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The rising prevalence of autism spectrum disorder (ASD) in recent decades might reflect an increased burden from the synergistic action of new ecotoxicological factors such as aluminum (Al3+), heavy metals, pesticides, fertilizers, endocrine disruptors, and others. ASD pathogenesis is still poorly understood. Although epidemiological studies have identified fluoride (F) as a developmental neurotoxin, F is not included among the ASD risk factors. Millions of people drink fluoridated tap water for the prevention of tooth decay. Currently, about 500 million people live in endemic areas with high concentrations of F in groundwater and in the biosphere. Endemic fluorosis is a progressive degenerative disease. Comparing the fluorosis pathological symptoms with ASD pathological symptoms supports the view that F might play a role in ASD etiology. Mitochondrial dysfunctions, oxidative stress and inflammation, decreased melatonin levels, and decrease of IQ have been observed in both ASD and endemic fluorosis. It has been estimated that, in the United States of America, the total costs of ASD per year will reach 461 billion USD by the year 2025. This significant burden, which has widespread effects from the personal level to the state economy, can be probably lowered by focusing more on ASD prevention, including the elimination of F. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study is to evaluate the prevalence of dental caries and dental fluorosis among the school going children in Mahabubnagar district, and also to assess F- levels in drinking water from different areas of Mahabubnagar district. Materials and Methods: The study was carried out in 2,000 children of age group 6–12 years. The dental caries status was assessed by Decayed/missed filled tooth (DMFT)/deft index using WHO criteria 1997 and dental fluorosis status using Modified Dean's fluorosis index. Alizarin visual method was used to estimate F levels in water. Statistical Analysis: All data entered to an SPSS (18) program (IBM Corporation, Chicago, USA); both descriptive and analytic approaches were used in the data analysis. The correlation of deft with different F- levels using ANOVA test. The P < 0.005 was considered statistically significant. Results: The prevalence of dental caries in primary teeth and permanent dentition was 64.2% and 26.6%, respectively. Indicating that dental caries was more among 7–8 years old children and less in 11–12 years old children (P > 0.005). Dental fluorosis in primary dentition was 15% and 70.3% in the permanent dentition; it was more in 9–10-year-old children and less in 6-year-old children. Conclusion: The dental caries and dental fluorosis were more in Northern, Eastern region of Mahabubnagar district, whereas dental caries and dental fluorosis were less in local villages of Mahabubnagar district. The F- content in Northern, Eastern zone of Mahabubnagar district was about 2 mg/l, whereas in local villages of Mahabubnagar is 1.2 mg/l. [ABSTRACT FROM AUTHOR]

Municipal fluoridation was a mid-twentieth century innovation based on the medical hypothesis that consuming low doses of fluoride when young provided protection against cavities with only a small risk of mild dental fluorosis, a cosmetic effect. In the 21st century, more than half of American teens are afflicted by dental fluorosis with approximately one in five having moderate to severe dental fluorosis in at least two teeth. Scientific literature since the 1990s has found that even low doses of fluoride adversely affect cognitive-behavioral development and that deficits are correlated with the severity of dental fluorosis in afflicted individuals. Evidence of neurotoxic impact from low dose systemic exposure to fluoride prompted an investigation by a branch of the governmental agency that has promoted fluoridation policy since its 1940's inception. This review identifies ten significant flaws in the design of an animal experiment conducted by the U.S. National Toxicology Program as part of that investigation into the neurotoxic impact of systemic prenatal and postnatal fluoride exposure. The authors hypothesize that organizational bias can and does compromise the integrity of fluoride research. [ABSTRACT FROM AUTHOR]

The article presents an American Association for Dental Research (AADR) Policy Statement on community water fluoridation (CWF). Topics include the missions of the AADR, issues related to dental, oral, and craniofacial health and research, information about fluoride and fluoridation chemistry, as well as the dental and health effects of CWF.

