Detection Rate Of Dental Fluorosis Research Articles

Spatial-Temporal Analysis of Drinking Water Type of Endemic Fluorosis - China, 2009-2022.

Endemic fluorosis, caused by high fluoride levels in drinking water, has been a significant health issue in rural areas of China for many decades. There has been a notable decline in the detection rate of dental fluorosis in children aged 8-12 years in drinking water fluorosis areas across the country from 2009 to 2022. While 14 provincial-level administrative divisions are classified as low-probability clusters, Tianjin remains classified as a high-probability cluster. The current policy for preventing and controlling endemic fluorosis in China needs adjustment. Rather than focusing solely on regions with high incidence, there should be a shift towards monitoring and early warning of fluoride exposure. Additionally, local containment measures should be intensified.

Dental fluorosis of children aged 8-12 in diseased areas in Xi’an City from 2014 to 2018

Objective To evaluate the dynamic prevalence of dental fluorosis of children and levels of fluoride in drinking water after improvement of water in Xi’an City, to provide scientific basis for water fluoridation improvement. Methods A total of 35 fluorosis endemic villages were selected as fixed monitor sites in 2014-2018, the ways of water improvement were surveyed, water fluorine content were detected and the prevalence of dental fluorosis in children aged 8 to 12 years were examined. Results Rates of excess fluoride in drinking water from 2014 to 2018 were 22.86%, 14.29%, 11.43%, 11.43% and 8.57%, the difference were significant ( χ 2 = 16.44, P <0.01).The dental fluorosis detection rates of children aged 8 to 12 years were 20.89%, 18.22%, 17.46%, 18.13% and 16.76% in 2014-2018 which showed a obvious descending trend by year ( χ 2 = 10.02, P <0.01). The detection rate of dental fluorosis in children aged 8 and 9 years showed a decreasing trend by year ( χ 2 = 6.53, 4.54, P <0.05). The difference of total rate of dental fluorisis, rate of mild cases rate of moderate-to-severe cases were statistically between the villages without qualified water and the villages with normal fluorine water ( χ 2 = 179.22, 167.93, 10.35, P <0.01). The rate of detection in the villages with the water fluorine exceed standard in 2014-2018 showed a declining trend year by year ( χ 2 = 28.50, P <0.01). The detection rate were significant different across water improvement methods ( χ 2 = 197.76, P <0.01). Detection rate of dental fluorosis decreased from 2014 to 2018 in the areas with municipal water supply showed a decreasing after year ( χ 2 = 12.16, P <0.01). Conclusion The improvement of municipal water supply shows significant effects on water fluorosis control, the detection rate of water fluoride and children’s dental fluorosis in some villages with the other ways of water improvement are still higher than expected, the continuously monitor of fluoride content in water and dental fluorosis in children should be strengthened. 【摘要】 目的 动态监测西安市饮水型氟中毒病区改水后水氟和儿童氟斑牙病情变化趋势,为改水降氟提供科学依据。 方法 2014—2018年在西安市选择 10 个区县的 35 个病区村作为固定监测点,调査改水方式、水氟含量和 8~ 12岁儿童氟 斑牙病情。 结果 2014—2018 年病区村水氟含量超标率分别为 22.86%, 14.29%,11.43%, 11.43%和 8.57%,差异有统计学 意义( χ 2 = 16.44, P <0.01)。各年度间 8~12岁儿童氟斑牙总检出率依次为 20.89%, 18.22%, 17.46%, 18.13%, 16.76%,且呈 逐年下降趋势( χ 2 趋势 = 10.02, P <0.01)。 8,9岁组儿童氟斑牙检出率各年度间比较,呈逐年下降的趋势( χ 2 趋势 值分别为 6.53, 4.54, P 值均<0.05)。水氟含量超标村儿童氟斑牙总检出率、轻度及以下、中度及以上检出率与水氟含量合格村比较,差异 有统计学意义( χ 2 值分别为 179.22,167.93,10.35, P 值均<0.01)。水氟含量超标病区村各年度间的氟斑牙检出率呈逐年 下降趋势( χ 2 趋势 =28.50, P <0.01)。市政供水、低氟井与除氟处理 3 种改水方式儿童氟斑牙检出率差异有统计学意义( χ 2 = 197.76, P <0.01)。市政供水各年度间儿童氟斑牙检出率呈逐年下降趋势( χ 2 趋势 = 12.16, P <0.01)。 结论 市政供水改水降 氟效果显著,其他改水方式仍有部分病区村水氟及儿童氟斑牙检出率未达标,应继续加强改水后水氟含量和儿童氟斑牙病 情监测。

Analysis of endemic fluorosis of Xinbaerhuyouqi in Hulunbeir city of Inner Mongolia in 2000 - 2009

