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      Concentración de flúor y metales pesados en aguas embotelladas: medidas barrera frente a caries dental y fluorosis Translated title: Fluoride and heavy metals concentration in bottled waters: barrier measures against dental caries and fluorosis

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          Abstract

          RESUMEN Fundamentos: El consumo diario de agua fluorada es una de las medidas mas beneficiosas en la prevención de la caries dental. El objetivo de este estudio fue analizar el contenido de flúor y metales pesados en el agua mineral natural embotellada disponible en los comercios de España. Métodos: Se realizó un estudio descriptivo y transversal a lo largo de 2019, analizando 20 marcas de aguas embotelladas comercializadas en España en ese año. Se midió principalmente la concentración de flúor (partes por millón/mililitro) (ppm/ml), que fue analizada con un electrodo ion-específico (modelo Orión 96-09, Orion Research, Cambridge) acoplado a un analizador de iones (Orion EA-940). Los metales pesados se analizaron mediante ICP-MS (Agilent modelo 7900). Se realizó un estudio estadístico descriptivo de los datos. Resultados: El valor mínimo de flúor encontrado fue de 0,05 ppm y el máximo de 0,95 ppm. El 80% de las marcas analizadas contenían menos de 0,6 ppm F. Solamente una marca superó las 0,8 ppm F. Cromo y arsénico fueron los metales pesados presentes en todas las marcas, sin superar la dosis máxima. Ninguna marca de agua embotellada indicaba los metales pesados en la etiqueta, y solo una marca indicó la concentración de flúor en la etiqueta. Conclusiones: Existe una gran variabilidad en la composición química de las aguas embotelladas comercializadas en España. La mayoría tienen una concentración de fluoruro inferior a la recomendada para prevenir la caries dental, por lo que se necesitaría un aporte extra de flúor. En las aguas embotelladas analizadas existen metales pesados, pero no superan las dosis máximas establecidas por la legislación.

          Translated abstract

          ABSTRACT Background: The daily consumption of fluoridated water is one of the most beneficial measures in dental caries prevention. The objective of this paper was to analyze the content of fluorine and heavy metals in the bottled natural mineral water available in stores in Spain. Methods: A descriptive and transversal study was done throughout 2019. Analysing a total of 20 bottled waters marketed in Spain during this year. Mainly, fluoride concentration (ppm/ml) was analyzed with an ion-specific electrode (Orion model 96-09, Orion Research, Cambridge, MA) coupled to an ion analyzer (Orion EA-940). The heavy metals were analyzed by ICP-MS (Agilent model 7900). A descriptive statistical study of the data was carried out. Results: The minimum value of fluorine found was 0.05 ppm and the maximum 0.95 ppm. 80% of the brands analyzed contain less than 0.6 ppm F. Only 1 brand exceeds 0.8 ppm F. Chromium and arsenic were the heavy metals present in all brands, without exceeding the maximum dose. No brand of bottled water indicated heavy metals on the label, and only 1 mark indicated the fluoride concentration on the label. Conclusions: There is a great variability in the chemical composition of bottled waters marketed in Spain. Most have a fluoride concentration lower than that recommended to prevent tooth decay, which would require an extra supply of fluoride. In the bottled waters analyzed there are heavy metals but they did not exceed the maximum doses established by legislation.

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          FLUORIDE: A REVIEW OF USE AND EFFECTS ON HEALTH

          Introduction: Appropriate oral health care is fundamental for any individual’s health. Dental caries is still one of the major public health problems. The most effective way of caries prevention is the use of fluoride. Aim: The aim of our research was to review the literature about fluoride toxicity and to inform physicians, dentists and public health specialists whether fluoride use is expedient and safe. Methods: Data we used in our review were systematically searched and collected from web pages and documents published from different international institutions. Results: Fluoride occurs naturally in our environment but we consume it in small amounts. Exposure can occur through dietary intake, respiration and fluoride supplements. The most important factor for fluoride presence in alimentation is fluoridated water. Methods, which led to greater fluoride exposure and lowered caries prevalence, are considered to be one of the greatest accomplishments in the 20th century`s public dental health. During pregnancy, the placenta acts as a barrier. The fluoride, therefore, crosses the placenta in low concentrations. Fluoride can be transmitted through the plasma into the mother’s milk; however, the concentration is low. The most important action of fluoride is topical, when it is present in the saliva in the appropriate concentration. The most important effect of fluoride on caries incidence is through its role in the process of remineralization and demineralization of tooth enamel. Acute toxicity can occur after ingesting one or more doses of fluoride over a short time period which then leads to poisoning. Today, poisoning is mainly due to unsupervised ingestion of products for dental and oral hygiene and over-fluoridated water. Conclusion: Even though fluoride can be toxic in extremely high concentrations, it`s topical use is safe. The European Academy of Paediatric Dentistry (EAPD) recommends a preventive topical use of fluoride supplements because of their cariostatic effect.
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            Focus on fluorides: update on the use of fluoride for the prevention of dental caries.

            Improving the efficacy of fluoride therapies reduces dental caries and lowers fluoride exposure.
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              Drinking water studies: A review on heavy metal, application of biomarker and health risk assessment (a special focus in Malaysia)

              Malaysia has abundant sources of drinking water from river and groundwater. However, rapid developments have deteriorated quality of drinking water sources in Malaysia. Heavy metal studies in terms of drinking water, applications of health risk assessment and bio-monitoring in Malaysia were reviewed from 2003 to 2013. Studies on heavy metal in drinking water showed the levels are under the permissible limits as suggested by World Health Organization and Malaysian Ministry of Health. Future studies on the applications of health risk assessment are crucial in order to understand the risk of heavy metal exposure through drinking water to Malaysian population. Among the biomarkers that have been reviewed, toenail is the most useful tool to evaluate body burden of heavy metal. Toenails are easy to collect, store, transport and analysed. This review will give a clear guidance for future studies of Malaysian drinking water. In this way, it will help risk managers to minimize the exposure at optimum level as well as the government to formulate policies in safe guarding the population.
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                Author and article information

                Journal
                resp
                Revista Española de Salud Pública
                Rev. Esp. Salud Publica
                Ministerio de Sanidad, Consumo y Bienestar social (Madrid, Madrid, Spain )
                1135-5727
                2173-9110
                2019
                : 93
                : e201912110
                Affiliations
                [1] Murcia Murcia orgnameUniversidad de Murcia orgdiv1Facultad de Medicina-Odontología orgdiv2Departamento de Odontología Integrada Infantil Spain
                [2] Murcia orgnameUnivesidad de Murcia orgdiv1Facultad de Medicina-Odontología orgdiv2Departamento de Odontología Preventiva y Comunitaria España
                [3] Piracicaba São Paulo orgnameUniversidad de Piracicaba. University of Campinas orgdiv1Facultad de Odontología orgdiv2Departamento de Ciencias Fisiológicas Brasil
                Article
                S1135-57272019000100452 S1135-5727(19)09300000452
                b098dfa6-8539-45f6-8701-6ea1d8579980

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

                History
                : 05 September 2019
                : 23 October 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 30, Pages: 0
                Product

                SciELO Public Health

                Categories
                Originales

                Dental fluorosis,Metales pesados,Agua embotellada,Fluoride,Caries dental,Bottled water,Dental caries,Flúor,Heavy metals

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