Policy on fluoride intake involves balancing caries against dental fluorosis in populations. The origin of this balance lies with Dean's research on fluoride concentration in water supplies, caries, and fluorosis. Dean identified cut points in the Index of Dental Fluorosis of 0.4 and 0.6 as critical. These equate to 1.3 and 1.6 mg fluoride (F)/L. However, 1.0 mg F/L, initially called a permissible level, was adopted for fluoridation programs. McClure, in 1943, derived an "optimum" fluoride intake based on this permissible concentration. It was not until 1944 that Dean referred to this concentration as the "optimal" concentration. These were critical steps that have informed health authorities through to today. Several countries have derived toxicological estimates of an adequate and an upper level of intake of fluoride as an important nutrient. The US Institute of Medicine (IOM) in 1997 estimated an Adequate Intake (AI) of 0.05 mg F/kg bodyweight (bw)/d and a Tolerable Upper Intake Level (UL) of 0.10 mg F/kg bw/d. These have been widely promulgated. However, a conundrum has existed with estimates of actual fluoride intake that exceed the UL without the expected adverse fluorosis effects being observed. Both the AI and UL need review. Fluoride intake at an individual level should be interpreted to inform more nuanced guidelines for individual behavior. An "optimum" intake should be based on community perceptions of caries and fluorosis, while the ultimate test for fluoride intake is monitoring caries and fluorosis in populations. [ABSTRACT FROM AUTHOR]

Since the classical epidemiological studies by Dean, it has been known that there should be an optimum level of exposure to fluoride that would be able to provide the maximum protection against caries, with minimum dental fluorosis. The "optimal" daily intake of fluoride for children (0.05-0.07 mg per kilogram bodyweight) that is still accepted worldwide was empirically determined. In the present review, we discuss the appropriateness of the current guidance for fluoride intake, in light of the windows of susceptibility to caries and fluorosis, the modern trends of fluoride intake from multiple sources, individual variations in fluoride metabolism, and recent epidemiological data. The main conclusion is that it is very difficult to think about a strict recommendation for an "optimal" range of fluoride intake at the individual level in light of existing knowledge of 1) the mechanisms of action of fluoride to control caries, 2) the mechanisms involved in dental fluorosis development, 3) the distinct factors that interfere in the metabolism of fluoride, and 4) the windows of susceptibility to both dental caries and fluorosis development. An "optimal" range of fluoride intake is, however, desirable at the population level to guide programs of community fluoridation, but further research is necessary to provide additional support for future decisions on guidance in this area. This list includes the effect of factors affecting fluoride metabolism, clinical trials on the effectiveness of low-fluoride dentifrices to prevent caries in the primary dentition, and validation of biomarkers of exposure to fluoride. [ABSTRACT FROM AUTHOR]

The purpose of this report is to examine critically the appropriateness of the current guidance for fluoride intake in the population (0.05-0.07 mg F/kg bodyweight/d), consider whether changes to the current guidance are desirable, and suggest further research that will strengthen the evidence base for future decisions on guidance/advice in this area. The benefits and the risks of using fluoride particularly concern preschool children because it is at this age that excessive fluoride intake may result in dental fluorosis. Data from mostly cross-sectional studies show a wide variation in exposure and a considerable variation in the amount of fluoride ingested. Fluorosis, mostly mild, is commonly observed. For considering changes in current guidance, there is a need for more knowledge on the relationship between exposure to fluoride at an early age and the development of fluorosis. For that, prospective epidemiological studies with sufficiently large and representative samples of children are required. It is also important to study children in communities both with and without water fluoridation and to include populations where salt or milk fluoridation is used. There is also a need for professional agreement on acceptable levels of mild and moderate/severe fluorosis and a more comprehensive knowledge on the appreciation of mild fluorosis among the public. [ABSTRACT FROM AUTHOR]

Purpose: Excessive fluoride ingestion has been associated with dental fluorosis. The purpose of this study was to determine if there was a difference in dental fluorosis prevalence comparing National Health and Nutrition Examination Survey (NHANES) trend data for adolescents, aged 16 and 17 years, when compared to data collected in 2001-2002 to data from 2011-2012. Methods: The sample included 875 participants. Data analyses included Chi square tests and logistic regressions. The data were from a nationally representative survey by calibrated dental examiners using the modified Dean's fluorosis classification system. The data analysis of the prevalence of fluorosis severity level was dichotomized to very mild/above vs. normal/questionable. Results: In 2001-2002, the weighted percentage prevalence of the denoted dental fluorosis categories were: 49.8% normal (i.e., unaffected), 20.5% questionable, and 29.7% very mild and above. In 2011-2012, the weighted percentage prevalence categories were: 31.2% normal, 7.5% questionable, and 61.3% very mild and above. When comparing years 2001-2002 with the years 2011-2012, the prevalence of very mild and above fluorosis increased by 31.6% (P <.0001) for the 2011-2012 group. In adjusted logistic regression, participants from the years 2011-2012 were more likely to have very mild and above dental fluorosis than participants in 2001-2002 as compared with normal/questionable fluorosis (Adjusted odds ratio- 3.85; 95% confidence interval= 2.20, 6.72; P <.0001). Conclusion: There was a difference of 31.6% in dental fluorosis prevalence between 2012-2011 when compared to data from 2002-2001 in adolescents aged 16 and 17 years. The continued increase in fluorosis rates in the U.S. indicates that additional measures need to be implemented to reduce its prevalence. [ABSTRACT FROM AUTHOR]

