Factors Associated to Endemic Dental Fluorosis in Brazilian Rural Communities

Abstract

The present paper examines the relationship between hydrochemical characteristics and endemic dental fluorosis, controlling for variables with information on an individual level. An epidemiological survey was carried out in seven rural communities in two municipalities in the state of Minas Gerais, Brazil. The Thystrup & Fejerskov index was employed by a single examiner for the diagnosis of dental fluorosis. A sampling campaign of deep groundwater in the rural communities of interest was carried out concomitantly to the epidemiological survey for the determination of physiochemical parameters. Multilevel modeling of 276 individuals from seven rural communities was achieved using the non-linear logit link function. Parameters were estimated using the restricted maximum likelihood method. Analysis was carried out considering two response variables: presence (TF 1 to 9) or absence (TF = 0) of any degree of dental fluorosis; and presence (TF ≥ 5—with loss of enamel structure) or absence of severe dental fluorosis (TF ≤ 4—with no loss of enamel structure). Hydrogeological analyses revealed that dental fluorosis is influenced by the concentration of fluoride (OR = 2.59 CI95% 1.07–6.27; p = 0.073) and bicarbonate (OR = 1.02 CI95% 1.01–1.03; p = 0.060) in the water of deep wells. No other variable was associated with this prevalence (p > 0.05). More severe dental fluorosis (TF ≥ 5) was only associated with age group (p < 0.05). No other variable was associated to the severe dental fluorosis (p > 0.05). Dental fluorosis was found to be highly prevalent and severe. A chemical element besides fluoride was found to be associated (p > 0.05) to the prevalence of dental fluorosis, although this last finding should be interpreted with caution due to its p value.

Dental fluorosis, fluoride in urine, and nutritional status in adolescent students living in the rural areas of Guanajuato, Mexico

“…Similarly, this has been observed in other countries, for instance, in a study performed in rural areas of Brazil was observed that children between 10 and 12 years and those between 13 and 15 years of age had greater chance of having severe dental fluorosis in comparison with the younger children and individuals aged between 16 and 22 years. [24] These results contrast to the study by Rwenyonyi et al . [25] who found significant increase in the severity of fluorosis with increasing age in a community with high concentration of fluoride in water.…”

Factors associated with dental fluorosis in school children in southern Brazil: a cross-sectional study

“…5 Epidemiological surveys in Brazil have found a prevalence rate ranging from 3% to 80.4%. 4,6 In other countries, prevalence rates ranging from 15.8% 7 to 60.4% 8 have been reported. 8 Depending on its severity, DF may not only have esthetic consequences, but may also cause fracture, loss of enamel and pain, and may also adversely affect food choices, compromise chewing efficiency, and require complex dental treatment.…”

“…3 It is known that the prevalence and severity of DF is directly related to the amount of F ingested, age at the time of exposure and duration of exposure. 4 In contrast to the prevalence of dental caries, the prevalence of DF has increased worldwide. 5 Epidemiological surveys in Brazil have found a prevalence rate ranging from 3% to 80.4%.…”

Nutritional status and dental fluorosis among schoolchildren in communities with different drinking water fluoride concentrations in a central region in Mexico

“…Nonetheless, other studies did not identify an association between fluorosis and sex, as in the communities 1 and 3 in this study (Sukhabogi et al, 2014;Ferreira et al, 2010). More research on the role of hormones and fluoride metabolism is required to elucidate this point.…”