Low Levels Of Fluoride Research Articles

Exploring the link between hair elemental composition and oral and general health of children in Northern and Central Dagestan Russia

Relevance. This article presents data on the level of trace elements in hair and oral and general health among various age groups of children (from 2 to 17 years) in Northern and Central Dagestan. It also reports findings on the relationship between oral health indicators and the content of such macro- and microelements as Ca, Cu, Mg, Mn, Zn, As, Fe, F. Identifying concentrations of macro- and microelements in hair proves to be a promising diagnostic method and aids in creating personalized prevention programs.Objective. To investigate the correlation between the elemental composition in children's hair and their oral and general health conditions in the cities of Kizlyar and Makhachkala, situated in Northern and Central Dagestan, Russia.Materials and methods. Established methods and physicochemical techniques were utilized for oral health evaluations to determine the quality indicators of drinking water, levels of elemental composition in hair, and methods to assess the general health of children (questionnaires, analysis of medical records of children).Results. A correlation was established between the levels of specific chemical elements in hair, the dental hard tissues, and mixed saliva with the oral and general health complications observed in children. Water analysis in Makhachkala, central part of the Republic of Dagestan, revealed an unbalanced presence of essential chemical elements such as fluoride, iron, manganese, zinc, and sulfates. In 74–84% of the examined water samples, the fluoride content was below 0.5 mg/l, and only 13–25% were within the normal range. The levels of fluoride and iron in hair and mixed saliva indicate shifts in mineral metabolism in children's bodies. Fluoride is crucial for iron absorption, and its deficiency results in significantly decreased absorption rates. A substantial reduction in water fluoride levels, compared to standard values, correlates with high rates of dental caries and iron deficiency anemia in children from Makhachkala, occurring in about 87% of cases (P < 0.05). This relationship is substantiated by the analysis of medical records from children aged 2 to 17 from hospitals in both Northern and Central Dagestan, highlighting the connection between iron deficiency anemia and the low fluoride levels in drinking water. Further studies into the oral health of children have shown that the incidence and severity of caries in deciduous teeth are greater in the Northern than in the Central Zone of Dagestan. Moreover, conditions such as cheilitis, aphthous stomatitis, and desquamative glossitis are frequently observed in children during the stages of temporary tooth occlusion, affecting on average 38.5% of cases, and this prevalence increases to 78.2% during the mixed and permanent occlusion stages.Conclusion. The conducted studies revealed that the drinking water supplied to the Dagestan population has elevated permissible levels of iron and arsenic. Additionally, there is a noted deficiency of fluoride, zinc, and copper, as well as low water hardness. Research into the quality of drinking water and the health impacts on the pediatric population of Dagestan established a correlation (R = 0.593) between unbalanced water, dietary intake, the severity of dental caries, and reduced immunity in children. High levels of arsenic, germanium, and molybdenum in the water and children's hair contribute to cumulative health effects. Environmental pollution is also linked to a rise in oral health issues, iron deficiency anemia, and broader health problems. Analyzing the chemical composition of children's hair serves as a diagnostic tool for detecting and preventing diseases related to deficiencies and excesses of macro- and microelements.

Fluoride exposure and thyroid hormone levels in pregnancy: The MIREC cohort

BackgroundFluoride exposure may increase the risk of hypothyroidism, but results from previous studies are inconsistent at low-level fluoride exposure (i.e., ≤0.7 mg/L). Human studies of fluoride and thyroid hormone levels in pregnancy are scarce. ObjectivesWe examined associations between fluoride exposure and maternal thyroid hormone levels in a Canadian pregnancy cohort, with consideration for fetal sex-specific effects. MethodsWe measured fluoride concentrations in drinking water and spot urine samples collected during each trimester from 1876 pregnant women enrolled in the Maternal-Infant Research on Environmental Chemicals (MIREC) study. We also measured maternal thyroid stimulating hormone (TSH), free thyroxine (FT4), and total thyroxine (TT4) levels during the first trimester of pregnancy. We used linear and non-linear regression models to estimate associations between fluoride exposure and levels of TSH, FT4, and TT4. We explored effect modification by fetal sex and considered maternal iodine status as a potential confounder. ResultsA 1 mg/L increase in urinary fluoride was associated with a 0.30 (95 %CI: 0.08, 0.51) logarithmic unit (i.e., 35.0 %) increase in TSH among women pregnant with females, but not males (B = 0.02; 95 %CI: −0.16, 0.19). Relative to women with urinary fluoride concentrations in the first quartile (0.05–0.32 mg/L), those with levels in the third quartile (0.49–0.75 mg/L) had higher FT4 and TT4 (i.e., inverted J-shaped associations), but the association was not statistically significant after adjustment for covariates (p = 0.06). Water fluoride concentration showed a U-shaped association with maternal FT4, whereby women with water fluoride concentrations in the second (0.13–0.52 mg/L) and third (0.52–0.62 mg/L) quartiles had significantly lower FT4 compared to those with levels in the first quartile (0.04–0.13 mg/L). Adjustment for maternal iodine status did not change the results. DiscussionFluoride exposure was associated with alterations in maternal thyroid hormone levels, the magnitude of which appeared to vary by fetal sex. Given the importance of maternal thyroid hormones for fetal neurodevelopment, replication of findings is warranted.

