluoride through public drinking water supplies in Estonia in 2004. Occurring high fluoride levels in groundwater is a complicated issue for drinking water providers in many regions of the world. They are faced with dilemma that deep groundwater from drilled wells is bacteriologically safe but is often not suitable because of the presence of excess naturally occurring chemicals such as fluorides, whereas surface water and water from traditional shallow dug wells have lower fluoride contents, but can be contaminated by faecal material
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