Optimal Fluoride Area Research Articles

Therapeutic application of fluoride varnish

Fluoride is the safest, economical, and effective tool for the prevention of dental caries. Food and Drug Administration has listed fluoride as an essential nutrient for human health. The World Health Organization (WHO) expert committee has included fluoride in its list of 14 trace elements that are essential for normal growth and development. Approximately half the population of the USA is consuming optimally fluoridated water since 1980 and countries like the UK, New Zealand, and Australia are protected by water fluoridation. In India, the preventive measures are not so effective and the caries incidence is still on the rise. The average DMFT in India by the age of 15 years is about 3. This high incidence could also be attributed to a low dentist–population ratio of 1:80,000 in India. According to WHO, the DMFT of 2 by the age of 15 should cause alarm. The answer for this health problem is prevention. Although many measures are available, the best option is to use systemic and topical fluorides. Approximately 5% of the population lives in endemic fluoride areas and 3% lives in optimal fluoride areas. About 85%–90% of the population lives in fluoride deficient areas and preventive measures should be directed toward this segment of the population. The use of fluoride in communal water supply and dentifrices does not interfere with normal oral hygiene measures. Fluorides in dentifrices had led to the decrease in the incidence of dental caries in the US, UK and Scandinavia.

Prevalence of malocclusion among 15-year-old school children using dental aesthetic index in Nalgonda district, Andhra Pradesh, India: A cross-sectional study

Background: The available literature on the prevalence of malocclusion among school children in endemic fluoride areas in India is scanty. Objectives: The objective was to assess the prevalence of malocclusion using dental aesthetic index (DAI) and its association with gender, area of residence, and fluoride concentration among 15-year-old school children. Materials and Methods: This cross-sectional study was conducted among 15-year-old school children in the rural and urban areas of Nalgonda district, Andhra Pradesh, India. Two-stage cluster sampling was used for selecting the eligible children. Six out of 59 mandals in Nalgonda district were selected by simple random sampling technique. All the secondary schools in rural and urban areas of these mandals were listed and subsequently, four schools from each of these mandals were selected using random sampling. All eligible children aged 15 years were selected and assessed for malocclusion using Dentofacial anomalies with criteria of DAI by three trained and calibrated dentists. The DAI in relation to gender and area of residence were compared and analyzed using SPSS 16. Student's t-test and one-way ANOVA were used for comparing the mean values between groups. The qualitative data were analyzed using the Chi-square test. Results: A total of 1484 children was examined. The prevalence of malocclusion was 17.9%. The prevalence was significantly higher (P = 0.001) among females (23.6%) compared to males (13%). The prevalence was significantly higher (P = 0.001) in urban areas (22.2%) compared to rural areas (15%). The prevalence was significantly less (P = 0.001) in optimal (13%) and above optimal areas (8%) compared to below optimal areas (23%). Conclusion: The prevalence and severity of malocclusion were more among females, urban, and below optimal fluoride areas.

Prevalence of dental caries and dental fluorosis among 12 and 15 years old school children in relation to fluoride concentration in drinking water in an endemic fluoride belt of Andhra Pradesh

The published literature on the prevalence and severity of dental caries and dental fluorosis among school going children in Nalgonda district - An Endemic Fluoride belt was lacking . To assess the prevalence and severity of dental fluorosis and dental caries among 12 and 15 years old children in relation to fluoride concentration in drinking water . It was a cross-sectional study, done in Nalgonda district of Andhra Pradesh, India (endemic fluoride belt) . 5 of the 59 mandals in the district of Nalgonda were selected by simple random sampling. Then, 3 schools from each of these selected mandals were chosen at random. All the eligible 6 th and 9 th standard children were considered for final analysis. The demographic and other relevant information was collected by 3 trained and calibrated dentists, using a structured questionnaire. Dental caries were recorded using dentition status and treatment needs and fluorosis were recorded by Dean's fluorosis index. The statistical analysis was done using SPSS version 16. The prevalence of dental caries among children was 56.3% with the highest in below optimal fluoride area (71.3%) and lowest in optimal fluoride area (24.3%). The prevalence of dental fluorosis was 71.5%. The prevalence was 39.7% in below optimal fluoride area and 100% in high and very fluoride areas. The prevalence and severity of fluorosis increased with increasing fluoride concentration. The caries experience was more among boys than girls. There was a negative correlation between dental caries and fluoride concentration for the entire study population. However, in high fluoride areas, there was a positive correlation between fluoride concentration and dental caries. Water defluoridation on an urgent basis is a priority here than water fluoridation, because the prevalence and severity of dental flurorosis is very high.