Potential risk of dental fluorosis associated with different baby formulas and water brands marketed in Spain.

Despite efforts to promote breastfeeding, many babies aged <6 months receive only baby formula reconstituted with bottled water. The intake of high levels of fluoride during amelogenesis has been associated with hypomineralization of the tooth enamel, with aesthetic and mechanical repercussions. The objective of this study was to determine the potential risk of dental fluorosis associated with baby formulas marketed in Spain. We measured 26 baby formulas frequently consumed in Spain; 17 brands for babies aged <6 months, 5 for those aged >6 months, and 4 ready-to-use brands. They were prepared with 4 types of water: distilled water and three brands of bottled water with different levels of fluoride. The fluoride concentration (mg/L or ppm F) was measured with an ion-specific electrode coupled to an ion analyzer. Each sample was prepared according to the manufacturer's instructions and analyzed in triplicate. A descriptive analysis was carried out. The minimum fluoride level found was 0.04 mg/L and the maximum was 1.02 mg/L. Considering the daily intake of these formulas, none exceeded the clinically-acceptable daily dose limit risk for fluorosis (0.07 mg F/day/kg body weight) when mixed with bottled water with a low level of fluoride (0.1 mg/L). However, when the same brands of formula were reconstituted with bottled water with a higher fluoride content (0.99 mg/L), they all exceeded the daily dose limit for the risk of fluorosis. As the potential risk of dental fluorosis associated with the formulas tested depends exclusively on the fluoride concentration of the waters used for reconstitution, formula packaging should contain a warning.

Measurement and analysis of microbial fluoride resistance in dental biofilm models.

The interactions between communities of microorganisms inhabiting the dental biofilm is a major determinant of oral health. These biofilms are periodically exposed to high concentrations of fluoride, which is present in almost all oral healthcare products. The microbes resist fluoride through the action of membrane export proteins. This chapter describes the culture, growth and harvest conditions of model three-species dental biofilm comprised of cariogenic pathogens Streptococcus mutans and Candida albicans and the commensal bacterium Streptococcus gordonii. In order to examine the role of fluoride export by S. mutans in model biofilms, procedures for generating a strain of S. mutans with a genetic knockout of the fluoride exporter are described. We present a case study examining the effects of this mutant strain on the biofilm mass, acid production and mineral dissolution under exposure to low levels of fluoride. These general approaches can be applied to study the effects of any gene of interest in physiologically realistic multispecies oral biofilms.

Determination and eco-friendly suppression of fluoride contamination in ground water samples using activated carbon constituents of carica papaya – A natural adsorbent

A significant contribution to increasing water supply comes from ground water and thereby meets the ever increasing demands for almost 90% of the Indian population. Problems are being faced due to the presence of excess fluoride, arsenic and nitrate in groundwater. It is also observed that low levels of fluoride in ground water can help prevent dental cavities, at the same time, higher levels of fluoride can induce dental fluorosis & skeletal fluorosis. Therefore, the fluoride level in ground water needs to be monitored and strictly controlled. Fluoride levels in drinking water should not be more than 1.5 mg/l, as recommended by the WHO and the Bureau of Indian Standards. The ideal fluoride limit for drinking and cooking is 1 mg/l, while 1.5 mg/l is acceptable if there is no other source available. Therefore, the present study analysis the water samples taken from various bore holes (provided with the locations of water sample using a Global Positioning System (GPS)) for all possible parameters like hardness, alkalinity, pH, TDS, EC, chloride, sulphate and fluoride followed by the removal of fluoride contamination in ground water samples using adsorptive filtration technique with the help of a novel, low cost natural adsorbent (activated charcoal obtained from carica papaya leaves). This work aims to determine and suggest a low cost material (Activated carbon obtained from carica papaya leaves) as an effective natural adsorbent for the defluoridation of ground water using the natural adsorbents in experimental testing. In addition to this, a mobile app for providing the related information and a separate Geographical Information System (GIS) mapping are also done. From the adsorption study, a reduction of about 84% fluoride was achieved. The obtained results were compared with the previously reported results. It is found that the prepared activated charcoal from papaya leaves is highly efficient than previously reported methods. Therefore, for the suppression of fluoride content in ground water samples, an eco-friendly reduction method using papaya leaf charcoal is suggested.

