The Relationships between Two Different Drinking Water Fluoride Levels, Dental Fluorosis and Bone Mineral Density of Children

Abstract

This field study included the whole population of children aged 10–15 years (77 from a 0.19 mg/L F area; 89 from a 3.00 mg/L F area), with similar nutritional, dietary habits and similar ethnic and socioeconomic status. The fluoride concentration in the drinking water, the bone mineral content, the bone density and the degree of dental fluorosis were determined. The left radius was measured for bone width, bone mineral content, and bone mineral density. The mean fluorosis score was 1.3 in the low fluoride area and 3,6 in the high fluoride area. More than half the children in the low fluoride area had no fluorosis (scores 0 and 1) while only 5% in the high fluoride area had none. Severe fluorosis (30%) was only observed in the high fluoride area. The Wilcoxon Rank Sum Test indicated that fluorosis levels differed significantly (p < 0.05) between the two areas. No relationships were found between dental fluorosis and bone width or between fluorosis and bone mineral density in the two areas (Spearment Rank correlations). A significant increase in bone width was found with age but no differences amongst and boys and girls. A significant positive correlation was found in the high fluoride area between bone mineral density over age. In the 12-13 and 13-14 year age groups in the high fluoride area, girls had higher bone mineral densities. However, a significant negative correlation (p<0.02) was found for the low fluoride area (0.19 mg/L F) over age.

Associations of fluoride intake with children's cortical bone mineral and strength measures at age 11

“…Associations of fluoride intake with children's cortical bone measures outcome measures robust. Our results are consistent with several ecological studies (i.e., studies that did not assess fluoride intakes at the individual level, but instead compared bone measures among children living in communities with fluoridated versus non-fluoridated water) which found no significant differences in bone outcomes by fluoridation status (5,6,9). Furthermore, a previous analysis of the IFS/IBDS data showed only modest relationships between DXA scans of hip, spine, and whole body and fluoride intakes at age 11 (10), with even weaker associations with DXA outcomes at age 15 (22).…”

Effects of Life-long Fluoride Intake on Bone Measures of Adolescents

“…Dual-energy x-ray absorptiometry (DXA) for assessment of bone outcomes showed that Canadian young adult women and Swedish adolescents residing in optimally fluoridated areas had significantly higher mineral density in lumbar vertebra and the whole body, respectively, than those in non-fluoridated areas (Arnold et al, 1997;Bratteb et al, 2002). A recent study compared left radial singlephoton absorptiometry bone measures of South African adolescents in residents from areas with 0.19-ppm vs. 3.00-ppm water fluoride levels (Grobler et al, 2009). In the 14-to 15-year-old age group only, radial BMD was significantly higher for children from high-vs. low-fluoride areas.…”

Fluoride intake and cortical and trabecular bone characteristics in adolescents at age 17: A prospective cohort study

“…The different results between this project and other studies are probably due in part to the different period‐specific fluoride intakes and densitometry techniques used. Another investigation found significant differences in left radius BMD of 14‐ to 15‐year‐old adolescents living in an area with 3 ppm water fluoride levels from those exposed to < 0.2 ppm fluoride, but not for 10‐ to 11‐year‐olds or 12‐ to 13‐year‐olds …”

“…year-olds or 12-to 13-year-olds. 10 Previous studies that investigated the effects of fluoride on bone measures were mostly ecological, where they did not assess fluoride intakes at the individual level, but compared bone measures of participants living in communities with different levels of water fluoride.…”