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Fluoride intake from regular and low fluoride dentifrices by 2-3-year-old children: influence of the dentifrice flavor
Moraes, Samanta Mascarenhas;Pessan, Juliano Pelim;Ramires, Irene;Buzalaf, Marília Afonso Rabelo;
Brazilian Oral Research , 2007, DOI: 10.1590/S1806-83242007000300008
Abstract: this study evaluated the fluoride intake from dentifrices with different fluoride concentrations ([f]) by children aged 24-36 months, as well as the influence of the dentifrice flavor in the amount of fluoride ingested during toothbrushing. thirty-three children were randomly divided into 3 groups, according to the [f] in the dentifrices: g-a (523 μgf/g), g-b (1,062 μgf/g) and g-c (1,373 μgf/g). dentifrices a and b are marketed for children, while dentifrice c is a regular product. the amount of f ingested was indirectly obtained, subtracting the amount expelled and the amount left on the toothbrush from the amount initially loaded onto the brush. the results were analyzed by anova, tukey's test and linear regression analysis (p < 0.05). children ingested around 60% of the dentifrice loaded onto the brush, but no significant differences were seen among the groups (p > 0.05). mean daily fluoride intake from dentifrice for g-a, g-b and g-c was 0.022a, 0.032a and 0.061b mg f/kg body weight, respectively (p < 0.01). there was a strong positive correlation (r = 0.86, p < 0.0001) between the amount of dentifrice used and the amount of fluoride ingested during toothbrushing. the results indicate the need for instructing children's parents and care givers to use a small amount of dentifrice (< 0.3 g) to avoid excessive ingestion of fluoride. the use of low-[f] dentifrices by children younger than 6 years also seems to be a good alternative to minimize fluoride intake. dentifrice flavor did not influence the percentage of fluoride intake.
Fingernail may not be a reliable biomarker of fluoride body burden from dentifrice
Lima-Arsati, Ynara Bosco Oliveira;Martins, Carolina Castro;Rocha, Lília Alves;Cury, Jaime Aparecido;
Brazilian Dental Journal , 2010, DOI: 10.1590/S0103-64402010000200001
Abstract: fingernail has been suggested as a biomarker of fluoride (f) body burden, but there is no consensus if it would be a reliable indicator of f exposure from dentifrice. therefore, the present study was conducted to investigate if fingernails would have sensitivity to detect f exposure from dentifrice in young children. twenty-three 1-3-year-old children living in the city of piracicaba (0.72 ppm f in water), brazil, were enrolled in two phases of different f exposure: in phase a (1st to 11th week), they were exposed to the combination of f from diet (solids and liquids) and dentifrice (1,500 μg f/g as mfp), and in phase b (12th to 29th week), only to f from diet (the use of f dentifrice was interrupted). fingernails were weekly clipped during 35 weeks for f determination. f intake from diet and dentifrice in each phase was also determined. both analyses were made with ion-specific electrode. f intake (mean ± sd) was significantly higher (p<0.01) when the children were exposed to f from diet+dentifrice than only to f from diet (0.086 ± 0.032 and 0.040 ± 0.009 mg f/day/kg body weight, respectively). however, f concentrations in nails collected during the whole experimental period of 35 weeks presented great variation with no trend of decreasing after f dentifrice intake interruption. the findings suggest that fingernail may not be a reliable f biomarker of body burden from dentifrice.