Effect of Fluoride on Oral Health Status Among General Population Residing in High- and Low-Level Fluoride Blocks in Erode District, Tamil Nadu, India: A Cross-Sectional Study.

The aim of this study was to evaluate the fluoride levels in groundwater and their effect on oral health status among the general population of Erode district, Tamil Nadu, India. A descriptive cross-sectional study was conducted among the general population of index age groups 5, 12, 15, 35-44, and 65-74 years. A total of 540 subjects participated in the study. High fluoride blocks of Erode district were selected based on the Central Ground Water Board (CGWB), Ministry of Jal Shakti, Department of Water Resources, River Development and Ganga Rejuvenation, Government of India, 2010, and the low fluoride were taken from the Groundwater Year Book (GWYB) of Tamil Nadu and UT of Puducherry, 2018. The Oral Health Assessment Form 2013 (adult and children) of the World Health Organization (WHO) was used to assess dental caries and enamel fluorosis. Clinical examination was performed using a mouth mirror and explorer under natural illumination by a single examiner. Data obtained were processed and analyzed using IBM SPSS Statistics version 26. A Chi-squared test was employed to analyze the difference between the high and low fluoride blocks. A P value of 0.05 was set to be statistically significant. The current study had a contrary finding with the CGWB on water quality analysis of fluoride levels in drinking water for high fluoride block, Ammapet (1.12 ppm) and Anthiyur (1.08 ppm). The prevalence of enamel fluorosis in high fluoride block Ammapet was 44.4% and Anthiyur was 54.8%. The prevalence of dental caries in high fluoride block Ammapet was 45.9% and in Anthiyur was 43%. The prevalence of enamel fluorosis in low fluoride block Bhavanisagar was 27.4% and in Gobichettipalayam was 28.2%. The prevalence of dental caries in low fluoride block Bhavanisagar was 61.5%, and in Gobichettipalayam was 54.8%. This study's contradictory finding emphasizes the importance of drinking water; sanitation staff should monitor and report water fluoridation data on a monthly basis in accordance with the Water Fluoridation Reporting System, and CGWB should plan and organize a team for the upgradation of water quality in India. The National Program for Prevention and Control of Dental Diseases should look on to the endemic areas for the prevention of dental fluorosis, which should be assessed, implemented, and monitored by the public health dentist who should be recruited as oral health program officers in both central and state governments.

Fluoride-Induced Mitochondrial Dysfunction and Approaches for Its Intervention.

Fluoride is present everywhere in nature. The primary way that individuals are exposed to fluoride is by drinking water. It's interesting to note that while low fluoride levels are good for bone and tooth growth, prolonged fluoride exposure is bad for human health. Additionally, preclinical studies link oxidative stress, inflammation, and programmed cell death to fluoride toxicity. Moreover, mitochondria play a crucial role in the production of reactive oxygen species (ROS). On the other hand, little is known about fluoride's impact on mitophagy, biogenesis, and mitochondrial dynamics. These actions control the growth, composition, and organisation of mitochondria, and the purification of mitochondrial DNA helps to inhibit the production of reactive oxygen species and the release of cytochrome c, which enables cells to survive the effects of fluoride poisoning. In this review, we discuss the different pathways involved in mitochondrial toxicity and dysfunction induced by fluoride. For therapeutic approaches, we discussed different phytochemical and pharmacological agents which reduce the toxicity of fluoride via maintained by imbalanced cellular processes, mitochondrial dynamics, and scavenging the ROS.

