Fluorosis & "Race"

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Fluorosis & "Race"

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©2004 PFPC

If fluorides are truly anti-thyroid agents, then fluoride effects (i.e. “dental fluorosis”, thyroid dysfunction) should be observable more so in black than in white children - as blacks have a considerably lower "normal thyroid status" and thus effects would be more pronounced among the black population (see: Long et al, 1985; Schectman et al. 1991, etc.).

This is indeed the case.

In 1962 Russel reported on the progress in Grand Rapids, after 16 years of fluoridation. There was fluorosis in 19.3% of white children, and 40.2 percent of black children.

In 1949, Hurme had also observed more enamel opacities in the upper incisors of black children.

Of course, this has been observed many more times since (Butler, 1985; Duncan et al, 1988; Silberman et al, 1991; Kumar 1999; etc.)


Butler WJ, Segreto V, Collins E - "Prevalence of dental mottling in school-aged lifetime residents of 16 Texas communities" Am J Public Health 75(12):1408-12 (1985)
"White and Spanish-surname children had about the same prevalence of mottling while Blacks had a higher prevalence...."
Duncan WK, Silberman SL, Trubman A - "Labial hypoplasia of primary canines in black Head Start children" ASDC J Dent Child 55(6):423-6 (1988)

Hurme VO -"Developmental Opacities of teeth in a New England community; their relation to fluorine toxicosis" Am J Dis Child 77:61-75 (1949)
In 1949 Hurme also observed more enamel opacities in the upper incisors of black children.
Kumar JV, Swango PA - "Fluoride exposure and dental fluorosis in Newburgh and Kingston, New York: policy implications" Community Dent Oral Epidemiol 27(3):171-80  (1999)
"The increase in risk from 1986 to 1995 was greater for African-American children."
Russell AL -"Dental Fluorosis in Grand Rapids during the 17th year of fluoridation" JAMA 65:608-612 (1962)
Fluorosis in 19.3% in the white children, and 40.2 percent in the black children.
Silberman SL, Duncan WK, Trubman A, Meydrech EF - "Primary canine hypoplasia in Head Start children" J Public Health Dent 49(1):15-8 (1989)

Silberman SL, Trubman A, Duncan WK, Meydrech EF - "Prevalence of primary canine hypoplasia of the mandibular teeth" Pediatr Dent 13(6):356-60 (1991)
"The prevalence rate of primary canine hypoplasia was 33.2% for black children and 17.2% for white children. These data indicate that this lesion is significantly more prevalent in blacks than whites, and that teeth with this lesion have a greater probability of developing dental caries."

Chek K, Kerr GR - "Factors associated with fetal mortality in the triethnic population in Texas, 1993 through 1995" Tex Med 95(12):78-83  (1999)

Edupuganti S, Svec F, Bao W, Srinivasan SR, Berenson GS - "Thyroid function in children with different lipoprotein profiles: observations in a biracial (black/white) population--the Bogalusa Heart Study" Am J Med Sci 313(2):80-4(1997)
"An unexpected finding was a significantly increased mean serum TSH in whites (2.09 + 0.91; mean + standard error of mean) when compared to blacks (1.74 + 0.10; P = 0.0185)."
Long TJ, Felice ME, Hollingsworth DR - "Goiter in pregnant teenagers" Am J Obstet Gynecol 1985 Jul 15;152(6 Pt 1):670-4(1985)
"Black patients had significantly more thyroid disease than Mexican-American (p less than 0.01) or white patients (p less than 0.005).”
Krogman W - "Child Growth" Ann Arbor: University of Michigan Press p.161 (1972)

Lorey FW, Cunningham GC - "Birth prevalence of primary congenital hypothyroidism by sex and ethnicity" Hum Biol 64(4):531-8 (1992)

Mulla ZD, Margo CE  -"Primary malignancies of the thyroid: epidemiologic analysis of the Florida Cancer Data System registry" Ann Epidemiol10(1):24-30 (2000) 

Schectman JM, Kallenberg GA, Hirsch RP, Shumacher RJ - "Report of an association between race and thyroid stimulating hormone level" Am J Public Health. 81(4):505-6 (1991)

Sowers M, Luborsky J, Perdue C, Araujo KL, Goldman MB, Harlow SD; SWAN -"Thyroid stimulating hormone (TSH) concentrations and menopausal status in women at the mid-life: SWAN" Clin Endocrinol (Oxf) 58(3):340-7 (2003)
"African American women had significantly lower mean TSH concentrations than Caucasian, Hispanic and Chinese women."

Seow WK - "Effects of preterm birth on oral growth and development" Aust Dent J 42(2):85-91 (1997)

Spitz MR, Sider JG, Katz RL, Pollack ES, Newell GR - "Ethnic patterns of thyroid cancer incidence in the United States, 1973-1981" Int J Cancer 42(4):549-53 (1988)

Thomas DB - "Epidemiologic studies of cancer in minority groups in the western United States" Natl Cancer Inst Monogr (53):103-13(1979)
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Martinez-Mier EA, Soto-Rojas AE - "Differences in exposure and biological markers of fluoride among White and African American children" J Public Health Dent 70(3):234-40 (2010)
https://onlinelibrary.wiley.com/doi/abs ... 10.00173.x

Objective: To determine differences in self‐reported fluoride exposure and fluoride exposure biomarkers between two racial groups.

Methods: Questionnaires regarding fluoride exposure, urine and water collection kits were distributed to African American and White 7‐14‐year‐old children. Children received a dental exam for fluorosis. Water, urine, and saliva were analyzed for fluoride content. Questionnaire responses and results of sample analyses were compared and observed differences were analyzed.

Results: 83 African American and 109 White children completed the study. Dental fluorosis was observed in 62.5 percent White and 80.1 percent African American children. Significant differences were found for fluorosis prevalence and severity between the groups (P <0.05). Less African American children reported having used fluoride supplements in the past. White children began brushing their teeth at an earlier age. More White children visited a dentist for the first time before age 3. African American children reported currently using larger amounts of toothpaste. More Whites than African Americans had received topical fluoride treatments over the previous year. All of these differences were significant. Multivariate models showed that supplement use and amount of toothpaste used for brushing had significant associations to a child's fluorosis scores. Fluoride concentration of water and saliva was not different for the two groups; however, the fluoride content in urine was significantly higher in African Americans than in Whites [P <0.05; 1.40 ±standard deviation (SD) 0.65 ppm versus 1.08 ±SD 0.28ppm].

Conclusions: Differences in fluoride exposure between two racial groups were observed. These differences are complex and need to be better defined.
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