Objective To investigate the dynamics and development trends of drinking water type of endemic fluorosis after water improvement in Xinbaerhuyouqi of Hulunbeir city, Inner Mongolia and to provide a scientific evidence for the development of countermeasures. Methods We mainly selected Adunchulusumu and Kerlunsumu in Xinbaerhuyouqi of Hulunbeir city as the two monitoring points after water improvement in 2000 -2009. Of these, 1 sample of centralized water supply source water and 3 samples of tap water and 5 samples of noncentralized water supply source water according to water well locations of east, west, south, north and center were collected and the levels of water fluoride were tested; the prevalence of dental fluorosis of school children aged 8 to 12 were examined; from 2002 onwards, the urine samples of 30 children aged 8 to 12(five age groups, six urine samples for each age group) were collected, and all urine samples were collected in the case of less than 30, and urine fluoride was tested. Dental fluorosis was diagnosed using Dean method; water fluoride was tested using fluoride ion selective electrode(WS/T 106-1999); urinary fluoride was tested by determination of fluoride in urine using ion-selective electrode(WS/T 89-1996). Results In 2000 - 2009, the mean levels of fluorine in drinking water in Adunchulusumu and Kerlunsumu were 1.79 - 4.35 mg/L and 1.38 - 3.18 mg/L, respectively; the detection rate of dental fluorosis of children aged 8 to 12 were 45.24％(19/42) - 89.78％(123/137) and 40.00％ (28/70) - 74.47％ (70/94), respectively; the median urinary fluoride of them were 2.30 - 4.15 mg/L and 2.73 - 4.55 mg/L, respectively. Conclusions The detection rate of children's dental fluorosis remains high in Xinbaerhuyouqi during the past 10 years after changing water. The endemic fluorosis remains a serious disease. Effective prevention and control measures must be taken to control the occurrence of fluorosis in the future. Key words: Fluoride poisoning; Drinking; Urine; Fluorosis, dental

Endemic fluorosis in Jilin province: analysis of surveillance data for 2006 - 2010

Objective To identify changes in the occurrence of endemic fluorosis in order to provide scientific basis for making countermeasures. Methods Five villages from 14 counties of mild, moderate and severe fluorosis affected areas were selected by stratified cluster sampling every year in the whole province during 2006 - 2010. Water and urinary fluorine were determined by ion selective electrode method(GB/T 8538-1995); dental fluorosis of children 8-12 years old was diagnosed with Dean method; skeletal fluorosis was diagnosed according to clinical indexing standards of endemic skeletal fluorosis (GB 16396-1996), between 2006 and 2008, and clinical diagnosis standard of endemic skeletal fluorosis(WS 192-2008) between 2009 and 2010. Results A total of 25 diseased villages were surveyed, 14 with water sources changed, covered a resident population of 8005 people, beneficiary population 7154, and accounting for 89.37% of the resident population; not changed villages 11. In accordance with the State drinking water health standards, in the 14 changed villages the fluoride in drinking water was qualified (≤ 1.20 mg/L), there were 3 schools whose water fluorine content exceeded the standard; among the 11 villages that did not change water sources 7 drinking water samples fluorine content exceeded the standard. Of the 8 to 12 years old children in villages with changed water sources, 363 of them were checked and 142 dental fluorosis were found, the detection rate of dental fluorosis was 39.12% (142/363); in villages with water sources not changed, 303 children were checked, the detection rate of dental fluorosis was 43.89%(133/303). Of sixteen and elder adults in water source changed villages, 6424 people were checked and 403 skeletal fluorosis were found, skeletal fluorosis detection rate was 6.27% (403/6424); 3572 people were checked in not changed villages, the detection rate of skeletal fluorosis was 13.89%(496/3572). In water sources changed areas, geometric mean of urinary fluoride was in the normal reference value(WS/T 256-2005, 1.40 mg/L)or less. Conclusions Endemic fluorosis is decreased in water improved areas, but in unimproved areas the disease is still severe, and control of endemic fluorosis is still an arduous task. Key words: Endemic diseases; Fluorosis, dental; Osteofluorosis

Drinking-water type of fluorosis in Shaanxi province in 2009: an analysis of surveillance results