Association between low fluoride exposure and children's intelligence: a meta-analysis relevant to community water fluoridation

ObjectivesPrevious meta-analyses have mainly focused on studies conducted in endemic fluorosis areas with relatively high fluoride concentrations. These are impoverished rural communities in China, India, and Iran, and the findings cannot be generalised to developed countries. Therefore, we investigated the association between fluoride concentrations relevant to community water fluoridation and children's cognition measured with IQ scores by synthesising effect sizes reported in observational studies. MethodsA previous meta-analysis and the National Toxicology Program database that included a search of multiple databases and the authors' search of PubMed, Google Scholar, and Mendeley provided the data. Cross-sectional and cohort studies examining the association between fluoride and children's cognition and intelligence scores were selected. Two reviewers abstracted data using standard procedures. We performed three meta-analyses to synthesise the effects using the random effects models. ResultsEight studies of standardized mean difference in IQ scores from non-endemic fluorosis areas found no statistically significant difference between recommended and lower levels of fluoride (standardized mean difference = 0.07; 95% confidence interval: −0.02, 0.17; I2 = 0%), and no significant fluctuation in IQ scores across the differences in fluoride concentrations by non-linear modeling with restricted cubic spline (P = 0.21). Meta-analyses of children's and maternal spot urinary fluoride associated pooled regression coefficients (Betachildren = 0.16; 95% confidence interval: −0.40, 0.73; P = 0.57; I2 = 0%, Betamaternal = −0.92; 95% CI: −3.29, 1.46; P = 0.45; I2 = 72%) were not statistically significant. Further regression analysis by standardizing absolute mean IQ scores from lower fluoride areas did not show a relationship between F concentration and IQ scores (Model Likelihood-ratio test: P-value = 0.34.) ConclusionsThese meta-analyses show that fluoride exposure relevant to community water fluoridation is not associated with lower IQ scores in children. However, the reported association observed at higher fluoride levels in endemic areas requires further investigation.

Fluoride exposure and hypothyroidism in a Canadian pregnancy cohort

BackgroundWhile fluoride can have thyroid-disrupting effects, associations between low-level fluoride exposure and thyroid conditions remain unclear, especially during pregnancy when insufficient thyroid hormones can adversely impact offspring development. ObjectivesWe evaluated associations between fluoride exposure and hypothyroidism in a Canadian pregnancy cohort. MethodsWe measured fluoride concentrations in drinking water and three dilution-corrected urine samples and estimated fluoride intake based on self-reported beverage consumption. We classified women enrolled in the Maternal-Infant Research on Environmental Chemicals Study as euthyroid (n = 1301), subclinical hypothyroid (n = 100) or primary hypothyroid (n = 107) based on their thyroid hormone levels in trimester one. We used multinomial logistic regression to estimate the association between fluoride exposure and classification of either subclinical or primary hypothyroidism and considered maternal thyroid peroxidase antibody (TPOAb) status, a marker of autoimmune hypothyroidism, as an effect modifier. In a subsample of 466 mother-child pairs, we used linear regression to explore the association between maternal hypothyroidism and child Full-Scale IQ (FSIQ) at ages 3-to-4 years and tested for effect modification by child sex. ResultsA 0.5 mg/L increase in drinking water fluoride concentration was associated with a 1.65 (95 % confidence interval [CI]: 1.04, 2.60) increased odds of primary hypothyroidism. In contrast, we did not find a significant association between urinary fluoride (adjusted odds ratio [aOR]: 1.00; 95%CI: 0.73, 1.39) or fluoride intake (aOR: 1.25; 95%CI: 0.99, 1.57) and hypothyroidism. Among women with normal TPOAb levels, the risk of primary hypothyroidism increased with both increasing water fluoride and fluoride intake (aOR water fluoride concentration: 2.85; 95%CI: 1.25, 6.50; aOR fluoride intake: 1.75; 95%CI: 1.27, 2.41). Children born to women with primary hypothyroidism had lower FSIQ scores compared to children of euthyroid women, especially among boys (B coefficient: −8.42; 95 % CI: −15.33, −1.50). DiscussionFluoride in drinking water was associated with increased risk of hypothyroidism in pregnant women. Thyroid disruption may contribute to developmental neurotoxicity of fluoride.

Metabolic effect of low fluoride levels in the islets of NOD mice: integrative morphological, immunohistochemical, and proteomic analyses.

