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
Summary
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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