Objective To investigate running conditions of water improvement projects and role of these projects in reducing fluoride in drinking-water type of fluorosis in Shaanxi province, and provide a scientific basis for prevention and control of disease. Methods Forty-eight villages of 16 counties in Xi'an, Baoji, and Yulin cities of Shaanxi province were monitored in 2009. Five water samples were collected randomly in water unimproved monitoring villages by position of east, west, south, north, and center parts. In water improved monitoring villages, 3 tap water and one source water samples were collected. fluoride was tested using fluoride ion selective electrode method according to Standard Testing Methods for Drinking Water (GB/T 5750-2006). All school children aged 8 to 12 in monitored villages were examined their dental fluorosis using Dean criteria. All people over 16 years old were examined clinical skeletal fluorosis, and 30% of project counties were randomly selected, then randomly selected one village among these counties, clinically diagnosed patients with skeletal fluorosis were examined again by X-ray using Diagnostic Criteria of Endemic Skeletal Fluorosis(WS 192-2007). Urine samples of 30 children aged 8 to 12 and of 20 adults over age of 16 were randomly collected, urinary fluoride was tested according to the Determination of Urinary Fluoride by Ion Selective Electrode Method (WS/T 89-19%). Results Of 22 water improvement projects that in normal operation, fluoride level of 8 source waters exceeded standard, accounting for 36.36%(8/22), and projects scrapped 5. Two hundred and two water samples were tested. In water improved historical diseased areas, median of water fluoride of source water and tap water were 0.72,0.62 mg/L, respectively, and average rate of water fluoride exceeded standard ere 36.36%(8/22) and 31.94%(23/72), respectively. In water unimproved historical diseased areas, median of water fluoride was 1.00 mg/L, and average rate of water fluoride exceeded standard was 39.81%(43/108). Detection rate of dental fluorosis among children aged 8 to 12 was 16.06% (367/2285), dental fluorosis index was 0.30, and prevalence was negative. Detection rate of clinical skeletal fluorosis among adults over 16 years old was 5.09%(1542/30 272), a totally of 198 people had X-ray film taken, positive 68, positive detection rate was 34.34%(68/198). One thousand and fifty-one copies of children's urine samples were tested, geometric mean of urinary fluoride was 0.95 mg/L; nine hundred and fourteen copies of adults urine samples were tested, geometric mean of urinary fluoride was 1.16 mg/L Conclusions Drinking-water type of fluorosis affects a large area in Shaanxi province, disease is still serious, and task of prevention remains very arduous. Further intensify water improvement project in diseased areas, and strengthen disease monitoring, health education and water improvement project management is key to prevention and control of endemic fluorosis. Key words: Fluoride poisoning; Drinking; Urine; Fluorosis, dental; Osteofluorosis

Analysis of survey results of endemic fluorosis in Shandong province in 2008

Objective To investigate the current status of endemic fluorosis in Shandong province, and to provide scientific evidence for the development of control strategies. Methods According to The National Technical Scheme for Endemic Disease Control in 2007, 19 counties were chosen to carry out the epidemiological investigation in 2008. Water and urinary fluoride were determined by F-ion selective electrode, dental fluorosis of children aged 8 to 12 were diagnosed by Dean method and skeletal fluorosis of adults over the age of 16 were examined clinically and by X-rays. Results In 19 counties, 186 villages were surveyed, 44 villages were found with mean water fluoride ≤ 1.00 mg/L, accounting for 23.66%(44/186);the value ＞ 1.00 mg/L in 142 villages,accounting for 76.34% (142/186);maximum water fluoride 8.88 mg/L. Total detection rate of dental fluorosis of children aged 8 to 12 was 66.35% (4518/6809), dental fluorosis index was 1.55, and defect rate was 15.39%(1048/6809). Children with urinary fluoride ＞ 1.40 mg/L was 83.29%(2149/2580), and the maximum value was 31.92 mg/L. Detection rates of skeletal fluorosis clinically and by X ray among adults over 16 years were 6.37%(5577/87 607) and 20.23% (229/1132), respectively. Conclusions Endemic fluorosis in Shandong province is still serious, prevention efforts need to be further increased. Key words: Endemic diseases; Fluorosis, dental; Osteofluorosis; Data collection

Operational state of drinking water defluorination project and situation of fluorosis in children aged 8 to 12 in Dagang district of Tianjin in 2009

Objective To investigate the state of drinking water defluorination project in Dagang district and study urinary fluoride levels and detect dental fluorosis of children aged 8 to 12, and to provide scientific basis for prevention and control of fluorosis. Methods Five defluorination projects in rural streets (towns) with highfluoride water and 2 urban water supply projects were choosen to investigate the running status in Dagang district Tianjin in 2009. Five rural and 2 urban schools were choosen to select 100 children aged 8 to 12 (for gender, age matched) in each primary school to study urinary fluoride levels and detection of dental fluorosis. Results A total of 66 defluorination projects in 73 villages were surveyed, among which 61 projects actually worked normally with using rate 92.4%(61/66). Water qualification of all projects could not be ensured due to direct project managers'lack of necessary expertise. In 2009, water qualification rate were 39.3%(24/61 )among the project normally used,with highlighted problem of biological pollution. A total of 490 children aged 8 - 12 in 5 rural towns were surveyed,dental fluorosis rate were 90%(441/490), and dental fluorosis index were 1.82. A total of 207 children aged 8 - 12in 2 urban areas were surveyed, the detection rate of dental fluorosis was 49.8%(103/207), and dental fluorosis index were 0.86. The urinary fluoride level of 230 children aged 8 - 12 in the 5 villages were surveyed. The Range of geometric mean of urinary fluoride were 1.82 - 2.70 mg/L. The urinary fluoride of 102 children aged 8 - 12 in the 2 urban area were surveyed. The Range of geometric mean of urinary fluoride were 1.53 - 1.72 mg/L. Conclusions There was phenomenon of high coverage, low utilization rate and less water consumption in the villages of Dagang district, Tianjin drinking water defluoridation projects, thus the health effects of the projects was minimum.Significant health effects is found in the defluorination projects in the urban areas with high coverage and high utilization rate. Studying new water improvment methods and new forms of water supply system is urgent for solving the problems met in the ineffective water defluorination project. Key words: Drinking water; Fluorosis, dental; Engineering; Data collection