Fluoride (F) has been widely used to control dental caries, and studies suggest beneficial effects against diabetes when a low dose of F is added to the drinking water (10 mgF/L). This study evaluated metabolic changes in pancreatic islets of NOD mice exposed to low doses of F and the main pathways altered by the treatment. In total, 42 female NOD mice were randomly divided into two groups, considering the concentration of F administered in the drinking water for 14 weeks: 0 or 10 mgF/L. After the experimental period, the pancreas was collected for morphological and immunohistochemical analysis, and the islets for proteomic analysis. In the morphological and immunohistochemical analysis, no significant differences were found in the percentage of cells labelled for insulin, glucagon, and acetylated histone H3, although the treated group had higher percentages than the control group. Moreover, no significant differences were found for the mean percentages of pancreatic areas occupied by islets and for the pancreatic inflammatory infiltrate between the control and treated groups. Proteomic analysis showed large increases in histones H3 and, to a lesser extent, in histone acetyltransferases, concomitant with a decrease in enzymes involved in the formation of acetyl-CoA, besides many changes in proteins involved in several metabolic pathways, especially energy metabolism. The conjunction analysis of these data showed an attempt by the organism to maintain protein synthesis in the islets, even with the dramatic changes in energy metabolism. Our data suggests epigenetic alterations in the islets of NOD mice exposed to F levels comparable to those found in public supply water consumed by humans.

Comparison of the Fluoride Ion Release from Composite and Compomer Materials under Varying pH Conditions—Preliminary In Vitro Study

Fluoride prevents the demineralization and supports remineralization of enamel. It is important to maintain a constant low level of fluoride in the oral cavity at all times. Dental restorative materials that are used for this purpose contain NaF in their composition, which is a source of fluoride ions that diffuse into body fluids and surrounding tissues. Two such materials, the flowable composite material Wave (W) (SDI, Hamilton Parkway Itasca, Australia) and compomer material Freedom (F) (SDI, Hamilton Parkway Itasca, Australia), were studied in regards to their release of fluoride ions into various solutions imitating the oral environment: artificial saliva solution with the addition of hydrated calcium chloride (CaCl2) × 2H2O in the pH range of 4.5 and 5.5; artificial saliva free of calcium chloride in the pH range of 4.5, 5.5, 6.0, 7.0, and 7.5; deionized water; and saline solution. The results were assessed over a period of 7 days, i.e., 168 h. The Freedom (F) compomer showed the highest cumulative release of fluoride ions into artificial saliva solution at pH 4.5 (31.195 ± 10.461 μg F/mm2) and the lowest into saline solution (3.694 ± 1.115 μg F/mm2). The Wave (W) composite material revealed the highest cumulative release of fluoride ions into deionized water (7.982 ± 2.011 μg F/mm2); its lowest cumulative emission was observed in artificial saliva solution at pH 7.0 (1.391 ± 0.489 μg F/mm2). The amounts of released fluoride from the Freedom (F) compomer were considerably higher compared to the Wave (W) composite material. The ability to release the largest amounts of fluoride ions in an acidic environment results from the erosion of the surface layer. Different calcium content in available experimental and commercial artificial saliva preparations may influence the obtained results. Both the flowable Wave composite and Freedom compomer released more fluoride in an acidic environment with a pH of 4.5–5.5, but with different dynamics—Wave material had its maximum on the third day while Freedom on the first day of the experiment.

Fluoride in water, health implications and plant-based remediation strategies

Abstract The high prevalence of dental fluorosis and bone mineralization deficiency as a result of exposure to fluorides has increased in Kenya over the years due to consumption of water with elevated levels of fluoride. The World Health Organization (WHO) provides a guideline of 1.5 mg/L level of fluoride in drinking water. However, majority of studies carried out in Kenya over the last 40 plus years have indicated very high levels of fluoride in drinking water in various regions, with a prevalence in dental fluorosis observed in children and adults living in Rift valley and central regions due to basaltic and volcanic rocks. Unfortunately, this trend of fluoride-induced enamel changes has been observed in other regions such as Nairobi and Machakos which were originally presumed to contain low fluoride levels. This study sought to analyse the applicability of Maerua subcordata root powder (MSRP) in the removal of fluorides in borehole drinking water. Fresh Maerua subcordata roots were peeled to obtain the white flesh, chopped into small pieces, dried and ground into powder. The process parameters varied were; fluoride ion concentration [F−] (0–12 mg/L), adsorbent dosage (0–200 g/L) and equilibration time (30–240 min) [F−] were hence analysed before and after treatment using ion selective electrode (ISE) fluoride meter. Results indicated that MSRP is a viable plant in fluoride treatment with approximately 68% fluoride ion removal efficiency. An MSRP dosage of 200 g/L was found optimal in [F−] reduction while a 2 mg/L [F−] concentration recorded the highest reduction of [F−]. The optimal equilibration time was found to be 30 min. The results can be used to develop a low-cost column for treatment of high fluoride waters in rural areas using MSRP. Borehole samples were treated with MSRP using the optimized conditions; however their reduction levels were lower than the [F−] standards used. It is envisaged that with further modification and/or doping with zero-valent iron nanoparticles, it’s efficiency will be improved.