Association Between Socioeconomic Factors and the Choice of Dentifrice and Fluoride Intake by Children  [PDF]
Carolina Castro Martins,Maria José Oliveira,Isabela Almeida Pordeus,Jaime Aparecido Cury,Saul Martins Paiva
International Journal of Environmental Research and Public Health , 2011, DOI: 10.3390/ijerph8114284
Abstract: It is questionable whether socioeconomic factors influence the choice of marketed children’s dentifrices and whether these products are associated with greater fluoride (F) intake in children. The present cross-sectional study involving 197 children (mean age: 40.98 ± 6.62 months) was carried out in Montes Claros, Brazil. Parents completed a questionnaire on socioeconomic status and the tooth brushing habits of their children. The children brushed their teeth and saliva residues were collected for F analysis. F intake from dentifrice was determined with an ion-specific electrode. Univariate analysis and logistic regression were used to test whether the type of dentifrice (children’s or family) and F dose (< 0.05 and ≥0.05 mg F/Kg of body weight/day) were associated with the independent variables (p < 0.05). No differences were found between children’s and family dentifrices regarding daily F intake (0.046 and 0.040 mg F/Kg/day, respectively; p = 0.513). The following were strong predictors for the use of a children’s dentifrice: studying at a private kindergarten (OR: 6.89; p < 0.001); age that the child begun to tooth brush < 2 years (OR: 2.93; p = 0.041), and the interaction between the variables “use of the same dentifrice as parents” and “type of tooth brush used” (OR: 27.20; p < 0.001). “The amount of dentifrice used” and “frequency of tooth brushing” (p ≤ 0.004) had a statistically and synergistic effect over the daily F dose. The present study found a social influence over the choice of dentifrice: children with a high socioeconomic status tend to use a children’s dentifrice. The amount of dentifrice used can strongly increase the risk of exposure to higher doses of F, regardless of the type of dentifrice.
Urinary fluoride output in children following the use of a dual-fluoride varnish formulation
Olympio, Kelly Polido Kaneshiro;Cardoso, Vanessa Eid da Silva;Bijella, Maria Fernanda Borro;Pessan, Juliano Pelim;Delbem, Alberto Carlos Botazzo;Buzalaf, Marília Afonso Rabelo;
Journal of Applied Oral Science , 2009, DOI: 10.1590/S1678-77572009000300009
Abstract: objective: this study evaluated the bioavailability of fluoride after topical application of a dual-fluoride varnish commercially available in brazil, when compared to duraphattm. material and methods: the urinary fluoride output was evaluated in seven 5-year-old children after application of the fluoride varnishes, in two different phases. in the first phase (i), children received topical application of the fluoride varnish duofluorid xii (2.92% fluorine, calcium fluoride + 2.71% fluorine, sodium fluoride, fgmtm). after 1-month interval (phase ii), the same amount (0.2 ml) of the fluoride varnish duraphat (2.26% fluorine, sodium fluoride, colgatetm) was applied. before each application all the volunteers brushed their teeth with placebo dentifrice for 7 days. urinary collections were carried out 24 h prior up to 48 h after the applications. fluoride intake from the diet was also estimated. fluoride concentration in diet samples and urine was analyzed with the fluoride ion-specific electrode and a miniature calomel reference electrode coupled to a potentiometer. data were tested by anova and tukey's post hoc test (p<0.05). results: there were significant differences in the urinary fluoride output between phases i and ii. the use of duofluorid xii did not significantly increase the urinary fluoride output, when compared to baseline levels. the application of duraphat caused a transitory increase in the urinary fluoride output, returning to baseline levels 48 h after its use. conclusions: the tested varnish formulation, which has been shown to be effective in in vitro studies, also can be considered safe.
Fluoride intake from drinking water and dentifrice by children living in a tropical area of Brazil
Omena, Leila Maria F.;Silva, Milton F. de A.;Pinheiro, Cleone Calheiros;Cavalcante, Jairo C.;Sampaio, Fábio Correia;
Journal of Applied Oral Science , 2006, DOI: 10.1590/S1678-77572006000500015
Abstract: objective: to assess fluoride (f-) intake from water and toothpaste by children aged 18 to 36 months and to monitor the f- concentrations in the drinking water system in a tropical city of brazil. methods: children (n=58) aged 18-36 months, all lifetime residents of penedo, state of alagoas, brazil, participated in this study. water f- analyses were carried out in 7 different occasions at least a week apart. for 2 days all the water drunk by each child was accounted for. fluoride intake from water for each child was estimated using the mean f- concentration of water in 7 different occasions. fluoride intake from toothpaste was estimated by subtracting the recovered post-brushing f- from the original amount placed in the toothbrush. the f- intake from water and toothpaste was estimated by dividing the total amount of f- ingested by the weight of each child. results: the mean f- concentration in the drinking water was 0.94 ppm (mean range 0.78-1.1 ppm), which is above the 0.7 ppm recommended for this area of brazil. mean total f- intake from water and toothpaste was 0.128 mg f-/kg body weight/day. the daily means of f- intake from water and toothpaste were 0.021 and 0.107 mg f-/kg body weight, respectively. ninety six percent of children showed f- intake above 0.07 mg f-/kg body weight/day. conclusions: children in penedo are at risk for developing dental fluorosis due to high f- intake from fluoridated toothpastes. water fluoridation showed low contribution to the total f- intake. however, high water f- concentrations in the water indicate the need of surveillance of the artificial water fluoridation system.