The US Public Health Service has finalized its recommendation relating to community water fluoridation (Federal Panel on Community Water Fluoridation, US Department of Health and Human Services, 2015). It recommends an optimal concentration of 0.7 mg/l F based on their argument that this concentration provides the best balance of protection from dental caries while limiting the risk of dental fluorosis. The rationale for this recommendation can be questioned, particularly given the contrasting etiologies and impact on the community. Uncertainty surrounds the key evidence considered by the panel. This study argues that the panel should have exercised more caution and called for further research before reducing the 'optimal' concentration of fluoride in water supplies. Up-to-date data on caries and fluorosis trend by age group or birth cohort, analyses on attributable risk for fluorosis, data on individual and population impact of caries and fluorosis, water intake over an extended period across the seasons, and the curvilinear relationship of fluoride concentration in water supplies and caries protection would have all been desirable to inform the panel, given the foreshadowing of the recommendation in late 2011. Further, a wider range of policy directions to achieve the best balance of protection from dental caries while limiting the risk of dental fluorosis are available from the international literature. Assessment of these should have been more evident. There is a public health policy responsibility to monitor water fluoridation programs so as to achieve a near maximum reduction in dental caries without unacceptable levels of dental fluorosis. However, recommendations to alter existing policy need to be cognizant of the balancing of risk and protective exposures across the entire population and potentially all ages and to be based on recent data that are purposefully collected, critically analyzed and carefully interpreted. [ABSTRACT FROM AUTHOR]

The article offers information on the topics discussed at a symposium of the International Association for Dental Research (IADR). Topics discussed include the need for a Dietary Reference Value (DRV) for fluoride intake in dental care; the toxicity resulting from high amount of fluoride intake; and the disease such as dental caries and fluorosis.

Abstract: Fluoride (F) intake is recognized to be important for dental health. Tea leaves are known F accumulators and brewed tea as well as the water used for brewing may contribute significantly to individual intake. The USDA''s Nutrient Data Laboratory determined the F content of brewed and microwaved teas using geographically matched tap water samples. Two brands of top-selling regular and one of decaffeinated teabags were purchased in 36 locations and brewed either by steeping in boiled water or with microwave heating followed by steeping. The mean F content for caffeinated regular brewed tea was 373±49μg/100g (n =63) and for decaffeinated tea was 270±46μg/100g (n =34). The overall mean for F in microwaved regular tea was lower than regular brew (364±40μg/100g vs. 322±30μg/100g (n =36)). In all cases, prepared tea using water from the Midwest had the highest F-values. The mean F content of the brewed teas was 3–4 times higher than the national mean of the tap water, analyzed separately (71±33μg/100g). These data are the first nationally representative F-values for brewed teas, and will provide valuable information to the dental and medical research communities in assessment of fluoride intake and impact on dental health. [Copyright &y& Elsevier]

Fluoride varnish prolongs the contact time between fluoride and tooth surface to reduce caries. Its active ingredient is usually 5% sodium fluoride, or 22,600 ppm fluoride. Its use as an "off-label" approved drug for caries control in the United States has been on the rise, along with increasing evidence of its efficacy in case-based studies. It sets rapidly on teeth, and it is simple, quick and easy to apply. Side effects or complications of its use are rare. Gagging and swallowing are unusual. The risk of dental fluorosis is minimal. And it can be safely used in young children. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to measure the fluoride concentrations in ready-to-eat infant food, and to determine if significant differences exist among flavors and brands. Methods: One hundred fifty samples of 5 infant food flavors from an organic infant food manufacturer and the largest infant food manufacturer were compared using the Taves microdiffusion method. Total fluoride ingestion per serving was calculated based on average amounts consumed and container size of individual products. Results: Fluoride concentrations ranged from 0.01 to 0.60 ppm (mean=0.170±0.125 [SD] ppm) for all samples, with both the highest and lowest fluoride concentrations found in processed banana infant food (Gerber, mean=0.0320 ±0.167 ppm; Earth's Best, mean=0.030±0.013 ppm). Significant differences were noted when comparing the 2 infant food manufacturers for all flavors. Conclusions: The fluoride concentrations in ready-to-eat infant food varied among the 5 flavors tested. All infant foods tested were found to provide less fluoride than the Institute of Medicine tolerable upper daily intake. No trends in fluoride concentrations for different flavors or brands were noted. Fluoride in infant foods should be considered when determining total fluoride intake. [ABSTRACT FROM AUTHOR]

