Assessing Fluorosis Incidence in Areas with Low Fluoride Content in the Drinking Water, Fluorotic Enamel Architecture, and Composition Alterations

Izabela Strużycka, Aneta Olszewska, Agnieszka Bogusławska-Kapała, Szymon Hryhorowicz, Marta Kaczmarek-Ryś, Beniamin Oskar Grabarek, Rafał Staszkiewicz, Izabela Kuciel-Polczak and Agata Czajka-Jakubowska
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Izabela Strużycka: Department of Comprehensive Dentistry, Medical University of Warsaw, 02-097 Warsaw, Poland
Aneta Olszewska: Department of Orthodontics and Temporomandibular Disorders, Poznan University of Medical Sciences, 60-567 Poznań, Poland
Agnieszka Bogusławska-Kapała: Department of Comprehensive Dentistry, Medical University of Warsaw, 02-097 Warsaw, Poland
Szymon Hryhorowicz: Institute of Human Genetics, Polish Academy of Sciences, 60-479 Poznań, Poland
Marta Kaczmarek-Ryś: Institute of Human Genetics, Polish Academy of Sciences, 60-479 Poznań, Poland
Beniamin Oskar Grabarek: Department of Histology, Cytophysiology and Embryology, Faculty of Medicine in Zabrze, Academy of Silesia, The University of Technology in Katowice, 41-800 Zabrze, Poland
Rafał Staszkiewicz: Department of Histology, Cytophysiology and Embryology, Faculty of Medicine in Zabrze, Academy of Silesia, The University of Technology in Katowice, 41-800 Zabrze, Poland
Izabela Kuciel-Polczak: Trauma Centre, Department of Ophthalmology, St. Barbara Hospital, 41-200 Sosnowiec, Poland
Agata Czajka-Jakubowska: Department of Orthodontics and Temporomandibular Disorders, Poznan University of Medical Sciences, 60-567 Poznań, Poland

IJERPH, 2022, vol. 19, issue 12, 1-12

Abstract: There is currently no consensus among researchers on the optimal level of fluoride for human growth and health. As drinking water is not the sole source of fluoride for humans, and fluoride can be found in many food sources, this work aimed to determine the incidence and severity of dental fluorosis in Poland, in areas where a low fluoride content characterizes the drinking water, and to assess the impact of fluoride on the enamel composition and microstructure. The dental examination involved 696 patients (aged 15–25 years) who had since birth lived in areas where the fluoride concentration in drinking water did not exceed 0.25 mg/L. The severity of the condition was evaluated using the Dean’s Index. Both healthy teeth and teeth with varying degrees of fluorosis underwent laboratory tests designed to assess the total protein and fluoride content of the enamel. Protein amount was assessed spectrophotometrically while the level of fluoride ions was measured by DX-120 ion chromatography. The clinical study revealed 89 cases (12.8%) of dental fluorosis of varying severity. The enamel of teeth with mild and moderate fluorosis contained a significantly higher protein ( p -value < 0.001 and 0.002, respectively) and fluoride level ( p < 0.001) than those with no clinical signs of fluorosis. SEM images showed irregularities in the structure of the fluorotic enamel. An excessive fluoride level during amelogenesis leads to adverse changes in the chemical composition of tooth enamel and its structure. Moreover, dental fluorosis present in areas where drinking water is low in fluorides indicates a need to monitor the supply of fluoride from other possible sources, regardless of its content in the water.

Keywords: fluoride; fluorosis; oral health; fluorosis epidemiology; Dean’s Index; dental fluorosis; developmental enamel defects (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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