Risk Of Fluorosis Research Articles

Prevalence of fluorosis and identification of fluoride endemic areas in Manur block of Tirunelveli District, Tamil Nadu, South India

Prevalence of fluorosis is mainly due to the consumption of more fluoride through drinking water. It is necessary to identify the fluoride endemic areas to adopt remedial measures for the people under the risk of fluorosis. The objectives of this study were to identify the exact location of fluoride endemic areas in Manur block of Tirunelveli District and to estimate fluoride exposure level through drinking water for different age groups. Identification of fluoride endemic areas was performed through Isopleth and Google earth mapping techniques. Fluoride level in drinking water samples was estimated by fluoride ion selective electrode method. A systematic clinical survey conducted in 19 villages of Manur block revealed the rate of prevalence of fluorosis. From this study, it has been found that Alavanthankulam, Melapilliyarkulam, Keezhapilliyarkulam, Nadupilliyarkulam, Keezhathenkalam and Papankulam are the fluoride endemic villages, where the fluoride level in drinking water is above 1 mg/l. Consumption of maximum fluoride exposure levels of 0.30 mg/kg/day for infants, 0.27 mg/kg/day for children and 0.15 mg/kg/day for adults were found among the respective age group people residing in high fluoride endemic area. As compared with adequate intake level of fluoride of 0.01 mg/kg/day for infants and 0.05 mg/kg/day for other age groups, the health risk due to excess fluoride intake to the people of Alavanthankulam and nearby areas has become evident. Hence the people of these areas are advised to consume drinking water with optimal fluoride to avoid further fluorosis risks.

The pollution control of fluorine and arsenic in roasted corn in “coal-burning” fluorosis area Yunnan, China

Pilot experiments were carried out to reduce the fluorine (F) and arsenic (As) pollution of roasted corn dried by open ovens in “coal-burning” fluorosis area Yunnan, China. The results indicated that the average emission amount of F and As in briquettes in experimental group were 29.20mg/kg and 0.76mg/kg in Xiaolongdong, and 46.8mg/kg and 0.54mg/kg in Mangbu respectively. The results also indicated that the fixing rate of F and As in briquettes in experimental group was more than 4 times and 1.2 times of that in control group respectively. The average concentration of F and As in roasted corn in experimental group were 3.86mg/kg and 13.23μg/kg in Xiaolongdong, and 4.77mg/kg and 122.96μg/kg in Mangbu respectively, which reduced by more than 65% and 75% respectively compared with that in control group. Adding local natural calcium-based materials in briquettes can reduce the emission of F and As and their pollution on roasted corn largely, and thus will reduce the risk of fluorosis for residents greatly in “coal-burning” fluorosis area of southwestern China.

Comparison of dental esthetic perceptions of young adolescents and their parents

To compare dental esthetic perceptions of adolescents at age 13 with those of parents and to assess associations with dental fluorosis. Adolescents aged 13 underwent dental examinations for fluorosis on maxillary anterior teeth using the Fluorosis Risk Index. Adolescents and parents completed questionnaires concerning satisfaction with adolescents' dental appearance. McNemar and Bowker tests of symmetry were used for comparisons of esthetics ratings between parents and adolescents. Comparison of satisfaction between subjects with fluorosis and subjects with no fluorosis was made using Cochran-Armitage Trend and Fisher's Exact tests. From 376 adolescents included in the study, 26 percent had definitive fluorosis, mostly at a mild level. Fifteen percent of adolescents were dissatisfied with dental appearance, and concerns were mainly about color (45 percent) and alignment (35 percent). Adolescents were less satisfied with overall dental appearance (P < 0.001) and color (P = 0.048) and more concerned about tooth shape (P = 0.002) than were their parents. Fluorosis status (yes/no) was not significantly associated with adolescents' perceptions (P > 0.05). Parents of subjects with fluorosis were more dissatisfied with dental appearance (P = 0.014) and color (P < 0.001) than other parents. The number of maxillary anterior zones exhibiting fluorosis was negatively associated with adolescent (P = 0.03) and parent (P = 0.002) satisfaction. Adolescents generally had less satisfaction with dental appearance and color, and were more concerned with tooth shape than were parents. For both parents and adolescents, decreased satisfaction was associated with the number of zones with definitive fluorosis.