Chankanka O, Levy SM, Warren JJ, Chalmers JM. A literature review of aesthetic perceptions of dental fluorosis and relationships with psychosocial aspects/oral health-related quality of life. Community Dent Oral Epidemiol 2010. © 2009 John Wiley & Sons A/S Aesthetic perceptions and oral health-related quality of life concerning dental fluorosis have been assessed in several studies during the past two decades. However, no comprehensive review article summarizing the studies investigating this issue has been published. Objective: To assess the relationships between perceptions of dental appearance/oral health-related quality of life (OHRQoL) and dental fluorosis. Methods: The PubMed database was searched using the Medical Subject Headings (MeSH) for English-language studies from 1985 to March 2009. Thirty-five articles qualified for inclusion and then were classified into three categories based on the type of study approach: (i) respondent review of photographs and assessment concerning satisfaction/acceptance, (ii) respondent assessment of study subject’s teeth concerning satisfaction/acceptance, and (iii) respondent assessments of the psychosocial/OHRQoL impact. Results: There were varied results from earlier studies focused on satisfaction/acceptance of very mild to mild fluorosis. More recent studies with methodological improvements to assess impact on quality of life clearly showed that mild fluorosis was not a concern. Furthermore, mild fluorosis was sometimes associated with improved OHRQoL. Severe fluorosis was consistently reported to have negative effects on OHRQoL. Conclusion: Because dental fluorosis in the United States and other nations without high levels of naturally-occurring fluoride is mild or very mild, with little impact on OHRQoL, dental professionals should emphasize the appropriate use of fluorides for caries prevention and preventing moderate/severe fluorosis. [ABSTRACT FROM AUTHOR]

Purpose: Exercise counseling by primary care physicians has been shown to improve physical activity in patients. However, the prevalence and effectiveness of physician counseling is unknown in rural populations that are at increased risk for chronic diseases. Methods: Using a population-based telephone survey at baseline and again at 1-year follow-up, we assessed physical activity behavior among 1141 adults (75% female, 95% white) living within 12 rural communities of Missouri, Tennessee, and Arkansas. We tested the association between physician counseling and patients meeting current physical activity recommendations using logistic regression analysis controlling for demographic variables. Results: Participants who saw a doctor for regular care were 54% more likely to be physically active (adjusted odds ratio [aOR]=1 .54; 95% confidence interval [Cl], 1.04-2.28). Overweight adults (body mass index [BMI]=25-29.9 kg/m²) who had been advised by their physician to exercise more were nearly 5 times more likely to meet physical activity recommendations if their doctor helped develop an exercise plan (aOR=4.99; 95% Cl, 1.69-14.73). Overweight individuals who received additional follow-up with the exercise plan from their doctor had a 5½-fold increase in likelihood of meeting physical activity recommendations (P<.05). In the overall sample, patients were significantly more likely to initiate (P=.01) and maintain (P=.002) physical activity when the physician prescribed and followed up on an exercise plan. Conclusion: This longitudinal study provides evidence that exercise counseling is most effective when the physician presents the counseling as a plan or prescription and when he or she follows up with the patient on it. [ABSTRACT FROM AUTHOR]