Fluoride toxicity: A tale of two sources

The aim of this study was to identify the cause and source of two patients’ clinical manifestations. Case#1 was a 47-year-old male with diffuse bone pain and weakness aggravated by exertion. Past medical history revealed two surgeries for a left fibular fracture with eventual resection of installed hardware. Current medications included: oxycodone, montelukast, and vitamin D3. Magnetic resonance imaging and x-ray showed L5–6 fusion and diffuse trabecular thickening. A pelvic bone biopsy showed features consistent with severe skeletal fluorosis. Case#2 was a 61-year-old male post-heart transplant patient. His medications included: cyclosporine A, prednisone, rosuvastatin, amlodipine, and voriconazole. He complained of joint pain, his alkaline phosphatase was 222 U/L (reference range 40–129 U/L), and his bone density scan showed periostitis. Fluoride was measured in heparinized-plasma in both patients using a fluoride ion-selective-electrode on an Orion™ Dual Star pH/ISE meter (Thermo Scientific). The analytical measurement range is 4.0–21.0 μmol/L with an upper reporting limit of 105 μmol/L. Case#1 and case#2 had plasma fluoride concentrations of 11.3 and 17.5 μmol/L, respectively (reference-range < 4 μmol/L). Fluoride is often added to drinking water, toothpastes, and mouth rinses to prevent dental cavities. While food generally contains low levels of fluoride, tea and seafood have been found to have higher levels. Several medications containing fluorine are used for treating skin diseases and cancer. Following ingestion, plasma concentrations peak within an hour and up to 50% is stored in bones/teeth while the rest is primarily eliminated in the urine. The average person ingests ∼2–3 mg fluoride per day with a recommended daily intake of 3–4 mg/day by the United States Department of Agriculture. Chronic ingestion exceeding 20 mg/day can pose a risk to bone health leading to denser brittle bones, joint pain, and limited joint movement. In case#1, the source of fluoride was identified as excessive consumption of strong black tea (> 10 servings per day). In case#2, voriconazole (trifluorinated antifungal) was associated with the development of excess fluoride and periostitis. Plasma fluoride testing can be useful for diagnosing acute environmental toxicity, as well as, monitoring those taking fluorine-containing drugs. Detailed patient histories are required to identify common (voriconazole) or less-common (tea) sources. Patient#1 limited his tea consumption to one cup/day and his fluoride levels returned to normal on follow-up three months later. Patient#2 was switched from voriconazole to itraconazole (nonfluorinated triazole) and fluoride levels returned to normal. Pain resolution or improvement was also noted in both cases.

Evaluation of dietary exposure to fluoride from fruit juices and nectars in children and adolescents

Fluoride is present in a multitude of foods, mainly in water, but fruit juices and nectars are also relevant dietary sources, not only because of their high water content but also because of the high consumption figures, especially in children and adolescents. Fluoride is a beneficial hormetin to prevent the appearance of cavities but in high exposures it can pose a health risk. The European Food Safety Authority (EFSA) has established a maximum Tolerable Intake Level (UL) between 0.1 and 0.12 mg/kg weight/day depending on age. The objectives of this study were to determine the fluoride content in 90 samples of fruit juices and nectars representative of the Spanish market and to estimate and evaluate the dietary exposure to fluoride from this dietary source in order to characterize the risk in different consumption scenarios. Variables such as the production area, the flavor and the type of production (ecological vs. conventional) have been considered in the analysis. Determination by potentiometry using a selective ion electrode has shown that soft drinks from fruit juices are the ones that contain less fluoride (0.19 mg/L) compared to juices from concentrate (0.43 mg/L) and nectars (0.36 mg/L). Organic juices and nectars are richer in fluoride. For each of the three consumption scenarios (200, 400 and 600 ml/day) the Estimated Daily Intakes (EDI) of fluoride are higher for juices from concentrate followed by nectars and juices. The consumption of 200 ml/day supposes 0.086 mg/L (5.73% of the UL); 0.038 mg/L (2.53% of the UL) and 0.072 mg/L (4.8% of the UL) of fluoride in the case of juices from concentrates, nectars and juices, respectively. It is recommended to moderate the consumption of these drinks, especially in children, and to choose refreshing fruit juice drinks due to their lower levels of fluoride, and to promote an improvement in the labeling of these products, incorporating the content of this anion in order to improve consumer information.

