TABLE 8-5 Prevalence and Severity of Enamel Fluorosis as a Function of Drinking Water Fluoride Concentration

     

Prevalence of Enamel Fluorosis, %a

No. of Studies

No. of Subjects

Drinking Water Fluoride (mg/liter)

Very Mild/Mild

Moderate/Severe

4

1,885

ca. 1.0

21.5 (9.0–39.1)

1.0 (0–2.4)

3

526

1.3–1.4

25.1 (15.6–31.6)

0.7 (0–1.1)

6

1,080

2.0–3.0

64.5 (39.9–86.5)

12.6 (3.3–32.8)

4

631

3.0–4.3

53.1 (34.9–72.5)

21.7 (4.4–36.1)

a Range of the mean values of prevalence from the individual studies is shown in parentheses.

SOURCE: USPHS, 1991.

RESEARCH RECOMMENDATIONS

  • Epidemiological studies (especially analytical studies) of the relationships among fluoride exposures from all major sources and the prevalence of dental caries and enamel fluorosis at specific life stages should continue for the purposes of detecting trends and determining the contribution of each source to the effects demonstrated.

  • Epidemiological and basic laboratory studies should further refine our understanding of the effects of fluoride on the quality and biomechanical properties of bone and on the calcification of soft tissue.

  • Studies are needed to define the effects of metabolic and environmental variables on the absorption, excretion, retention, and biological effects of fluoride. Such variables would include the composition of the diet (for example, calcium content), acid-base balance, and the altitude of residence.



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