Prevalence of Dental Fluorosis in a City without Fluoridation in its Water Supply: Effect of Sampling
Keywords:
Epidemiologic Studies, Cross-Sectional Studies, Fluorosis, Dental, DentifricesAbstract
Objective: To determine the prevalence of dental fluorosis in a population not exposed to fluoridated water and to evaluate the effect of the sampling technique on this measurement. Material and Methods: This observational, cross-sectional and quantitative study was conducted in the city of Mariana, Brazil. The participants were selected based on age, so that they had access to fluoridated dentifrice during the formation of the permanent upper teeth. Based on a nominal survey of schoolchildren aged 14 to 19, a probabilistic sample of 304 such children was clinically examined. Dental fluorosis was measured by the Thylstrup-Fejerskov index. The prevalence of fluorosis identified in a previous study, conducted in 2011 in the same city, using the same methodology but employing convenience sampling, was used as a control to compare the effect of the two sampling techniques. Results: The prevalence of dental fluorosis was 3% based on the probabilistic sampling of the subjects. In the previous study, the prevalence of fluorosis was 7% (p<0.05) based on convenience sampling of the same age group. Both studies detected a Thylstrup-Fejerskov fluorosis index value of 1, corresponding to only a mild degree of dental fluorosis. Conclusion: The convenience sampling technique seems to have affected the prevalence of dental fluorosis identified, with a 4% difference between the two studies. The prevalence of dental fluorosis attributed to the use of fluoridated dentifrice in a population not exposed to fluoridation of the water supply was considered low.
References
O'Mullane DM, Ketley CE, Cochran JA, Whelton HP, Holbrook WP, van Loveren C, et al. Fluoride ingestion from toothpaste: Conclusions of European Union-funded multicentre project. Community Dent Oral Epidemiol 2004; 32(Supply 1):74-6. https://doi.org/10.1111/j.1600-0528.2004.00143.x
Marinho VC, Higgins JP, Sheiham A, Logan S. Fluoride toothpastes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2003; (1):CD002278. https://doi.org/10.1002/14651858.CD002278
Wong MC, Clarkson J, Glenny AM, Lo EC, Marinho VC, Tsang BW, et al. Cochrane reviews on the benefits/risks of fluoride toothpastes. J Dent Res 2011; 90(5):573-9. https://doi.org/10.1177/0022034510393346
O'Mullane DM, Baez RJ, Jones S, Lennon MA, Petersen PE, Rugg-Gunn AJ, et als. Fluoride and oral health. Community Dental Health 2016; 33(2):69-99.
Walsh T, Worthington HV, Glenny AM, Marinho VC, Jeroncic A. Fluoride toothpastes of different concentrations for preventing dental caries. Cochrane Database Syst Rev 2019; 3:CD007868. https://doi.org/10.1002/14651858.CD007868.pub3
Clark MB, Slayton RL, Section on Oral Health. Fluoride use in caries prevention in the primary care setting. Pediatrics 2014; 134(3):626-33. https://doi.org/10.1542/peds.2014-1699
Petersen PE, Ogawa H. Prevention of dental caries through the use of fluoride – the WHO approach. Community Dental Health 2016; 33:66-8. https://doi.org/10.1922/CDH_Petersen03
Whelton HP, Spencer AJ, Do LG, Rugg-Gunn AJ. Fluoride revolution and dental caries: evolution of policies for global use. J Dent Res 2019; 98(8):837-46. https://doi.org/10.1177/0022034519843495
Cury JA, Tenuta LMA, Ribeiro CCC, Paes Leme AF. The importance of fluoride dentifrices to the current dental caries prevalence in Brazil. Braz Dent J 2004; 15(3):167-74. https://doi.org/10.1590/S0103-64402004000300001
Brasil. Agência Brasileira de Desenvolvimento Industrial. Estudo Prospectivo. Indústria de Higiene Pessoal Perfumaria e Cosméticos. Série Cadernos da Indústria ABDI Brasília: Vol XIII; 2009. Available from: http://www.abdi.com.br/Estudo/XIII.pdf. [Accessed on April 14, 2019] [In Portuguese].
Brasil. Instituto Brasileiro de Geografia e Estatística. Pesquisa Nacional de Sáude 2013. Saúde Bucal: 62. Available from: http://biblioteca.ibge.gov.br/visualizacao/livros/liv91110.pdf. [Accessed on April 14, 2019] [In Portuguese].
Angulo M, Cuitiño E, Molina-Frechero N, Emilson CG. The association between the prevalence of dental fluorosis and the socio-economic status and area of residence of 12-year-old students in Uruguay. Acta Odontol Scand 2020; 78(1):26-30. https://doi.org/10.1080/00016357.2019.1642514
Do LG, Spencer AJ. Risk-benefit balance in the use of fluoride among young children. J Dent Res 2007; 86(8):723-8. https://doi.org/10.1177/154405910708600807
Raghavan R, Bipin N, Abraham A. Prevalence of dental fluorosis and fluoride content of drinking water in rural areas of Malappuram district, Kerala. Int J Med Sci Public Health 2014; 3(1):27-30. https://doi.org/10.5455/ijmsph.2013.200920132
Horowitz HS. Fluoride and enamel defects. Adv Dent Res 1989; 3(2):143-6.
