DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20213036

Dental caries and its association with increasing water fluoride concentration in district Rudraprayag, Uttarakhand

Nidhi Sharma, Vartika Saxena, Manisha Naithani

Abstract


Background: Evidence from scientific literature confirms both beneficial and detrimental effects of fluoride on human health with only a narrow range between intakes associated with these effects. The limits of this range have been controversial among researchers since the 1930s. Considering this, the World Health Organization (WHO) permissible limit of fluoride in India has been reduced from 1.5 to 1.0 mg/l in 1998. This study aimed to evaluate the association between increasing water fluoride levels and dental caries prevention on permanent teeth.

Methods: This cross-sectional study involved 1400 children (aged 6–19 years). Caries experience and dental fluorosis were recorded using DMFT/deft and Dean's index respectively. Also, fluoride concentration in drinking water was analyzed. Around 14.4% of children had dental caries with maximum frequency among 9-10 years of age. A significant negative correlation between caries experience and water fluoride level was found (p<0.05), with the lowest DMFT scores at the fluoride level of 0.61–2 mg/l and the highest at 0.0–0.3 mg/l. Whereas, high prevalence of dental fluorosis was observed above 0.7 mg/l.

Results: The study revealed that the presence of 0.3-0.7 mg/l fluoride in drinking water reduces dental caries, without an objectionable rise in dental fluorosis.

Conclusions: It can be suggested that fluoride has anticaries property but due to a ‘narrow therapeutic window’ of 0.3-0.7 mg/l, in a country like India where endemic fluorosis is prevalent, its topical application should be encouraged which is almost equally effective with less systemic adverse effects.


Keywords


Optimum fluoride, Dental caries, Dental fluorosis, Uttarakhand

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References


Sheiham A. Oral health, general health and quality of life. Vol. 83, Bulletin of the World Health Organization. World Health Organization. 2005. http://www.who. Accessed on 19th March, 2021.

FDI World Dental Federation. Facts, Figures and Stats, Oral disease: 10 key facts. 2012. https://www.fdiworlddental.org/oral-health/ask-the-dentist/facts-figures-and-stats. Accessed on 19th March, 2021.

Aslani H, Zarei M, Taghipour H, Khashabi E, Ghanbari H, Ejlali A. Monitoring, mapping and health risk assessment of fluoride in drinking water supplies in rural areas of Maku and Poldasht, Iran. Environ Geochem Health. 2019;41(5):2281-94.

Kirkeskov L, Kristiansen E, Bøggild H, Von Platen-Hallermund F, Sckerl H, Carlsen A, et al. The association between fluoride in drinking water and dental caries in Danish children. Linking data from health registers, environmental registers and administrative registers. Community Dent Oral Epidemol. 2010;38(3):206-12.

Yeung CA. A systematic review on the efficacy and safety of fluoridation [Internet]. Vol. 9, Evidence-Based Dentistry. Evid Based Dent. 2008;39-43.

The ethics of water fluoridation. 2019. https://pubmed.ncbi.nlm.nih.gov/11253350/. Accessed on 19th March, 2021.

Cross DW, Carton RJ. Fluoridation: A Violation of Medical Ethics and Human Rights. Int J Occup Environ Health. 2003;9(1):24-9.

Srivastava AK, Singh A, Yadav S, Mathur A. Research Article Endemic Dental and Skeletal Fluorosis: Effects of High Ground Water Fluoride in some North Indian Villages. Int J Oral Maxillofac Pathol. 2011;2(2):7-12.

Pandey VK, Aggarwal P, Kakkar R. Modified BG prasad socio-economic classification, update - 2019. Indian J Community Heal. 2019;31(1):123-5.

Prevalence of caries among tribal school children in Phulbani district, Orissa. 2021. https://pubmed.ncbi.nlm.nih.gov/6590628/. Accessed on 19th March, 2021.

Chu CH, Wong AWY, Lo ECM, Courtel F. Oral health status and behaviours of children in rural districts of Cambodia. Int Dent J. 2008;58(1):15-22.

SS Rao, P V. Prevalence of dental caries among school-going children in South India. Int J Med Sci Public Heal. 2016;5(4):700.

Viswanath D, Sabu N. Prevalence of dental caries, the effect of sugar intake and tooth brushing practices in children aged 5-11 years in Bangalore North. SRM J Res Dent Sci. 2014;;5(3):155.

Touger-Decker R, van Loveren C. Sugars and dental caries. The American journal of clinical nutrition. Am J Clin Nutr. 2003;78.

Chowdhury A, Adak MK, Mukherjee A, Dhak P, Khatun J, Dhak D. A critical review on geochemical and geological aspects of fluoride belts, fluorosis and natural materials and other sources for alternatives to fluoride exposure. J Hydrol. 2019;574:333-59.

Skórka-Majewicz M, Goschorska M, Żwierełło W, Baranowska-Bosiacka I, Styburski D, Kapczuk P, et al. Effect of fluoride on endocrine tissues and their secretory functions -- review. Chemosphere. 2020;260.

Ramezani G, Valaie N, Rakhshan V. The effect of water fluoride concentration on dental caries and fluorosis in five Iran provinces: A multi-center two-phase study. Dent Res J (Isfahan). 2015;12(1):31-7.

Petersen PE, Ogawa H. Prevention of dental caries through the use of fl uoride-the WHO approach. Community Dent Health. 2016;33:66-8.

Al-Akwa AA, Al-Maweri SA. Dental caries prevalence and its association with fluoride level in drinking water in Sana’a, Yemen. Eur J Dent. 2018;12(1):15-20.

Nor NAM, Chadwick BL, Farnell D, Chestnutt IG. The prevalence of enamel and dentine caries lesions and their determinant factors among children living in fluoridated and non-fluoridated areas. Community Dent Health. 2019;36(3):229-36.

Cate JM, Buzalaf MAR. Fluoride Mode of Action: Once There Was an Observant Dentist. J Dent Res. 2019;98(7):725-30.

Goldberg M. Central Fluorides in Dental Tissues: Caries Prevention and Fluorosis. JSM Dent. 2020;8(1):1123.

Article R. The Untold Story of Fluoridation : Revisiting the Changing Perspectives. 2018;121-7.

Fluoride in dentistry (Book, 1996) [WorldCat.org]. https://www.worldcat.org/title/fluoride-in-dentist ry/oclc/36126959. Accessed on 19th March, 2021.

Hosur MB, Puranik RS, Vanaki S, Puranik SR. Study of thyroid hormones free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) in subjects with dental fluorosis. Eur J Dent. 2012;6(2):184-90.