The prevalence of dental fluorosis in the United States has increased during the last 30 years. In this study, we used a mathematical model commonly employed by the U.S. Environmental Protection Agency to estimate average daily intake of fluoride via all applicable exposure pathways contributing to fluorosis risk for infants and children living in hypothetical fluoridated and non- fluoridated communities. We also estimated hazard quotients for each exposure pathway and hazard indices for exposure conditions representative of central tendency exposure (CTE) and reasonable maximum exposure (RME) conditions. The exposure pathways considered were uptake of fluoride via fluoridated drinking water, beverages, cow's milk, foods, and fluoride supplements for both age groups. Additionally, consumption of infant formula for infants and inadvertent swallowing of toothpaste while brushing and incidental ingestion of soil for children were also considered. The cumulative daily fluoride intake in fluoridated areas was estimated as 0.20 and 0.11 mg/kg-day for RME and CTE scenarios, respectively, for infants. On the other hand, the RME and CTE estimates for children were 0.23 and 0.06 mg/kg-day, respectively. In areas where municipal water is not fluoridated, our RME and CTE estimates for cumulative daily average intake were, respectively, 0.11 and 0.08 mg/kg-day for infants and 0.21 and 0.06 mg/kg-day for children. Our theoretical estimates are in good agreement with measurement-based estimates reported in the literature. Although CTE estimates were within the optimum range for dental caries prevention, the RME estimates were above the upper tolerable intake limit. This suggests that some children may be at risk for fluorosis. [ABSTRACT FROM AUTHOR]

Decisions concerning use of fluoride in its many forms for caries prevention are more complicated now than in the past because of the need to balance these benefits with the risks of dental fluorosis. This article reviews pertinent literature concerning dental fluorosis (definition, appearance, prevalence), pre- and post-eruptive use of fluoride, esthetic perceptions of dental fluorosis, fluoride levels of beverages and foods, the Iowa Fluoride Study, and the U.S. Centers for Diseases Control and Prevention's " Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States." Water fluoridation and use of fluoride dentifrice are the most efficient and cost-effective way to prevent dental caries; other modalities should be targeted toward high-risk individuals. [ABSTRACT FROM AUTHOR]

Highlights the U.S. Centers for Disease Control and Prevention's recommendations for using fluoride to prevent and control dental caries. Claim that use of fluoride can lead to savings of public and private resources; Description of how fluoride works to prevent and control and dental decay.

The article discusses recommendation from U.S. Public Health Service (PHS) in 1962 for community water systems to add fluoride to drinking water to prevent tooth decay. Topics discussed include the need to update the 1962 PHS recommendations on fluoridation as Americans have access to more sources of fluoride and recommendations from a panel of physicians, dental professionals and epidemiologists that community water systems use a single concentration of 0.7mg/L of fluoride in drinking water.

Recent epidemiologic and related evidence suggests the following trends; 1. the prevalence of caries continues to decline in children of the US and several other developed countries; 2. the prevalence of mild dental fluorosis is increasing; 3. the majority of the cariostatic effects of fluoride are topical; and 4. dietary fluoride supplements are a risk factor for dental fluorosis. These trends, and the scientific evidence on fluoride and fluorosis, suggest that it is time to re-evaluate the use of dietary fluoride supplements. This paper examines the evidence for each of the four trends and the use of fluoride supplements in caries prevention today. [ABSTRACT FROM AUTHOR]

Dean's community mottling index, though a useful summary measure, suffers from the use of arbitrary scores and the inability to describe the frequency in each of the levels of mottling. An alternative statistical approach, based on the proportional odds model, is used here to describe the severity of mottling in a community. The use of this model is demonstrated on prevalence data collected on 16 Texas communities. [ABSTRACT FROM AUTHOR]

The article presents the results of a pilot study undertaken by the U.S. researcher Carrie B. McKnight and colleagues in relation to esthetic perceptions of dental fluorosis in the U.S. They compared perception of fluorosis among laypersons and dentists at various levels. Results of the study suggested that fluorosis is likely to become a serious esthetic concern in the future as prevalance of the disease has increased in the last fifty years, affecting about 15-50 percent of the population.

This case-control study investigated risk factors for enamel fluorosis in optimally fluoridated children, born after the US infant formula industry voluntarily reduced the fluoride content of their products. Analysis was performed on 233 children, aged 10–14 years. Case-control status was determined using the Fluorosis Risk Index (FRI). Risk factor exposure was ascertained via a mailed questionnaire. Logistic regression analyses revealed a strong association between mild-to-moderate enamel fluorosis on early forming (FRI classification I) enamel surfaces and both fluoride supplement use (odds ratio (OR) = 5·95, 95% confidence interval (CI) 1·06–33.53), and early fluoride toothpaste use (OR = 6.35, 95% CI 1.21–33.40). The authors found a suggestive, but nonsignificant, association between fluorosis on these enamel surfaces and infant formula in the form of powdered concentrate (OR = 4.33, 95% CI 0.73–25.66). There was a strong association between mild-to-moderate fluorosis on later forming (FRI classification II) enamel surfaces and infant formula use in the form of powdered concentrate (OR = 10.77, 95% CI 1.89–61.25), fluoride supplement use (OR = 10.83, 95% CI 1.90–61.55), and early fluoride toothpaste use (OR = 8.37, 95% CI 1.68–41.72). No association was observed between the use of ready to feed infant formula and enamel fluorosis. Am J Epidemiol 1998; 148: 967–74. [ABSTRACT FROM AUTHOR]