Riscos do uso do dentifrício fluoretado na prevenção e controle de cárie na primeira infância

Dentifrício fluoretado tem sido considerado responsável pelo declínio de carie dentária ocorrida tanto em países desenvolvidos quanto nos em desenvolvimento, como o Brasil. Entretanto, como as crianças involuntariamente ingerem certa quantidade de dentifrício quando escovam os dentes, há preocupação com a fluorose decorrente. Entretanto, o risco em potencial do dentifrício provocar fluorose tem sido estimado com base na dose de ingestão de fluoreto, considerando como limite a dose de 0,07 mg F/dia/kg de peso e não na fluorose decorrente. A dose de ingestão de fluoreto por dentifrícios tem sido superestimada, porque não considera quanto do fluoreto ingerido está biodisponível para ser absorvido e provocar fluorose. A falta de associação entre dose de ingestão e fluorose tem sido mostrada experimentalmente e comprovada epidemiologicamente pelo grau não preocupante de fluorose encontrado, possibilitando ratificar a importância da recomendação do uso de dentifrício fluoretado para o controle de cárie, sem grandes preocupações com possíveis efeitos colaterais.

Adolescents' perceptions of the aesthetic impact of dental fluorosis vs. other dental conditions in areas with and without water fluoridation

BackgroundThe use of fluorides for caries prevention is well established but is linked with an increased risk of dental fluorosis, some of which may be considered to be aesthetically objectionable. Patient opinion should be considered when determining impact on aesthetics. The aim of this study was to assess participant rating of dental aesthetics (from photographic images) of 11 to 13 year olds participating in an epidemiological caries and fluorosis survey in a fluoridated and a non-fluoridated community in Northern England.MethodsConsented participants were invited to rank in order of preference (appearance) a collage of 10 computer generated images on a touch-screen laptop. The images comprised an assortment of presentations of teeth that included white teeth, a spectrum of developmental defects of enamel and dental caries. Data were captured directly and exported into SPSS for analysis.ResultsData were available for 1553 participants. In general, there were no significant differences in the rank positions between the fluoridated and non-fluoridated communities, with the exception of teeth with caries and teeth with large demarcated opacities. Very white teeth had the highest rating in both localities. Overall, there was a trend for teeth with fluorosis to be ranked more favourably in the fluoridated community; for TF 1 and TF 2 this preference was significant (p < 0.001).ConclusionsThe results of this study suggest teeth that are uniformly very white have the highest preference. The rankings suggest teeth with a fluorosis score of TF 1 may not be considered aesthetically objectionable to this population and age group. The image depicting a tooth with caries and the image with large demarcated opacities were deemed to be the least favoured. Participant preference of images depicting fluorosis falls with increasing severity of fluorosis.

Examiner reliability of fluorosis scoring: a comparison of photographic and clinical examination findings

To assess and compare examiner reliability of clinical and photographic fluorosis examinations using the Fluorosis Risk Index (FRI) among children in the Iowa Fluoride Study (IFS). The IFS examined 538 children for fluorosis and dental caries at age 13 and obtained intraoral photographs from nearly all of them. To assess examiner reliability, duplicate clinical examinations were conducted for 40 of the subjects. In addition, 200 of the photographs were scored independently for fluorosis by two examiners in a standardized manner. Fluorosis data were compared between examiners for the clinical exams and separately for the photographic exams, and a comparison was made between clinical and photographic exams. For all three comparisons, examiner reliability was assessed using kappa statistics at the tooth level. Interexaminer reliability for the duplicate clinical exams on the sample of 40 subjects as measured by kappa was 0.59, while the repeat exams of the 200 photographs yielded a kappa of 0.64. For the comparison of photographic and clinical exams, interexaminer reliability, as measured by weighted kappa, was 0.46. FRI scores obtained using the photographs were higher on average than those obtained from the clinical exams. Fluorosis prevalence was higher for photographs (33 percent) than found for clinical exam (18 percent). Results suggest that interexaminer reliability is greater and fluorosis scores are higher when using photographic compared with clinical examinations.

