Prevalence and extent of enamel defects in the permanent teeth of 8‐year‐old Nigerian children

Abstract

Objectives: Enamel formation is a vulnerable developmental process, susceptible to environmental influences such as excessive systemic fluoride (F) exposure and infant/childhood disease. This study determined prevalence and extent of developmental enamel defects (DDE) and dental fluorosis in 8-year-old Nigerians and explored associations with key predictors.Methods: A sample of 322 healthy 8-year-olds (155 males, 167 females) from primary schools in lower and higher water F areas of (i) rural and (ii) urban parts of Oyo State in south-west Nigeria (n = 4 areas) (in which the mean (SD) F concentration of community water supplies ranged from 0.07 (0.02) to 2.13 (0.64) mg F/L) were dentally examined using modified DDE (mDDE) and Thylstrup and Fejerskov (TF) indices. Drinking waters, cooking waters and toothpaste samples were analysed for F concentration using a F ion-selective electrode (F-ISE). Information on infant/ childhood diseases, infant feeding and tooth cleaning practices was obtained from parents/legal guardians. Data were analysed using ANOVA, chi-square tests, Spearman correlation and binary logistic regression as appropriate.Results: Mean (SD) F concentration of actual drinking and actual cooking waters consumed by participants was 0.25 (0.20) and 0.24 (0.14) mg F/L respectively in the urban higher F area; 1.11 (1.00) and 1.16 (1.02) mg F/L, respectively in the rural higher F area (P < .05). Overall, mouth prevalence of DDE in the permanent dentition was 61.2% with a mean (SD) of 2.4 (2.2) index teeth affected. Dental fluorosis mouth prevalence was 29.8% with a mean of 2.1 (3.7) teeth affected. Prevalence and extent of DDE and dental fluorosis were greater in higher F than lower water F areas (P < .001). A weak positive correlation was seen between extent of dental fluorosis and drinking water F concentration (q = 0.28). The absence of infant/childhood disease was associated with a lower risk of DDE being present (P = .001),with an odds ratio of 0.43 (95% CI = 0.26, 0.71). Gender was a statistically significant (P = .014) predictor for dental fluorosis with females having a higher risk OR 1.94 (95% CI = 1.14, 3.28) of dental fluorosis than males.Conclusions: In these Nigerian 8-year-olds (n = 322), mouth prevalence of DDE was 61.2% (mean (SD) teeth affected = 2.4 (2.2)), and a key positive predictor was a history of infant/childhood disease. With 29.8% of these children exhibiting dental fluorosis (mean (SD) teeth affected = 2.1(3.7)), drinking water F concentration was

Fluoride intake and urinary fluoride excretion in 4‐ and 8‐year‐old children living in urban and rural areas of Southwest Nigeria

“…This study represented Phase 2 of a larger study in which the prevalence of dental defects of enamel in Nigerian four and 8‐year‐old children was determined and was undertaken between the end of the dry season (February) and mid‐rainy season (July) in 2013.…”

“…Fluoride analysis of 124 water samples collected from common community ground water supplies (wells and boreholes) in rural and urban locations in these two LGAs was undertaken to identify 4 areas, namely urban higher F (0.80‐1.0 ppm), rural higher F (2.0‐3.0 ppm), urban lower F (0.04‐0.07 ppm) and rural lower F (0.06‐0.07 ppm) and these formed the setting in which the study was subsequently undertaken. The cluster sampling of 624 four (n = 302) and eight (n = 322) year‐olds of both genders undertaken in randomly selected nursery and primary schools in Phase 1 of the overall project was based on a power of 95% at an alpha level of 5% to determine a difference in mouth prevalence of DDE of 3% between areas with a non‐completion rate of 30%. A 23% subsample (to allow for attrition) of these children was randomly selected and consented to participate in this present study.…”

Developmental Enamel Defects in Children from the Southern Region of Ecuador

“…In the case of the southern region of Ecuador, there are reports of the presence of high levels of fluoride in the water. This chemical element has been associated as a contaminant responsible for pathologies at the level of dental enamel [ 34 ] when administered in the stages of dental formation [ 34 , 35 , 36 ] or due to the involuntary consumption of toothpaste already reported in studies carried out in Ecuador [ 25 , 37 ].…”

Single Nucleotide Polymorphisms in COL1A2 Gene and Dental Fluorosis Among 4 and 8-Year-Old Nigerian Children

“…A cross-sectional study was conducted in Ibadan, Nigeria where dental fluorosis has been previously reported [20]. The fluoride concentration of water in Ibadan ranges between 0.07 ppm and 2.13 ppm [21]. Cluster sampling of 302 four-year-olds and 322 eight-year-olds of both genders was undertaken, in randomly selected nursery and primary schools respectively, as part of a larger project, from which a 20% subsample (n=65 four-year-olds and 60 eight-year-olds) who met inclusion criteria and then randomly selected from the main sample to participate in this present study [22].…”

“…Inclusion criteria for the included being healthy and residence in study area since birth. Samples of drinking and cooking waters consumed by study participants were obtained for F analysis by direct method using a F -ion selective electrode [21,23].…”