Based upon the analysis of 44 market basket food collections, the average daily dietary fluoride intakes of 6-mo-old and 2-yr-old children residing in cities with water fluoride levels of 0.05 to 1.04 ppm were determined. In cities with >0.7 ppm fluoride in the drinking water, a 6-mo-old child (infant) and a 2-yr-old child (toddler) had mean dietary fluoride intakes of 0.418 mg/day (0.052 mg/kg body weight) and 0.621 mg/day (0.050 mg/kg body weight) respectively. The data indicate that the average dietary fluoride intake of infants and toddlers did not exceed 0.08 mg/ kg, and in all but three cases was within or below the optimum range of 0.05-0.07 mg/kg. The ingestion of fluoride-containing dentifrice or milk formula diluted with fluoridated water may result in intake levels exceeding that associated with the development of dental fluorosis (0.1 mg F/kg body wt). [ABSTRACT FROM AUTHOR]

Fluorosis prevalence has increased in North America since the 1930's-1940's. It may also have increased since 1970, though the evidence for that is less clear. Continued monitoring will help determine whether increased fluorosis prevalence in children in the United States is a cohort effect from the 1970's. This review considers the evidence for an increase in fluoride ingestion from all sources since the 1970's. Ifan increase has occurred, the most likely sources are fluoride dietary supplements, inadvertent swallowing of fluoride toothpastes, and increased fluoride in food and beverages. For adults, there is no evidence from dietary surveys to show that fluoride intake has increased over the last generation. Dietary surveys for children aged six months to two years are similarly inconclusive, though the great variation in fluoride content of various infant foods might be obscuring real effects. The data on fluoride intake by children from food and beverages, infant foods included, are not strong enough to conclude that an increase in fluoride ingestion has occurred since the 1970's. However, the suggested upper limit of fluoride intake is substantially being reached in many children by ingestion of fluoride from food and drink (0.2-0.3 mgper day) and from fluoride toothpaste (0.2-0.3 mg per day). Two public health issues that arise from this review are: (a) the need for a downward revision in the schedule for fluoride supplementation, and (b) education on the potential for high fluoride concentration of soft drinks and processed fruit juices. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the occurrence of fluorides in drinking waters in the United States. The effects of fluorine in the diet on the deposition of calcium and bone structure are discussed. Results indicate that no relationship exists between fluoridated water and mottled enamel.

The article presents a study on the incidence of mottled enamel in segregated populations of the United States. Various environmental factors in endemic areas related to the development of mottled enamel are reviewed. Results indicate that enamel dystrophy is closely associated to the fluoridation of the water supply.

Introduction In October of 2005 the authors traveled to the Cape Verde Islands as part of a humanitarian group supported by Healing the Children Northeast Inc, in order to provide basic dental care to the relatively isolated island population of Brava, the smallest island of the Cape Verde Archipelago. Aim of the study Aim of this study is to present the clinical findings of the dental screening control in the isolated population of Brava island. Methods A total of 174 patients were screened, and it was determined, based upon clinical findings, that 73 (41.95%) of these patients demonstrated some degree of enamel mottling of the dentition. As this was a serendipitous and unexpected clinical finding in this patient population, samples of potable tap and/or drinking water from the island of Brava were obtained and transported to the United States for analysis as to fluoride concentration. Results The water samples demonstrated a fluoride concentration of 1.4 ppm, indicative of a high natural concentration of natural fluoride in the water samples obtained. Conclusions As such, this demonstrates a unique case of natural fluoride-induced enamel hypoplasia (dental fluorosis) in an isolated island population. As an initial descriptive study of this clinical finding in this isolated island population, this should serve as a basis for further study of the effects of high natural concentrations of fluoride on the island of Brava. [ABSTRACT FROM AUTHOR]

The article reports that a panel from the National Reseach Council (NRC) has urged the government to lower the maximum contaminant level goal (MLCG) for fluoride in the U.S. According to the NRC, the current MLCG for fluoride does not protect children from suffering severe enamel fluorosis and should be lowered. the panel's 576-page report, concludes that severe enamel fluorosis, a permanent pitting of tooth enamel caused by early exposure to elevated fluoride levels, is an adverse health effect that can occur at drinking water fluoride levels at or near the current MCLG.