Evaluation of fluoride bottled water and its incidence in fluoride endemic and non endemic areas

Summary Background & aims Water is a vital element for hydratation of the human body. Access to drinking water of good quality became a real problem in many areas of the world and more particularly in Algeria. In the eastern zone of northern Sahara, several epidemiological investigations have revealed the existence of an endemic fluorosis problem associated to excess of fluoride in drinking water. However, in some areas of North Algeria, the prevalence of tooth decay is estimated at 67% in school-children that consume low fluoride water. Thus, the best choice for the population is to consume the local mineral or spring bottled waters although they are expensive. Considering the large variety of the sources of bottled waters in Algeria and the lack of data regarding fluoride content in these waters, it becomes essential to evaluate the fluoride concentration of the consumed water, in order to ensure its benefits on the prevention of caries without incurring the risk of dental or osseous fluorosis. Thus, the aim of this study is to determine the fluoride concentration in bottled waters sold in Algerian market and compare with the stated value in the label. Methods Twenty nine commercial brands of bottled waters were collected from various markets in Algeria. Potentiometric method using a fluoride selective ion electrode (ELIT 8221F − 41936) is carried out to evaluate fluoride content of the water samples. Three readings were taken for each brand and the average was estimated and also compared with the fluoride content printed on the label. Results The obtained results revealed that the fluoride concentration of Algerian bottled waters is ranged from 0.19 ± 0.02 to 1.07 ± 0.026 mg/L. Almost half of the bottled waters (48.28%) did not exceed 0.5 mg F − /L and 37.93% were weakly fluoridated (≤0.3 mg F − /L). Only three (3) among twenty nine (29) brands of bottled waters tested have specified the fluoride concentration on their labels. Conclusions The results show that Algerian bottled waters can be regarded as a relevant source of dietary fluoride. Significant differences were found in fluoride concentration of bottled waters tested. These data are essential to consumer and all health care professionals especially dentists.

External control of the public water supply in 29 Brazilian cities

The fluoridation of public water supplies is considered the most efficient public health measure for dental caries prevention. However, fluoride levels in the public water supply must be kept constant and adequate for the population to gain preventive benefit. The aim of this study was to analyze fluoride levels in the public water supply of 29 Brazilian municipalities during a 48-month period from November 2004 to October 2008. Three collection sites were defined for each source of municipal public water supply. Water samples were collected monthly and analyzed at the Research Laboratory of the Nucleus for Public Health (NEPESCO), Public Health Postgraduate Program, Araçatuba Dental School (UNESP). Of the 6862 samples analyzed, the fluoride levels of 53.5% (n = 3671) were within the recommended parameters, those of 30.4% (n = 2084) were below these parameters, and those of 16.1% (n = 1107) were above recommended values. Samples from the same collection site showed temporal variability in fluoride levels. Variation was also observed among samples from collection sites with different sources within the same municipality. Although 53.5% of the samples contained the recommended fluoride levels, these findings reinforce the importance of monitoring to minimize the risk of dental fluorosis and to achieve the maximum benefit in the prevention of dental caries.

Overview of fluoride distribution in major aquifer units of northern Nigeria

Symptoms of dental fluorosis such as mottled teeth are common among adults, youth and children in several rural communities in northern Nigeria. This has inspired the Authors to investigate the concentration of fluoride in the natural water systems of the major aquifer units (Basement, Sedimentary, Volcanic and Younger Granites) in some parts of northern Nigeria and to delineate areas of high risk of dental fluorosis, crippling skeletal fluorosis and dental caries. Six hundred and twenty seven analytical values for water were obtained from the literature and from analysis of samples from the major aquifer units of northern Nigeria: Basement-232, Sedimentary-328, Younger Granites-38 and Volcanic-28. Fluoride concentrations range from 0.03 to 10.30 mg/L in the Basement Aquifer; 0.00 to 5.00 mg/L in the Sedimentary Aquifer; 0.00 to 0.89 mg/L in the Younger Granites Aquifer; and 0.00 to 0.78 mg/L in the Volcanic Aquifer. A background value of 1.0 mg/L for fluoride concentration for northern Nigeria has been determined in this study. Areas identified with high fluoride in their waters above the World Health Organisation (WHO) recommended maximum permissible level in drinking water of 1.5 mg/L are: Dzuma, Dilchidima, Ngalbi, Udin, Kaltungo Biliri, Shongwom, Dass in the the northeast basement aquifers; Maiduguri, Mafa, Mobbar, Ngala, Logomani, Gombe in the northeast sedimentary aquifers: Langtang, Dorong, Furzi in the north-central basement aquifers and Pakoro in the northcentral sedimentary aquifers: Shawo and Barkin Lamba in the northwest basement aquifers. No anomalously high values of fluoride were recorded in the northwest sedimentary aquifers. All waters sampled in the Younger Granites and the Volcanic Aquifers have fluoride contents lower than the WHO recommended maximum permissible level in drinking water of 1.5 mg/L; and over ninety percent of the waters have fluoride concentration below the 0.5 mg/L recommended by WHO for the prevention of dental caries. Positive correlation between dental fluorosis and high fluoride water consumption has been established in all the areas with high fluoride in their waters. Positive correlation has also been established between genu valgum (bowing of legs) and consumption of high fluo-ride waters in Langtang Area. These data have been used to delineate areas of the Younger Granites Province and the Volcanic Province where inhabitants are at high risk of having dental caries.

