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      Factors associated with dental fluorosis in three zones of Ecuador

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          Abstract

          Background

          To determine the prevalence of dental fluorosis in 10-12 year-old school children, in three provinces of the inter-andean Region of Ecuador: Imbabura, Pichincha and Chimborazo, as well as the relationship between certain factors, considering that the latest studies go back to the year 2009.

          Material and Methods

          A cross-sectional and observational study was proposed. A sample of 599 was calculated at 95% of confidence considering population projections for children between 10 and 12 old of three zones of Ecuador. However, 608 school children, who had the acceptance and informed consent of their parents to participate, completed a survey about factors associated with dental fluorosis. Once the survey was completed, the vestibular surfaces of the upper and lower anterior teeth of the infant were photographed, following standardized distance and light procedures. Three evaluators, trained in the detection of fluorosis using the Thylstrup and Fejerskov index, analyzed the photographs. The Stata 13.0 software was used for the statistical analysis, with a level of significance of 5% and with a confidence interval of 95%. To relate the risk factor of fluorosis, a multinomial logistic model was used.

          Results

          The prevalence of dental fluorosis was of 89.96%, with a greater presence of grade 2 TF. A positive statistical relationship and statistical significance was detected between dental fluorosis and consumption of bottled beverages. Also the amount of toothpaste used and its ingestion during brushing ( p = 0.000) were analyzed.

          Conclusions

          The populations evaluated, that are related to the consumption of bottled beverages and involuntary toothpaste ingestion, and have a high prevalence of a mild level of fluorosis.

          Key words:Fluorosis, dental, risk factors, epidemiology.

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          Most cited references27

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          Toxic effects of fluoride on organisms

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            Are topical fluorides effective for treating incipient carious lesions?: A systematic review and meta-analysis.

            This systematic review and meta-analysis evaluated the effectiveness of professional topical fluoride application (gels or varnishes) on the reversal treatment of incipient enamel carious lesions in primary or permanent dentition.
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              Assessment of potential health risk of fluoride consumption through rice, pulses, and vegetables in addition to consumption of fluoride-contaminated drinking water of West Bengal, India.

              A study was conducted in fluoride-affected Bankura and Purulia districts of West Bengal to assess the potential health risk from fluoride exposure among children, teenagers, and adults due to consumption of rice, pulses, and vegetables in addition to drinking water and incidental ingestion of soil by children. Higher mean fluoride contents (13-63 mg/kg dry weight) were observed in radish, carrot, onion bulb, brinjal, potato tuber, cauliflower, cabbage, coriander, and pigeon pea. The combined influence of rice, pulses, and vegetables to cumulative estimated daily intake (EDI) of fluoride for the studied population was found to be 9.5-16%. Results also showed that intake of ivy gourd, broad beans, rice, turnip, fenugreek leaves, mustard, spinach, and amaranth grown in the study area is safe at least for time being. The cumulative EDI values of fluoride (0.06-0.19 mg/kg-day) among different age group of people of the study area were evaluated to be ~104 times higher than those living in the control area; the values for children (0.19 and 0.52 mg/kg-day for CTE and RME scenarios, respectively) were also greater than the "Tolerable Upper Intake Level" value of fluoride. The estimated hazard index (HI) for children (3.2 and 8.7 for CTE and RME scenarios, respectively) living in the two affected districts reveals that they are at high risk of developing dental fluorosis due to the consumption of fluoride-contaminated rice, pulses, and vegetables grown in the study area in addition to the consumption of contaminated drinking water.
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                Author and article information

                Journal
                J Clin Exp Dent
                J Clin Exp Dent
                Medicina Oral S.L.
                Journal of Clinical and Experimental Dentistry
                Medicina Oral S.L.
                1989-5488
                1 January 2019
                January 2019
                : 11
                : 1
                : e42-e48
                Affiliations
                [1 ]PhD. MSc. DDs. Oral Health Research Center–CISO. Teacher, Universidad UTE. Avenida Mariscal Sucre y Mariana de Jesús. ZIP-Code: 170902. Quito, Ecuador
                [2 ]PhD. MSc. DDs. Director of the Public Health Group. University of Cartagena, Colombia. Department of Research, School of Dentistry. Universidad de Cartagena, Colombia. Campus Zaragocilla. Cra 30 # 39b-192. Cartagena, Colombia
                [3 ]DDs. Clinica Dental Artist. Universidad Central del Ecuador, Avenida América y Universitaria, Quito, Ecuador
                [4 ]DDs, Clinica Advance. Universidad Internacional del Ecuador, Ignacio Lecumberry OE6-223 y Nela Martínez. Quito, Ecuador
                [5 ]MSc. Ing. Chief Evaluation Officer, Universidad UTE, Campus Occidental. Avenida Mariscal Sucre y Mariana de Jesús. Quito, Ecuador
                [6 ]DDs, Clinica Dental Artist. Universidad Central del Ecuador, Avenida América y Universitaria, Quito, Ecuador
                Author notes
                Clinica Dental Artist, Av. America , E-mail: fabriche20@ 123456hotmail.com

                Conflict of interest statement: The authors have declared that no conflict of interest exist.

                Article
                55124
                10.4317/jced.55124
                6343983
                30697393
                490dfcbd-7365-437d-a78f-90731f07589c
                Copyright: © 2019 Medicina Oral S.L.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 12 October 2018
                : 4 July 2018
                Categories
                Research
                Community and Preventive Dentistry

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