Document Detail

Associations between fluorosis of permanent incisors and fluoride intake from infant formula, other dietary sources and dentifrice during early childhood.
MedLine Citation:
PMID:  20884921     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The authors describe associations between dental fluorosis and fluoride intakes, with an emphasis on intake from fluoride in infant formula.
METHODS: The authors administered periodic questionnaires to parents to assess children's early fluoride intake sources from beverages, selected foods, dentifrice and supplements. They later assessed relationships between fluorosis of the permanent maxillary incisors and fluoride intake from beverages and other sources, both for individual time points and cumulatively using area-under-the-curve (AUC) estimates. The authors determined effects associated with fluoride in reconstituted powdered infant formulas, along with risks associated with intake of fluoride from dentifrice and other sources.
RESULTS: Considering only fluoride intake from ages 3 to 9 months, the authors found that participants with fluorosis (97 percent of which was mild) had significantly greater cumulative fluoride intake (AUC) from reconstituted powdered infant formula and other beverages with added water than did those without fluorosis. Considering only intake from ages 16 to 36 months, participants with fluorosis had significantly higher fluoride intake from water by itself and dentifrice than did those without fluorosis. In a model combining both the 3- to 9-months and 16- to 36-months age groups, the significant variables were fluoride intake from reconstituted powder concentrate formula (by participants at ages 3-9 months), other beverages with added water (also by participants at ages 3-9 months) and dentifrice (by participants at ages 16-36 months).
CONCLUSIONS: Greater fluoride intakes from reconstituted powdered formulas (when participants were aged 3-9 months) and other water-added beverages (when participants were aged 3-9 months) increased fluorosis risk, as did higher dentifrice intake by participants when aged 16 to 36 months.
CLINICAL IMPLICATIONS: Results suggest that prevalence of mild dental fluorosis could be reduced by avoiding ingestion of large quantities of fluoride from reconstituted powdered concentrate infant formula and fluoridated dentifrice.
Steven M Levy; Barbara Broffitt; Teresa A Marshall; Julie M Eichenberger-Gilmore; John J Warren
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of the American Dental Association (1939)     Volume:  141     ISSN:  1943-4723     ISO Abbreviation:  J Am Dent Assoc     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-04     Completed Date:  2011-02-04     Revised Date:  2012-08-22    
Medline Journal Info:
Nlm Unique ID:  7503060     Medline TA:  J Am Dent Assoc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1190-201     Citation Subset:  D; IM    
Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa 52242-1010, USA.
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MeSH Terms
Age Factors
Area Under Curve
Beverages / analysis
Cariostatic Agents / administration & dosage*,  analysis
Child, Preschool
Dentifrices / administration & dosage*
Dentition, Mixed
Dietary Supplements
Fluorides / administration & dosage*,  analysis
Fluorosis, Dental / classification,  etiology*
Incisor / pathology*
Infant Food* / analysis
Infant Formula / administration & dosage*,  chemistry
Longitudinal Studies
Milk / chemistry
Risk Factors
Soy Milk / chemistry
Water Supply / analysis
Grant Support
Reg. No./Substance:
0/Cariostatic Agents; 0/Dentifrices; 0/Fluorides
Comment In:
J Am Dent Assoc. 2011 Apr;142(4):369-70; author reply 370   [PMID:  21454840 ]
J Evid Based Dent Pract. 2012 Jun;12(2):119-20   [PMID:  22726798 ]

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