Ingestion of Fluoride from Dentifrices by Young Children and Fluorosis of the Teeth - A Literature Review

The ADA recommends the use of fluoridated dentifrices as soon as the primary teeth erupt, so as to reduce the incidence of dental caries. However young children can ingest a significant amount of dentifrice during normal toothbrushing; this is a potential problem because the permanent teeth are at risk from fluorosis for the first seven years of life. the objective of this paper was to review the literature on the role of fluoride dentifrices in causing dental fluorosis. a search for literature was performed using MEDLINE, OVID with the key words fluorosis, dentifrice, ingestion, and children. The search was limited to English language publications. Subsequently, 31 articles were retrieved, additional relevant articles were collected from the references cited in the initially identified papers. Ultimately, 96 articles were retrieved for review. Fluoride, should be used with caution so that the benefits out-way the adverse affects. Oral health care providers need to systematically assess individual tooth brushing habits and emphasize the advantages of early use of a fluoridated dentifrice whilst still meeting the need for the prudent use of small quantities of dentifrice. Dentifrices with a low concentration of fluoride may be appropriate for young children who are considered to be at low caries risk and the risk of fluorosis is minimal for children who ingest this dentifrice; nevertheless, it appears that more research is still required on the therapeutic effects of fluoride dentifrices which contain fluoride at a low concentration.

The comparison study of Fluoride kinetics in saliva after the use of chewing gums containing different fluoride compounds In Iraqi subjects

There is a relationship between the use of fluoride, the reduction of dental caries and the increase of dental fluorosis. The purpose of this study was to analyze the fluoride kinetics in saliva after using two commercially available chewing gums with fluoride, which contains (3.38) mg of fluoride as marketed Sodium monofluorophosphate (NaMFP) and sodium fluoride (NaF) which are the two most common sources of fluoride used in currently fluoride dentifrices.Fifteen 7-9 year-old volunteers were instructed to chew the fluoridated gums. Total saliva was collected, at 0, 3, 6, 9 and 15 minutes after 3 minutes starting chewing. Salivary fluoride was analyzed with a fluoride-specific electrode (201 Fluoride E. HANNA instruments) after acid hydrolysis.The fluoride amount in the saliva samples after the use of chewing gum which contains Sodium monofluorophosphate (NaMFP) was 0.4 mg which higher than after the use of chewing gum contains sodium fluoride (NaF) which was 0.041mg in all experimental periods, The high fluoride presence in saliva after the use of chewing gum of (NaMFP) is significant to prevent dental caries and this should be evaluated in clinical researches. On the other hand, children at an age of risk for dental fluorosis should avoid the use of this kind of chewing gums.

Fluoride Intake of Japanese Infants from Infant Milk Formula

This study aimed to measure the fluoride (F) content of all infant milk formulas (IMF) available for purchase in Japan and estimate the F exposure of infants whose primary source of nutrition is IMF when reconstituted with different F concentrations of water. Twenty-two commercially available IMFs were purchased from 6 manufacturers in Japan. These IMFs included 21 milk-based products and 1 soy-based product. Each IMF was reconstituted using distilled water and 0.13 µg F/ml fluoridated water according to the manufacturers’ instructions. The F concentrations in each sample were measured using the hexamethyldisiloxane diffusion technique and an F ion-selective electrode. The mean F concentration of all products was 0.41 (range 0.15–1.24) µg/g. There were no statistically significant differences among mean F concentrations of newborn milks, follow-on milks and other milks or among manufacturers. The mean F concentration of all products, when reconstituted with distilled water and 0.13 µg F/ml water, was 0.09 and 0.18 µg/ml, respectively. The mean F intake from IMF ranged from 0.039 to 0.134 mg/day with distilled water and from 0.078 to 0.258 mg/day with 0.13 µg/ml fluoridated water, respectively. These results suggested that F intake of infants from IMFs depended on the F concentration of added water, and therefore the risk of dental fluorosis for most Japanese infants would be small since most Japanese municipal water supplies are low in F. However, there was a possibility to exceed the tolerable upper intake level, even under the limit of the law, especially for infants within the first 5 months of life.