Bronckers ALJJ, Lyaruu DM, DenBesten PK. The impact of fluoride on ameloblasts and the mechanisms of enamel fluorosis. J Dent Res 2009; 88(10):877-893. https://doi.org/10.1177/0022034509343280
Franzman MR, Levy SM, Warren JJ, Broffitt B. Fluoride dentifrice ingestion and fluorosis of the permanent incisors. J Am Dent Assoc 2006; 137(5):645-52. https://doi.org/10.14219/jada.archive.2006.0261
Mascarenhas AK. Risk factors for dental fluorosis: a review of the recent literature. Pediatric Dent 2000; 22(4):269- 77.
Martinez-Mier EA, Shone DB, Buckley CM, Ando M, Lippert F, Soto-Rojas AE. Relationship between enamel fluorosis severity and fluoride content. J Dent 2016; 46:42-6. https://doi.org/10.1016/j.jdent.2016.01.007
Lee GH, Pang HN, McGrath C, Yiu CK. Oral health of Hong Kong children: a historical and epidemiological perspective. Hong Kong Med J 2016; 22(4):372-81. https://doi.org/10.12809/hkmj154686
Lima-Arsati YBO, Gomes ARLF, Santos HKA, Arsati F, Oliveira MC, Freitas VS. Exposure to fluoride of children during the critical age for dental fluorosis, in the semiarid region of Brazil. Cien Saúde Coletiva 2018; 23(4):1045-54. https://doi.org/10.1590/1413-81232018234.07952016
Pendrys DG, Katz RV. Risk of enamel fluorosis associated with fluoride supplementation, infant formula, and fluoride dentifrice use. Am J Epidemiol 1989; 130(6):1199-208. https://doi.org/10.1093/oxfordjournals.aje.a115448
Jordão MRA. Influência do dentifrício fluoretado na prevalência de fluorose dental no Brasil. [Dissertation]. Piracicaba: Universidade Estadual de Campinas; 2002. [In Portuguese].
Osujp OO, Leake JL, Chipman ML, Nikiforuk G, Locker D, Levine N. Risk factors for dental fluorosis in a fluoridated community. J Dent Res 1988; 67(12):1488-92. https://doi.org/10.1177/00220345880670120901
Uchôa H, Melo MLT, Lopes ES, Guimarães LO, Chianca TK. Fluoração do sal de consumo humano no município de Cabo Frio - RJ. Rev Bras Odontol 1993; 50(2):49-56. [In Portuguese].
Carvalho TS, Kehrle HM, Sampaio FC. Prevalence and severity of dental fluorosis among students from João Pessoa, PB, Brazil. Braz Oral Res 2007; 21(3):198-203. https://doi.org/10.1590/S1806-83242007000300002
Brasil. Ministério da Saúde. Secretaria de Políticas de Saúde. Departamento de Atenção Básica. Área Técnica de Saúde Bucal. Projeto SB 2003: Condições de Saúde Bucal da População Brasileira no Ano de 2002-2003. Brasília: Ministério da Saúde; 2004. pp.54-55. [In Portuguese].
Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Secretaria de Vigilância em Saúde. SB Brasil 2010: Pesquisa Nacional de Saúde Bucal: Resultados Principais. Brasília: Ministério da Saúde; 2012. 47pp. [In Portuguese].
Lima IFP, Nóbrega DF, Cericato GO, Ziegelmann PK, Paranhos LR. Prevalence of dental fluorosis in regions supplied with non-fluoridated water in the Brazilian territory: a systematic review and meta-analysis. Cien Saúde Coletiva 2019; 24(8):2909-22. https://doi.org/10.1590/1413-81232018248.19172017
Goodarzi F, Mahvi AH, Hosseini M, Nedjat S, Nabizadeh Nodehi R, Kharazifard MJ, et al. The prevalence of dental fluorosis and exposure to fluoride in drinking water: a systematic review. J Dent Res Dent Clin Dent Prospects 2016; 10(3):127-35. https://doi.org/10.15171/joddd.2016.021
Steiner M, Menghini G, Thomet E, Jäger A, Pfister J, Imfeld T. Assessment of dental fluorosis prevalence in Swiss populations. Schweiz Monatsschr Zahnmed 2010; 120(1):12-20.
Castilho MCM. Efeito dos dentifrícios fluoretados sobre a prevalência de fluorose dental em uma região de água não fluoretada. [Dissertation]. Campinas: Centro de Pós-Graduação São Leopoldo Mandic; 2011. [In Portuguese].
World Health Organization. Oral Health Survey: Basic Methods. 5th ed. Geneva: WHO; 2013.