Alimentary fluoride intake in preschool children
Edgar Oganessian, Romana Ivancakova, Erika Lencova, Zdenek Broukal
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-768
Abstract: Daily alimentary fluoride intake was measured in a group of 36 children with an average age of 4.75 years and an average weight of 20.69 kg at baseline, by means of a double plate method. This was repeated after six months. Parents recorded their child's diet over 24 hours and collected duplicated portions of food and beverages received by children during this period. Pooled samples of food and beverages were weighed and solid food samples were homogenized. Fluoride was quantitatively extracted from solid food samples by a microdiffusion method using hexadecyldisiloxane and perchloric acid. The content of fluoride extracted from solid food samples, as well as fluoride in beverages, was measured potentiometrically by means of a fluoride ion selective electrode.Average daily fluoride intake at baseline was 0.389 (SD 0.054) mg per day. Six months later it was 0.378 (SD 0.084) mg per day which represents 0.020 (SD 0.010) and 0.018 (SD 0.008) mg of fluoride respectively calculated per kg bw/day.When adding the values of unwanted fluoride intake from the toothpaste shown in the literature (0.17-1.21 mg per day) the estimate of the total daily intake of fluoride amounted to 0.554-1.594 mg/day and recalculated to the child's body weight to 0.027-0.077 mg/kg bw/day.In the children studied, observed daily fluoride intake reached the threshold for safe fluoride intake. When adding the potential fluoride intake from swallowed toothpaste, alimentary intake reached the optimum range for daily fluoride intake. These results showed that in preschool children, when trying to maximize the benefit of fluoride in caries prevention and to minimize its risk, caution should be exercised when giving advice on the fluoride containing components of child's diet or prescribing fluoride supplements.Over the last 15 years, there have been several studies of alimentary fluoride intake in younger pre-school children. Alimentary fluoride intake has been studied in children from 6 months to 10 year
Ingest?o de flúor por crian?as pela água e dentifrício
Lima,Ynara Bosco de Oliveira; Cury,Jaime Aparecido;
Revista de Saúde Pública , 2001, DOI: 10.1590/S0034-89102001000600012
Abstract: objective: to determine the total fluoride dose to which children were exposed during the critical age of developing dental fluorosis, in an optimally fluoridated region, having diet (liquids and solids) and dentifrice as fluoride sources. methods: for the pilot study, 39 children (aged 20 to 30 months) were selected from a day care center in piracicaba, brazil. they drank and ate food prepared with fluoridated water. to determine the total dose of fluoride exposure, duplicate-plate samples and products from tooth brushing were collected for two consecutive days, in four periods of the year. fluoride was determined using an ion specific electrode. a 5% level of significance variance analysis (anova) was carried out. results: children were exposed to a total fluoride dose of 0.090 mg/day/kg of body weight, of which 45% came from the diet and 55% from dentifrice. conclusions: assuming 0.07 mg/kg as a threshold value of fluoride systemic exposure, children were exposed to a risk dose for dental fluorosis. thus, measures to reduce fluoride intake at the studied age range would be recommended. reducing the amount of dentifrice used for tooth brushing seems to be the best measure, given the risk/benefits of fluoride use from the public health perspective.