Sex determination using mandibular canine index in optimal-fluoride and high-fluoride areas

Objectives: The objective of this study was to find out if exposure since birth to a naturally fluoridated drinking water supply has any impact on sexual dimorphism as assessed by measurement of the mandibular canine index. Materials and Methods: Children from two areas were selected for the study: Aaspur (Dungarpur) and Chikhalwas (Udaipur), which are high-fluoride (4.0 ppm) and optimal-fluoride (1.1 ppm) areas, respectively. Data were obtained from 145 school children in the 14-15 year age-group. Of these, 75 were from the high-fluoride area and 70 were from the optimal-fluoride area. Alginate impressions of the mandibular arch were made for all subjects and these were poured immediately in type IV dental stone to minimize dimensional shrinkage. The parameters considered were canine width, intercanine distance, and mandibular canine index. All the measurements were recorded using a modified vernier calipers and divider. Data were statistically analyzed using SPSS/PC+ (SPSS Inc., Illinois, USA). Results: Significant differences were found between optimum-fluoride and high-fluoride areas in all the considered parameters except for the right canine width and the intercanine distance. Standard mandibular canine index is a quick and easy method for determining sex. Conclusion: Fluoride level does not have any particular impact on assessment of sexual dimorphism using the mandibular canine index.

The effect of domestic water filters on water fluoride content.

The effect of filtration on water fluoride level was investigated in a study using commercially available filters. Testing was carried out in London (low fluoride), Braintree (optimum fluoride, naturally occurring) and Birmingham (optimum fluoride, artificially adjusted). It was found that none of the filters removed fluoride. In Birmingham, but not in either Braintree or London, there was a small, clinically insignificant increase in fluoride levels with filtration using two of the five filters. It is concluded that the water filtration systems tested will not affect the advantage offered by optimum water fluoride levels. Fluoride dietary supplements should not be prescribed for children living in optimal fluoride areas, irrespective of whether they use household filters.

Caries incidence in relation to salivary mutans streptococci and fluoride varnish applications in preschool children from low- and optimal-fluoride areas.

Caries incidence during a 2-year period was studied in 4- to 5-year-old children from three areas with contrasting levels of natural fluoride (F) in the drinking water and different regimens of topical fluoride varnish applications; group A (n = 448) was from an area with a low level of F (0.1 ppm) and semi-annual applications of fluoride varnish; group B (n = 374) was from a low F area (0.1 ppm) and no fluoride varnish treatments; group C (n = 206) was from an area with optimal F (1.2 ppm) and fluoride varnish treatments. All children were clinically assessed at baseline and after 2 years according to WHO criteria. The number of salivary mutans streptococci was estimated and scored at baseline and after 2 years with the Strip mutans method. The varnish containing 0.1% F was applied every 6 months on all accessible tooth surfaces after cleaning with a pumice paste. Basic preventive care was given to all children and restorative treatment on individual indications. Higher levels (p < 0.05) of salivary mutans streptococci were found in the low-fluoride areas compared to the optimal fluoride area at baseline and after 2 years. The caries incidence (mean dft +/- SD) in the different groups was A: 0.65 +/- 1.40; B: 1.09 +/- 1.85; C: 0.53 +/- 1.09. The difference between group B and groups A and C was statistically significant (p < 0.05). A positive relationship (p < 0.05-0.001) between salivary mutans streptococci scores at baseline and caries incidence was found in all three groups. This study confirms the close association between salivary mutans streptococci and caries incidence in preschool children and suggests a caries-reducing effect of topical applications of the fluoride silane varnish.

Prevalence of dental caries and dental fluorosis in areas with negligible, optimal, and above-optimal fluoride concentrations in drinking water

The prevalence of dental caries and dental fluorosis was assessed in 1,123 children aged 8 to 16 years who were lifelong residents of areas with negligible, optimal, and above-optimal concentrations of natural fluoride in drinking water. Caries prevalence in the optimal fluoride area was 38.1% lower than it was in the negligible fluoride area, and, in the higher-than-optimal fluoride areas, even greater caries protection was evident. Caries protection was compromised in children with severe fluorosis. Findings do not support the contention that definite increases in the prevalence of fluorosis are occurring in communities with negligible and optimal water-fluoride concentrations because of increased total fluoride consumption from various sources.

