Abstract

Drinking water is a major source of dietary fluoride intake in communities with water fluoridation. We examined the association between urinary fluoride adjusted for specific gravity (UFSG) and tap water fluoride levels, by age and sex, among individuals living in Canada. Participants included 1629 individuals aged 3 to 79 years from Cycle 3 (2012–2013) of the Canadian Health Measures Survey. We used multiple linear regression to estimate unique associations of tap water fluoride levels, age, sex, ethnicity, body mass index (BMI), use of fluoride-containing dental products, smoking in the home, and tea consumption with UFSG. UFSG concentration was significantly higher among participants who received fluoridated drinking water (mean = 1.06 mg/L, standard deviation = 0.83) than among those who did not (M = 0.58 mg/L, SD = 0.47), p < 0.01. UFSG increased over adulthood (ages 19 to 79). Higher UFSG concentration was associated with being female, tea drinking, and smoking in the home. In conclusion, community water fluoridation is a major source of contemporary fluoride exposure for Canadians. Lifestyle factors including tea consumption, as well as demographic variables such as age and sex, also predict urinary fluoride level, and are therefore important factors when interpreting population-based fluoride biomonitoring data.

Highlights

  • Fluoride has been added to public drinking water supplies since the 1940s for prevention of dental caries

  • 0.7 mg/L for community water fluoridation (CWF), naturally occurring fluoride levels can exceed this standard in some regions

  • Given that drinking water is a main source of fluoride exposure for most individuals [6,7], this study sought to characterize differences in urinary fluoride adjusted for specific gravity (UFSG ) as a function of CWF

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Summary

Introduction

Fluoride has been added to public drinking water supplies since the 1940s for prevention of dental caries. 73% of the U.S population using public drinking water systems receives fluoridated water compared with 39% of Canadians [1] and only 3%. In the U.S and Canada, 0.7 mg/L is the recommended concentration of fluoride in drinking water for the prevention of dental caries [4,5]. Provide nationally or provincially representative reference values for urinary fluoride levels that are not separated by community water fluoridation (CWF) status. Water fluoride concentrations are moderately to strongly correlated with fluoride levels in urine [14,15,16,17] and blood plasma [18,19,20].

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