Abstract
Nicaraguan legislation has established that fluoride concentrations in salt should be 200-225 mg/kg, but no report describes fluoride concentrations in salt marketed in this country. We evaluated the fluoride concentrations in 33 packages of salt of 11 brands (n = 3 each) purchased in Managua, Nicaragua. According to the package information, 9 of the 11 brands were fluoridated. Six aliquots of each package were weighed (mean 2.5 ± 0.3 g; n = 198) and dissolved in 0.025 g/ml water. Duplicates of 1.0 ml of solutions prepared were buffered (1:1; v/v) with TISAB II. Fluoride concentrations were determined with ion-specific electrode, calibrated with standard solutions (0.25-16.0 μg F/ml) mixed (1:1; v/v) with TISAB II added to 0.025 g (p.a.) NaCl/ml. The mean (± standard deviation, n = 3) fluoride concentrations of two fluoridated brands were in accord with Nicaraguan law (209.8 ± 48.0 and 211.4 ± 26.0 mg F/kg), and those of five brands were below the mandated range (131.0 ± 34.3, 180.6 ± 12.3, 184.6 ± 34.8, 190 ± 47.2, and 199.0 ± 18.9 mg F/kg); two brands contained only traces of fluoride. The two non-fluoridated brands had traces of fluoride. The findings show that the surveillance system for the salt fluoridation program in Nicaragua should be improved, as most salt analyzed violated the requirements of the national legislation.
Highlights
Submitted: Jan 11, 2018 Accepted for publication: Mar 27, 2018 Last revision: Apr 13, 2018Community-based methods of fluoride use, such as water and salt fluoridation, play important roles in the control of dental caries.[1]
Salt fluoridation has been widely implemented as a public health strategy to reduce dental caries,[2] but the monitoring of the fluoride concentration in salt is mandatory to guarantee the balance between benefits and risks of this way of fluoride use.[4]
In Nicaragua, the salt fluoridation program is supported by law since 2007,14 but there is no study about the fluoride concentration in salts marketed in this country
Summary
Community-based methods of fluoride use, such as water and salt fluoridation, play important roles in the control of dental caries.[1] When water fluoridation is not feasible, salt fluoridation is recommended as an alternative community approach.[2] In Latin America, the adoption of salt fluoridation programs has increased since 1986.3. An effective surveillance system is required as part of a salt fluoridation program to ensure balance between the anticaries effect of fluoride (benefit) and the minimization of dental fluorosis (risk). The Pan American Health Organization has emphatically recommended the monitoring of fluoride concentrations in salt marketed in countries with salt fluoridation programs.[4] fluoride concentrations in violation of local legislation have been found in salt brands marketed in México, Colombia, Peru, El Salvador, and Guatemala.[5,6,7,8,9,10,11,12,13]
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