Fluoride Intake through Consumption of Tap Water and Bottled Water in Belgium  [PDF]
Stefanie Vandevijvere,Benoit Horion,Michel Fondu,Marie-Josée Mozin,Michèle Ulens,Inge Huybrechts,Herman Van Oyen,Alfred Noirfalise
International Journal of Environmental Research and Public Health , 2009, DOI: 10.3390/ijerph6051676
Abstract: There is a tendency to align higher levels of fluoride in natural mineral water with the existing higher levels in tap water. Treatment of natural mineral waters could harm the preservation of their natural character. In this study fluoride intake through bottled and tap water consumption in the Belgian adult population was assessed, taking into account regional differences. A deterministic approach was used whereby consumption quantities of tap water and different brands of bottled water were linked with their respective fluoride concentrations. Data from the national food consumption survey (2004) were used and the Nusser methodology was applied to obtain usual intake estimates. Mean intake of fluoride through total water consumption in Flanders was 1.4±0.7 mg/day (97.5th percentile: 3.1 mg/day), while in the Walloon region it was on average 0.9±0.6 mg/day (97.5th percentile: 2.4 mg/day). The probability of exceeding the UL of 7 mg per day via a normal diet was estimated to be low. Consequently, there is no need to revise the existing norms, but higher fluoride concentrations should be more clearly indicated on the labels. Reliable data about total dietary fluoride intake in children, including intake of fluoride via tooth paste and food supplements, are needed.
Effect of Discontinuation of Fluoride Intake from Water and Toothpaste on Urinary Excretion in Young Children  [PDF]
Carolina C. Martins,Saul M. Paiva,Jaime A. Cury
International Journal of Environmental Research and Public Health , 2011, DOI: 10.3390/ijerph8062132
Abstract: As there is no homeostatic mechanism for maintaining circulating fluoride (F) in the human body, the concentration may decrease and increase again when intake is interrupted and re-started. The present study prospectively evaluated this process in children exposed to F intake from water and toothpaste, using F in urine as a biomarker. Eleven children from Ibiá, Brazil (with sub-optimally fluoridated water supply) aged two to four years who regularly used fluoridated toothpaste (1,100 ppm F) took part in the study. Twenty-four-hour urine was collected at baseline (Day 0, F exposure from water and toothpaste) as well as after the interruption of fluoride intake from water and dentifrice (Days 1 to 28) (F interruption) and after fluoride intake from these sources had been re-established (Days 29 to 34) (F re-exposure). Urinary volume was measured, fluoride concentration was determined and the amount of fluoride excreted was calculated and expressed in mg F/day. Urinary fluoride excretion (UFE) during the periods of fluoride exposure, interruption and re-exposure was analyzed using the Wilcoxon test. Mean UFE was 0.25 mg F/day (SD: 0.15) at baseline, dropped to a mean of 0.14 mg F/day during F interruption (SD: 0.07; range: 0.11 to 0.17 mg F/day) and rose to 0.21 (SD: 0.09) and 0.19 (SD: 0.08) following F re-exposure. The difference between baseline UFE and the period of F interruption was statistically significant (p < 0.05), while the difference between baseline and the period of F re-exposure was non-significant (p > 0.05). The findings suggest that circulating F in the body of young children rapidly decreases in the first 24 hours and again increases very fast after discontinuation and re-exposure of F from water and toothpaste.
Salivary Fluoride level in preschool children after toothbrushing with standard and low fluoride content dentifrice, using the transversal dentifrice application technique: pilot study  [PDF]
Fabiana Jandre Melo
RGO : Revista Gaúcha de Odontologia , 2008,
Abstract: Objective: To investigate the salivary fluoride concentration in pre-school children after toothbrushing with dentifrice containing standard (1100ppmF/NaF) and low (500ppmF/NaF) fluoride concentration, using the transversal technique of placing the product on the toothbrush. Methods: Eight children of both sexes, ranging from 4 to 9 years, and 5 years and 6 months of age, participated in the study. The experiment was divided into two phases with a weekly interval. In the first stage, the children used the standard concentration dentifrice for one week, and in the second, the low concentration product. Samples were collected at the end of each experimental stage, at the following times: Before brushing, immediately afterwards, and after 15, 30 and 45 minutes. The fluoride contents were analyzed by the microdiffusion technique. Statistical analysis was done by the analysis of variance ANOVA and Student’s-t test (p<0.05). Results: The salivary fluoride concentration was significantly higher at all times, when the standard concentration product was used. The comparison between the Halogen concentration found before bushing and immediately afterwards, showed that there was a 6.8 times increase in the standard dentifrice (0.19 x 1.29μgF/ml) and in the low concentration product, an increase of 20.5 times (0.02 x 0.41μgF/ml). Conclusion: Toothbrushing with both products promoted relevant increases in the salivary fluoride concentration; however, longitudinal studies are necessary to verify the clinical result of this measurement.
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