Dietary Fluoride Exposure During Early Childhood and Its Association with Dental Fluorosis in a Sample of Mexican Adolescents

Gina A. Castiblanco-Rubio, Emily C. Hector, Jose Urena-Cirett, Alejandra Cantoral, Howard Hu, Karen E. Peterson, Martha M. Tellez-Rojo and E. Angeles Martinez-Mier ()
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Gina A. Castiblanco-Rubio: Department of Dental Public Health and Dental Informatics, Indiana University School of Dentistry, Indianapolis, IN 46203, USA
Emily C. Hector: Department of Statistics, North Carolina State University, Raleigh, NC 27695, USA
Jose Urena-Cirett: Faculty of Dentistry, Universidad La Salle Mexico, Mexico City 01376, Mexico
Alejandra Cantoral: Health Department, Universidad Iberoamericana, Mexico City 01376, Mexico
Howard Hu: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
Karen E. Peterson: Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
Martha M. Tellez-Rojo: Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca 62100, Morelos, Mexico
E. Angeles Martinez-Mier: Department of Dental Public Health and Dental Informatics, Indiana University School of Dentistry, Indianapolis, IN 46203, USA

IJERPH, 2025, vol. 22, issue 5, 1-14

Abstract: Dental fluorosis indicates past fluoride intake. People living in Mexico City are exposed to fluoridated salt, which contributes significantly to fluoride intake. This study aimed to (1) estimate fluoride intake during early childhood and fluorosis prevalence in permanent teeth in adolescence and (2) identify intake windows associated with higher fluorosis scores in upper central incisors (UCIs). We included 432 participants from the ELEMENT project (Early-Life Exposures in Mexico to Environmental Toxicants), with data on fluoride intake at ages 1–5 and fluorosis (TFI) at adolescence. Median intakes ranged from 0.56 at age 1 to 1.14 mg/day at age 5, exceeding recommendations. All adolescents had some level of fluorosis, predominantly mild (62% with TFI 2). For every 0.1 mg of daily fluoride intake at age 1, the odds of higher TFI in UCIs were 1.08 [95% CI: 1.00–1.17]. At age 2, the odds were marginally significant [OR: 1.07; 95% CI: 1.00–1.16]. In conclusion, for participants of ELEMENT: (1) fluoride intake during early childhood exceeded recommendations and the prevalence of mild fluorosis in adolescence was high, and (2) fluorosis in UCIs was associated with dietary exposure during the first two years of life and may be used in future ELEMENT studies as exposure biomarkers.

Keywords: fluorides; trace elements; dental fluorosis; environmental biomarkers; dietary exposure; preschool child (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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