Comparison between observed children's tooth brushing habits and those reported by mothers

BackgroundInformation bias can occur in epidemiological studies and compromise scientific outcomes, especially when evaluating information given by a patient regarding their own health. The oral habits of children reported by their mothers are commonly used to evaluate tooth brushing practices and to estimate fluoride intake by children. The aim of the present study was to compare observed tooth-brushing habits of young children using fluoridated toothpaste with those reported by mothers.MethodsA sample of 201 mothers and their children (aged 24-48 months) from Montes Claros, Brazil, took part in a cross-sectional study. At day-care centres, the mothers answered a self-administered questionnaire on their child's tooth-brushing habits. The structured questionnaire had six items with two to three possible answers. An appointment was then made with each mother/child pair at day-care centres. The participants were asked to demonstrate the tooth-brushing practice as usually performed at home. A trained examiner observed and documented the procedure. Observed tooth brushing and that reported by mothers were compared for overall agreement using Cohen's Kappa coefficient and the McNemar test.ResultsCohen's Kappa values comparing mothers' reports and tooth brushing observed by the examiner ranged from poor-to-good (0.00-0.75). There were statistically significant differences between observed tooth brushing habits and those reported by mothers (p < 0.001). When observed by the examiner, the frequencies of dentifrice dispersed on all bristles (35.9%), children who brushed their teeth alone (33.8%) and those who did not rinse their mouths during brushing (42.0%) were higher than those reported by the mothers (12.1%, 18.9% and 6.5%, respectively; p < 0.001).ConclusionsIn general, there was low agreement between observed tooth brushing and mothers' reports. Moreover, the different methods of estimation resulted in differences in the frequencies of tooth brushing habits, indicative of reporting bias. Data regarding children's tooth-brushing habits as reported by mothers should be considered with caution in epidemiological surveys on fluoridated dentifrice use and the risk of dental fluorosis.

Tea fluoride concentration and the pediatric patient

The purpose of this study was to measure the fluoride concentrations of various commercially available tea infusions, with a specific focus on risk of fluorosis. 100ml infusions of 43 different tea brands were kept at a constant temperature of 85°C and measured for fluoride concentration at 5, 15, 30, 60, and 120min using a fluoride ion-specific electrode and millivolt meter. After 5min at 85°C mean fluoride concentration, in μg/ml with standard deviation, was 2.08±1.24 for caffeinated tea infusions, 4.38±0.97 for decaffeinated tea infusions, and 0.05±0.02 for herbal teas. Caffeinated teas derived from the traditional source, Camellia sinensis, demonstrated significantly higher concentrations of fluoride than herbal teas (p<0.01). Furthermore, decaffeinated teas demonstrated significantly higher concentrations of fluoride than caffeinated teas (p<0.01). Some tea infusions may place a pediatric patient at higher risk for fluorosis if consumed as the primary source of hydration.

Assessing and managing fluorosis risk in children and adults in rural Madhya Pradesh, India

This paper presents the application of quantitative chemical risk assessment for assessing and managing fluorosis in 19 schools and 6 villages in Madhya Pradesh, India. A longitudinal study was undertaken with a baseline survey in 2005 and an endline in 2007. Household surveys, water quality and food analysis were undertaken to measure the impact of an Integrated Fluorosis Mitigation programme that included water and nutritional interventions. The baseline survey indicated a maximum fluoride content of 7.8 mg/l in food and 3.7 mg/l in water, equating to a maximum fluoride uptake of 4.8 and 3.7 mg/l in food and water respectively. Mean (actual) daily intake of fluoride for all exposure routes was 0.4 mg/kg of combined adult and child body weight. Intake of fluoride through food was more than 40% of total intake. Calculated guideline values for age groups &amp;lt;18 years and &amp;gt;18 years were 1.7 and 1.9 mg/l respectively. Using WHO methodology, the Guideline Value would be 1.7 mg/l. Fluoride dilution was implemented to reduce the fluoride content to below this level. The endline survey indicated reduction in the prevalence of grade 1 fluorosis of 86%, of grade 2 of 77%, of grade 4 of 60% in all children examined.

