Abstract

Objective:To assess fluoride (F-) intake from water and toothpaste by children aged 18 to 36 months and to monitor the F- concentrations in the drinking water system in a tropical city of Brazil.Methods:Children (n=58) aged 18-36 months, all lifetime residents of Penedo, state of Alagoas, Brazil, participated in this study. Water F- analyses were carried out in 7 different occasions at least a week apart. For 2 days all the water drunk by each child was accounted for. Fluoride intake from water for each child was estimated using the mean F- concentration of water in 7 different occasions. Fluoride intake from toothpaste was estimated by subtracting the recovered post-brushing F- from the original amount placed in the toothbrush. The F- intake from water and toothpaste was estimated by dividing the total amount of F- ingested by the weight of each child.Results:The mean F- concentration in the drinking water was 0.94 ppm (mean range 0.78-1.1 ppm), which is above the 0.7 ppm recommended for this area of Brazil. Mean total F- intake from water and toothpaste was 0.128 mg F-/Kg Body Weight/day. The daily means of F- intake from water and toothpaste were 0.021 and 0.107 mg F-/Kg Body Weight, respectively. Ninety six percent of children showed F- intake above 0.07 mg F-/Kg Body Weight/day.Conclusions:Children in Penedo are at risk for developing dental fluorosis due to high F- intake from fluoridated toothpastes. Water fluoridation showed low contribution to the total F- intake. However, high water F- concentrations in the water indicate the need of surveillance of the artificial water fluoridation system.

Highlights

  • Fluoridated toothpastes have been regarded as one of the most important factors responsible for the decline of caries incidence in the western world during the last decades[5,16]

  • Two previous Brazilian studies performed in the South Region of Brazil demonstrated a total F intake in children of 0.09 mg F-/Kg body weight/day with 55% attributed to fluoridated toothpastes[15] and 0.13 mg F-/Kg body weight/ day with 80% attributed to fluoridated toothpastes[1]

  • The purpose of this study was twofold: a) to assess the fluoride intake by children aged 18 to 36 months living in a tropical area of Brazil from fluoridated water and toothpaste and b) to assess the F- concentration in the drinking water of the city of Penedo

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Summary

Introduction

Fluoridated toothpastes have been regarded as one of the most important factors responsible for the decline of caries incidence in the western world during the last decades[5,16]. Fluoride (F-) has been implicated with an increase in dental fluorosis[23,6,17]. There are compelling evidences that the use of fluoridated toothpaste before six years of age is a risk indicator for dental fluorosis[17,7]. In order to avoid the side effect of fluorosis, the amount of ingested fluoride should not exceed 0.07 mg F-/Kg body weight/day[3,14]. Two previous Brazilian studies performed in the South Region of Brazil demonstrated a total F intake in children of 0.09 mg F-/Kg body weight/day with 55% attributed to fluoridated toothpastes[15] and 0.13 mg F-/Kg body weight/ day with 80% attributed to fluoridated toothpastes[1]. No data are available about the fluoride intake by children from the Northeast Region of Brazil, where industrial food is less consumed and utilization of fluoridated toothpastes may differ

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