Comparative Study on Lake Chemical Parameters of Varanda and Ankarsol Ka Naka in Dungarpur District, Rajasthan

The present investigation was carried out to high-lights the comparative water quality status of two water bodies Varanda and Ankarsol ka Naka of district Durgapur. The Study was conducted during the post monsoon period. Limno-chemical parameters are important criteria for determining the suitability of water for fish production. Water quality was determined by various parameters like turbidity, water color, pH, alkalinity, hardness, calcium, nitrate, Fluoride DO, etc. On the basis of results of water quality parameters in general, reservoir, Akarsol ka Naka having much more dissolve oxygen 6.8 mg/l as compare to Varanda i.e., 5.6 mg/l. it was also recorded that Akarsol ka Naka has significant low level of fluoride 0.05 mg/l as compare to Varanda 0.35 mg/l. Other parameters were also observed that Akarsol ka Naka showed low concentration of Calcium 28.0 mg/l as compare to 60.0 mg/l Varanda. There was no significant amount of Nitrate content found in both the water bodies. These water bodies are rain fed with some limited catchment area and water level exhibits fluctuations in season to season. Thus the present study indicates that the Ankarsol ka Naka reservoir is more productive for fish culture as compare to Varanda reservoir.

Prevalence of Arrested Caries in Three Areas of South India with Different Groundwater Fluoride Levels: An Epidemiological Study.

BackgroundDental caries, though a progressive disease, if intervened early may become arrested, provided there is a change in the oral environment. One such factor which may lead to caries arrest is prolonged exposure to naturally available groundwater fluoride.AimThe aim of the study is to know the prevalence of arrested caries in three geographical areas with different levels of fluoride in groundwater and to attribute if there is any correlation between the natural high fluoride levels in groundwater and the prevalence of arrested caries.DesignA cross-sectional study is conducted on schoolchildren residing in three geographical areas of south India with high, moderate, and low groundwater fluoride levels. A total of 5,982 children, from all the three regions between the age-groups 5-9 years, are examined and 1,514 children with caries are included in the study. The teeth and surfaces with active and arrested caries are identified and recorded in a structured pro forma. All the data obtained was tabulated and subjected to statistical analysis.ResultsThe prevalence of arrested carious lesions is found to be significantly higher in areas with high groundwater fluoride level when compared to the other two areas.ConclusionIt can be concluded that the progression of caries in children residing in areas with high groundwater fluoride level is slow and gets arrested early in the presence of a high amount of fluoride.How to cite this articleMudusu SP, Jampanapally SR, Konda S, et al. Prevalence of Arrested Caries in Three Areas of South India with Different Groundwater Fluoride Levels: An Epidemiological Study. Int J Clin Pediatr Dent 2022;15(S-2):S186-S190.

A novel sustained release fluoride strip based Poly(propylene carbonate) for preventing caries

Low-level fluoride in the oral environment for a long sustained period is more effective for preventing caries. However, the current fluoride delivery methods have a short fluoride retention time and high-dose fluoride administration may increase the risk of dental fluorosis. This study developed a novel fluoride strip based poly(propylene carbonate) (PPC), which can improve oral fluoride retention for desirable anticaries effect with minimal side effects. The fluoride strips based PPC (NaF-PPC strips) with different fluoride contents (0, 1.25, 2.5 and 5 wt.%) were developed by melt-blending method. The physico-chemical characteristics, drug loading, drug release properties, remineralization and antibacterial efficacy and biocompatibility of NaF-PPC strips were investigated. The in vitro drug release studies indicated that fluoride release in a sustained manner with no initial burst release and approximately 100% of fluoride ions were released from PPC strips over 24 days. NaF-PPC strips exhibited excellent remineralization and antibacterial potential when fluoride content up to 5%. Combination with biocompatibility, 2.5% NaF-PPC strips could be a promising fluoride application for preventing caries. This work provides an effective and novel topical fluoride delivery for general use.