Amoxicillin use during early childhood and fluorosis of later developing tooth zones

Amoxicillin use has been reported to be associated with developmental defects on enamel surfaces. This analysis assessed the association between amoxicillin use and fluorosis on late-erupting permanent teeth. As part of the Iowa Fluoride Study, subjects were followed from birth to 32 months with questionnaires every 3-4 months to gather information on fluoride intake and amoxicillin use (n = 357 subjects for this analysis). Permanent tooth fluorosis on late-erupting zones was assessed by three trained dentists using the fluorosis risk index (FRI) at approximately age 13. A case was defined as fluorosis if a subject had at least two FRI classification II zone scores of 2 or 3. Chi-square tests and logistic regression were used, and relative risks (RRs) and odds ratios (ORs) were calculated. There were 113 cases and 244 controls. In bivariate analyses, amoxicillin use from 20 to 24 months significantly increased the risk of fluorosis on FRI classification II zones [44.2 percent versus 30.4 percent, [RR = 1.45, 95 percent confidence interval (CI) 1.05-2.04], but other individual time periods did not. Multivariable logistic regression confirmed the increased risk of fluorosis for amoxicillin use from 20 to 24 months (OR = 2.92, 95 percent CI = 1.34-6.40), after controlling for otitis media, breast-feeding, and fluoride intake. Amoxicillin use during early childhood could be a risk factor in the etiology of fluorosis on late-erupting permanent tooth zones, but further research is needed.

Dietary fluoride intake from infant and toddler formulas in Poland

Risk of enamel fluorosis associated with excessive fluoride intake during infancy and early childhood has been widely reported in literature. Results of several studies indicate that infant formula consumption, especially in the form of powdered concentrate, may appreciably increase children’s fluoride exposure in optimally fluoridated communities. The aim of the study was to measure fluoride content of infant and toddler formulas available in Poland and to discuss implications of the results. Twenty nine brands of powdered formulas were evaluated. Analyzes were performed with the use of ionselective fluoride electrode (09-37 type) and a RAE 111 chloride-silver reference electrode (MARAT). Results revealed that concentration of fluoride in all products was low (mean 29.0μg/100g), and that the formula itself is not a significant source of fluoride exposure. However, when reconstituted with water containing more than 0.5ppm of fluoride, starting formulas and follow-on formulas may provide a daily fluoride intake of above the suggested threshold for fluorosis. Thus, fully formula-fed infants consuming mother milk substitutes prepared with optimally fluoridated water may be at increased risk of dental fluorosis.

Cochrane review: Topical fluoride as a cause of dental fluorosis in children

Cochrane review: Topical fluoride as a cause of dental fluorosis in children

Quality of drinking water fluoridation of Capão Bonito, SP, Brazil, evaluated by operational and external controls

PURPOSE: To evaluate the quality of drinking water fluoridation of Capao Bonito, SP, Brazil, whose optimal fluoride concentration should be between 0.6 to 0.8 ppm F, considering the balance benefits/risks. METHODS: Historical records (n=1,964) from 2005 to 2009 of the water treatment plant (operational control) were evaluated. Also, from July 2009 to June 2010, 120 samples of the network water were collected for analysis and the fluoride concentrations found (external control) were compared with records of operational control of the same period. RESULTS: According to the historical records, 76.3% of the samples had acceptable fluoride concentration and this value was confirmed by the external control done during one year, which found that 80.8% of samples were within the optimal range. However, considering the samples out the optimal range, while the records of the operational control showed values below the minimum, the results of the external control found higher percentage of samples above the maximum. CONCLUSION: The data show the relevance to have a quality control of drinking water fluoridation because at same time the operational control analysis suggests that certain percentage of the population would not be receiving anticaries benefits, the external control indicates that it would be in increased risk of fluorosis.

Fluorine in Water and Dental Fluorosis in a Community of Queretaro State Mexico

The community La Llave, Queretaro State, Mexico, has not been identified by the sanitary authorities as living in a hazard area related to dental fluorosis. However; a high concentration of fluoride is found in their drinking water causing them dental fluorosis. Physical-chemical analysis was carried out in the groundwater sources to determine the prevalence of dental fluorosis risk and caries accordingly to criteria of The World Health Organization, and 154 school children of ages 10 to 13 years were examined. As a result, 1.9 mg/L of fluorine concentration in drinking water was obtained; dental fluorosis presence was detected in the school children with an incidence of about 98%, in 47% of cases severe fluorosis with a dental caries index of 3.06 was traced. The groundwater sources in La Llave community contains fluorine above the limits dictated by Mexican regulations, producing serious repercussions on the health of school children, with an unnaturally high incidence of dental fluorosis.