The article discusses the career of dental researcher Henry Klein. Studies that Klein took part in during the 1930s regarding the use of fluoride and dental caries are discussed. Concepts that have been raised regarding the adding of fluoride to drinking water and dental caries that are experienced by siblings are mentioned. The involvement that both human and animal subjects have had in Klein's research over the years is discussed. The condition of people's oral health in the United States at the time that Klein was researching is mentioned.

The article discusses presentations at a symposium of International Association for Dental Research by several persons focusing on the guidelines for fluoride intake in dental care. Topics discussed include the presentation by doctor Spencer on enamel fluorosis and whether fluoride intake should be a part of public policy; the presentation by doctor Buzalaf, focusing on the development of caries; and the presentation by doctor Mejàre, focusing on the risk of developing enamel fluorosis.

The article presents the nonprofit American Academy of Pediatric Dentistry's (AAPD) policy concerning the use of fluoride to reduce dental caries risk and reversing the demineralization of dental enamel. It comments on the fluoridation of water and secondary fluoride supplements if water fluoridation is impossible. It talks about the use of fluoride toothpaste in toothbrushing, the potential of enamel fluorosis prior to the maturation of dental enamel, and research into fluoride products.

Solar-powered water filtration systems developed by US company Pall Corp are being deployed in villages in Senegal to help stem the high incidence of fluorosis among the local population. [Copyright &y& Elsevier]

The article reports on the suggestion by the U.S. Department of Health and Human Services to lower the amount of fluoride added to municipal water to stop the rise in dental fluorousis in the country, a condition in which teeth become discolored or pitted due to excessive fluoride exposure.

Focuses on a recommendation by the U.S. Preventive Services Task Force for primary care physicians to prescribe oral fluoride supplements. Children and infants who would be considered for the supplements, which can help prevent dental cavities; Internet addresses for more information, including fluoride recommendations for the community water supply; Concern about oversupplementation and fluorosis.

Objectives: To evaluate the role of partial recording protocols (PRPs) in reporting prevalence and severity of dental fluorosis and assess whether prevalence/severity estimates derived from PRPs differ by race/ethnicity., Methods: Data from the National Health and Nutrition Examination Survey (NHANES) for the years 1999-2004 were analyzed with Stata(®) v.11. Prevalence of dental fluorosis obtained from a full-mouth examination (28 teeth gold standard) was compared with estimates derived from four subsets of teeth (maxillary canine-to-canine; maxillary first-premolar-to-first-premolar; all-premolars; all-molars). Sensitivity, negative predictive value (NPV), absolute bias, and correction factors were calculated against gold standard estimate. Analysis was stratified according to race/ethnicity to assess differences in estimates derived from PRPs., Results: All subsets underestimated prevalence albeit to varying degrees. Two subsets (all-premolars and all-molars) had prevalence and severity estimates closest to gold standard estimates. The all-molars subset (eight teeth) recorded the highest sensitivity (84.5%) and the lowest absolute bias (3.5%) of all subsets relative to gold standard. Subsets derived from esthetically relevant teeth produced the lowest fluorosis prevalence. For instance, the maxillary canine-to-canine subset underestimated prevalence by 9.5%; incorporating the maxillary first premolars in the span improved prevalence estimate by 31%. Among non-Hispanic Whites, the all-premolars subset produced estimates closest to gold standard while the all-molars subset produced estimates closest to the gold standard among non-Hispanic Blacks and Hispanics., Conclusion: While the majority of dental fluorosis in the United States is very mild, concerns regarding its growing prevalence underscore the need for careful monitoring. The use of PRPs offers an alternative method of assessment, with validity of reported prevalence and severity dependent on choice of subset., (Published 2014. This article is a U.S. Government work and is in the public domain in the USA.)

Discusses the reduction of unnecessary and inappropriate fluoride exposures while still enabling patients to benefit from fluoride's preventive effects. Sources of fluoride; Increase in dental fluorosis in the U.S. in the 1980s; Guidelines for health professionals in reducing the health risk of using fluoride.