Pulp Polyp Exhibiting a Unique Worm-shaped Presentation in an Ectopic Deciduous Tooth: A Novel Case Report

Pulp polyp is a reactive lesion that occurs as a result of chronic long standing caries. Dental caries is common in children for a variety of reasons, including increased bacterial colonisation, frequent exposure to dietary sugars, improper bottle feeding technique, low community water fluoride levels, inadequate tooth brushing, and a lack of parental knowledge about oral health. Failure to treat such carious lesions during childhood will result in chronic long-term caries leading to pulpal necrosis or reactionary proliferations of pulpal tissue known as pulp polyp. Apart from caries, trauma can also lead to hyperplastic behaviour of the pulp. Pulp polyps are most commonly found in the molars due to their abundant blood supply, whereas their presence in the anterior teeth is considered uncommon. Pulp polyp can cause anxiety among parents when they spot it in their child’s oral cavity. This is due to the unique clinical appearance, discomfort while having food and occasional bleeding while irritated. This case report presents an unusual presentation of pulp polyp in an 11-years-old female patient with a chief complaint of pain, discomfort, and bleeding on irritation. Its peculiar worm-shaped clinical appearance in the anterior attached gingival region imposed a diagnostic dilemma which on histological examination was confirmed to be pulp polyp and was excised subsequently. Therefore, emphasises the fact that pulp polyps are not only limited to the occlusal surface of posterior teeth with a typical mushroom-shaped appearance but also have a wide range of presentations regardless of their location and appearance

Fluoride Exposure and Age of Menarche: Potential Differences Among Adolescent Girls and Women in the United States

Fluoride exposure is associated with later pubertal development and decreased testosterone production in adolescent and adult males. However, its effects on female reproductive health and pubertal development are unclear. Therefore, we examined associations of fluoride exposure with reproductive health outcomes among adolescent girls and women in the United States. Participants were from The National Health and Nutrition Examination Surveys (2013 to 2016), aged 16–19 and identified as female. There were 524 and 460 participants with measures of plasma fluoride and household tap water fluoride respectively, who had at least one reproductive health outcome examined, and complete covariate data. We applied covariate adjusted survey-weighted linear or logistic regression to examine associations of fluoride exposure with age of menarche, menstrual cycle regularity, or serum sex steroid hormone levels. Median interquartile range (IQR) water and plasma fluoride concentrations were 0.48 (0.53) mg/L and 0.34 (0.30) µmol/L respectively. An IQR increase in water fluoride was associated with a 3.3 month earlier first menstrual period (B = − 0.28, 95%CI − 0.54, − 0.02, p = 0.05). Additionally, we observed a significant interaction between plasma fluoride and race/ethnicity in association with age of menarche (p = 0.01). Among Non-Hispanic Black adolescents, each IQR increase in plasma fluoride was associated with a 5-month earlier age of menarche (B = − 0.42, 95%CI − 0.61, − 0.23, p < 0.001). Potential impacts of chronic low-level fluoride exposure on reproductive health outcomes are an important area of study. Current study findings, as well as potential health disparities due to disproportionate fluoride exposure should be examined in prospective studies.

Fluoride exposure during early adolescence and its association with internalizing symptoms

BackgroundEarly, chronic, low-level fluoride exposure has been linked to attention-deficit hyperactivity disorder (ADHD) and learning deficits in children. Rodent studies suggest a link between fluoride exposure and internalizing behaviors. No human studies have examined the impact of fluoride on internalizing behaviors during adolescence. ObjectiveEvaluate the relationship between urinary fluoride and early adolescent internalizing symptoms in the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS). MethodsParticipants in CCAAPS provided non-fasting spot urine samples at age 12 years (n = 286). Urine samples were analyzed using a microdiffusion method to determine childhood urinary fluoride (CUF) concentrations and were log-transformed for analyses. Caregivers of CCAAPS participants completed the Behavior Assessment System for Children-2 (BASC-2) at the age 12 study visit to assess internalizing symptoms (e.g., anxiety, depression, somatization), and a composite score of the three domains; T-scores ≥ 60 were used to identify adolescents in a clinically “at-risk” range. Race, age of the adolescent, household income, maternal age at birth, caregiver depression, caregiver-child relationships, and age 12-year serum cotinine concentrations were considered covariates in regression models. Sex-specific effects of fluoride exposures were investigated through the inclusion of interaction terms. ResultsHigher CUF concentrations were significantly associated with increased somatization (β = 3.64, 95% CI 0.49, 6.81) and internalizing composite T-scores in a clinically “at-risk” range (OR = 2.9, 95% CI 1.24, 6.9). Compared to females, males with higher CUF concentrations had more internalizing (pinteraction = 0.04) and somatization symptoms (pinteraction = 0.02) and were nearly seven times more likely to exhibit “at-risk” internalizing symptomology. CUF concentrations were not significantly associated with depression or anxiety symptoms. ConclusionsThis is the first study to link fluoride exposure and internalizing symptoms, specifically somatization. Somatization represents an interface of physical and psychological health. Continued follow-up will help shed light on the sex-specific relationship between fluoride and mental health and the role of somatization.