https://pmc.ncbi.nlm.nih.gov/articles/PMC13457802/
Abstract
Background: Dental fluorosis causes tooth color changes, creating esthetic, functional, and physiological problems. High fluoride consumption impairs mental development and lowers intelligence quotient (IQ) in children, affecting dental esthetics and well-being.
Objectives: To estimate fluoride levels and the relation between water fluoride levels and dental fluorosis in 12- to 15-year-old schoolchildren.
Materials and methods: A cross-sectional study was conducted among 1,182 schoolchildren aged 12-15 years. Fluoride analysis by ion-selective electrode method covered 41 villages of Chittoor mandal, Chittoor district, Andhra Pradesh. Among these, 25 villages had suboptimal fluoride levels, 16 had optimal levels, and none exceeded the optimal level. A stratified random sampling technique was employed. Dental fluorosis was recorded using the modified Dean's fluorosis index (1942) and community fluorosis index (CFI). Statistical analysis was done using the Chi-squared test and Pearson's correlation.
Results: Dental fluorosis prevalence was 66.5%. Children who consumed borewell water had 75% fluorosis. Boys showed 53.3% higher prevalence than girls. About 99.8% had no history of fluoride toothpaste or tablet usage in fluoride zones. Also, 83.6% had no familial history of fluorosis. Pearson correlation between fluoride concentration in drinking water and CFI shows positive correlation (r = 0.960). CFI scores ranged 0.48-1.17. The majority of villages showed medium public health significance (1.02-1.17).
Conclusion: Even at optimum fluoride levels, the prevalence of fluorosis is at a higher level. Scanty rainfall, deep borewells, and drought were the reasons for increased prevalence even at optimum fluoride levels. Optimum level of 1 parts per million (ppm) does not seem to be appreciable for Indian conditions. Results serve as a blueprint for public health administrators, dental professionals, and policymakers.