A new method for assessing the prevalence of dental fluorosis—the Tooth Surface Index of Fluorosis

A new index for measuring the prevalence of dental fluorosis, the Tooth Surface Index of Fluorosis (TSIF), was used to assess the condition in the permanent teeth of 807 children, aged 8 to 16, who had resided all their lives in one of seven Illinois communities with an optimal concentration of fluoride in its water or with 2, 3, or 4 times the optimal concentration. Fluorosis was absent in 84.5% of all tooth surfaces examined in the community with optimal fluoride. In contract, only 31.9% of tooth surfaces had no fluorosis in the community with 4-times the optimal fluoride level. In the optimal fluoride area, 79% of facial surfaces of maxillary anterior teeth, which are esthetically conspicuous, had no fluorosis, whereas only 15.8% of these surfaces in the 4-times optimal area were unaffected. The percentages of all tooth surfaces affected by fluorosis characterized by staining, pitting, or both were 1%, 8%, 19%, and 38%, respectively, in communities with 1-, 2-, 3-, and 4- times optimal fluoride. Differences in fluorosis based on maximum score for all tooth surfaces in a child were statistically significant (an extended chi 2 statistic) among all communities. First molars and incisors in children 8 to 10 years old were affected by more fluorosis than were the same teeth in children 13 to 16 years old. These teeth had been erupted for about 5 years longer in the older age group. The difference might result from abrasion or remineralization of these teeth in the older children or from greater consumption of fluoride by the younger children during tooth development.(ABSTRACT TRUNCATED AT 250 WORDS)

Prevalence of Dental Caries and Dental Fluorosis in Areas with Optimal and Above-Optimal Water Fluoride Concentrations

The prevalence of dental caries and dental fluorosis was assessed among 807 schoolchildren in four areas of Illinois where the respective water supplies contained natural fluoride at concentrations of 1, 2, 3, and 4 times the recommended optimal for the geographic area. Mean caries scores in all three above-optimal fluoride areas were significantly lower than in the optimal area. The prevalence of dental fluorosis was characteristically low in the optimal fluoride area. Substantial increases in fluorosis occurred in the above-optimal fluoride areas, with the condition being most pronounced in the 4-times optimal area.

Influence of fluoride in surface enamel and degree of dental fluorosis on caries development in vitro.

The aim of the present study was to investigate the influence of surface enamel on the susceptibility of the tissue to acid attack by exposing both unabraded and abraded surfaces to an identical artificial caries system. Enamel from teeth developed in ‘low’, ‘optimal’ and ‘high’ fluoride areas was used for the experiment and the fluoride content of the surface enamel under test was sampled. Results confirmed the protective nature of surface enamel and the resistance of the fluorosed tissue to the artificial caries process. However, no difference was found between enamel from low and optimal fluoride areas in either the fluoride content of the surface enamel or its susceptibility to acid attack. It is, therefore, suggested that the cariostatic effect of fluoride in optimal fluoride areas may well be a result of its topical effect.

Fluoride content of prepackaged fruit juices and carbonated soft drinks.

Epidemiological studies have established the beneficial effects of water fluoridation. Present dietary trends, however, indicate that many Australian children may consume more prepackaged fluids than actual tap water. The fluoride concentrations of a selection of carbonated soft drinks and prepackaged fruit juices were investigated. The results indicate that, in an optimal fluoride area such as Sydney, children who consume a consistent and large proportion of their fluids as carbonated soft drinks in cans, fruit juices and fruit drinks may not be receiving the full benefit of the water fluoridation.

Self-application of fluoride as a community preventive measure: rationale, procedures, and three-year results

Results after three years of two clinical trials in which a fluoride self-application treatment program was administered to schoolchildren confirm the caries-reducing benefits of the program. The rationale and procedures for conducting the program are given. The semiannual supervised self-application of a prophylactic paste, containing 9% stannous fluoride, in school programs, resulted in a statistically significant protective effect against the development of caries. The rationale and detailed procedures for implementing and conducting self-application treatment programs with a stannous fluoride paste are presented. The results observed with the semiannual use of this treatment procedure for a three-year period in children 6 to 14 years of age who were lifetime residents of an optimal fluoride area indicated a significant reduction in the incidence of dental caries of 30.1% and 24.7% as expressed by DMF teeth and surfaces, respectively. If only the teeth that erupted during the study period were considered, the magnitude of the protective effect was 38.4%. The findings in a similarly designed study involving children living in a fluoride-deficient community indicated that the treatments resulted in significant reductions in DMF teeth and surfaces of 31.6% and 37.4%, respectively. In this instance, 37.0% fewer lesions were observed in the teeth that erupted during the study. These findings indicate that this procedure should be considered in public health programs as a means of contributing to the control of dental caries.