Ganguli M, Lytle ME, Reynolds MD, Dodge HH. Random versus volunteer selection for a community-based study. J Gerontol A Biol Sci Med Sci 1998; 53(1):M39-46. https://doi.org/10.1093/gerona/53a.1.m39
Etikan I, Musa AS, Alkassim RS. Comparison of convenience sampling and purposive sampling. Am J Theor Appl Statist 2016; 5(1):1-4. https://doi.org/10.11648/j.ajtas.20160501.11
Gravetter FJ, Forzano LB. Research Methods for the Behavioral Sciences. 4th ed. Boston: Cengage Learning; 2012.
Trochim WMK. Research methods knowledge base. 2020. Available from: https://socialresearchmethods.net/kb/probability-sampling. [Accessed on March 11, 2020].
World Health Organization. Health Research Methodology: A Guide for Training in Research Methods. 2nd ed. Manila: WHO Regional Office for the Western Pacific; 2001.
Shah PB, Jha PJ. Quantitative Aptitude statistics For CACPT Examination. New Delhi: Mcgrawhill HED; 2009. pp. 275-276.
Brasil. Instituto Brasileiro de Geografia e Estatística. Censo Demográfico 2010. Cidades. Available from: http://www.cidades.ibge.gov.br/xtras/perfil.php?lang=&codmun=314000. [Accessed on March 11, 2020]. [In Portuguese].
Paiva SM, Barros F, Manoel A. Contribuição ao estudo da fluorose dentária, na dentição permanente, numa comunidade com fluorose endêmica (Cocal - Urussanga - Santa Catarina). Rev Odontopediatr 1993; 2:5-12. [In Portuguese].
Fejerskov O, Manji F, Baelum V, Moller IJ. Dental Fluorosis. A Handbook for Health Workers. Copenhagen: Munksgaard; 1988. 123pp.
Faraco Júniro, IM, Feldens EG, Tovo MF, Sari GT. Fluorose dentária no Brasil: quadro epidemiológico atual. Rev Ibero-am Odontopediatr Odontol Bebê 2004; 7(38):387-94. [In Portuguese].
Ely HC, Pretto SM. Dental fluorosis and dental caries: an epidemiologic study in cities of Rio Grande do Sul with different fluoride levels in drinking water. Rev Odonto Cienc 2000; 15(31):143-73.
São Paulo. Secretaria Estadual de Saúde. Faculdade de Saúde Pública. Universidade de São Paulo. Condições de Saúde Bucal no Estado de São Paulo em 2002: Relatório Final. São Paulo: SES-SP / FSP-USP; 2002. [In Portuguese].
Heintze SD, Bastos JR, Bastos R. Urinary fluoride levels and prevalence of dental fluorosis in three Brazilian cities with different fluoride concentrations in the drinking water. Community Dent Oral Epidemiol 1998; 26(5):316-23. https://doi.org/10.1111/j.1600-0528.1998.tb01967.x
São Paulo. Secretaria Estadual de Saúde. Faculdade de Saúde Pública. Universidade de São Paulo. Levantamento Epidemiológico em Saúde Bucal: Estado de São Paulo, 1998: Relatório. São Paulo: SES-SP / FSP-USP; 1999. [In Portuguese].
Saliba NA, Moimaz SAS, Saliba O, Santos KT, Sundfeld RH, Lelis RT. Dental fluorosis in adolescents not exposed to the fluoride water during of teeth formation. Arq Odontol 2006; 42(2):113-123.
Cortes DF, Ellwood RP, O'Mullane DM, Bastos JR. Drinking water fluoride levels, dental fluorosis and caries experience in Brazil. J Public Health Dent 1996; 56(4):226-8. https://doi.org/10.1111/j.1752-7325.1996.tb02441.x
Barros SFB, Matos DL. Prevalence of dental fluorosis in 12 year-old schoolchildren, Ouro Preto/MG – 2003. Rev Bras Epidemiol 2005; 8(4):425-31. https://doi.org/10.1590/S1415-790X2005000400011
Carvalho RB, Medeiros UV, Santos KT, Pacheco AC. Influence of different concentrations of fluoride in the water on epidemiologic indicators of oral health/disease. Ciênc Saúde Coletiva 2011; 16(8):3509-18. https://doi.org/10.1590/S1413-81232011000900019
Aimée NR, van Wijk AJ, Maltz M, Varjão MM, Mestrinho HD, Carvalho JC. Dental caries, fluorosis, oral health determinants, and quality of life in adolescentes. Clin Oral Investig 2017; 21(5):1811-20. https://doi.org/10.1007/s00784-016-1964-3
Adair PM, Pine CM, Burnside G, Nicoll AD, Gellett A, Anwar S, et al. Familial and cultural perceptions and beliefs of oral hygiene and dietary practices among ethnically and socio-economically diverse groups. Community Dental Health 2004; 21(Supplement):102-11.
Bratthall D, Hänsel-Petersson G, Sundberg H. Reasons for the caries decline: what do the experts believe? Eur J Oral Sci 1996; 104(4):416-22. https://doi.org/10.1111/j.1600-0722.1996.tb00104.x
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