Changing risk factors for fluorosis among South Australian children

Research in the last decade has shown changing exposure patterns to discretionary fluorides and declining prevalence of fluorosis among South Australian children, raising the question of how risk factors for fluorosis have changed. Objective: To examine and compare risk factors for fluorosis among representative samples of South Australian children in 1992/93 and 2003/03. Methods: Similar sampling strategies and data collection methods were employed in the Child Fluoride Study (CFS) Marks 1 (1992/93) and 2 (2002/03). Participants in each CFS round were examined for fluorosis using the TF Index. Exposure history was collected for fluoride in water, toothpaste, fluoride supplements and infant formula allowing for a fluorosis risk assessment analysis. Data were re-weighted to represent the child population at each time. Changes in prevalence of fluorosis, defined as having a TF score of 1+ on maxillary central incisors, fluoride exposure and risk factors between the two rounds were evaluated. Result: Some 375 and 677 children participated in 1992/93 and 2002/03 rounds. Prevalence of fluorosis, declined significantly from 45.3 to 25.9%. Reduced use of fluoride supplements and increased use of child’s 400-550-ppm F toothpaste were the most substantial fluoride exposure changes. Early toothpaste use, exposure to fluoridated water and fluoride supplement use were risk factors in 1992/93. Early toothpaste use and fluoride supplement use were not risk factors, while fluoridated water, use of standard 1000-ppm toothpaste, large amount of toothpaste used and eating/licking toothpaste when toothpaste use started were risk factors in 2002/03 round. Conclusion: Introduction of 400-550-ppm F toothpaste and use of smaller amount of toothpaste restricted risk associated with early toothpaste use. Stricter fluoride supplements regimens also restricted fluorosis risk. Periodic monitoring of risk of fluorosis is required to adjust guidelines for fluoride use in caries prevention. Supported by NHMRC, ADRF and University of Adelaide.

AJ Spencer*, L Do

Presented at the 84th General Session and Exhibition of the IADR, 28 June – 1 July 2006, Brisbane Australia

Note: * indicates presenter

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