Is there also “dental fluorosis”?

FAQ on Salt Fluoridation

Is there also “dental fluorosis”?

Postby admin » Sun Aug 30, 2015 9:29 am

Is there also “dental fluorosis”?

The incidence of dental fluorosis is said to be less common in areas where salt fluoridation is used which, as Yewe-Dyer states, "might well be because too little salt is eaten at an early age to cause this problem." (Yewe-Dyer, 2002).

If this were indeed true, it would be very disturbing news as it would mean that the most-studied and acknowledged indicator of fluoride over-exposure - dental fluorosis, would no longer be appropriate for exposure investigations. The condition can occur only from fluoride exposure during the critical times of enamel formation - from in utero to approx. 2 1/2 years of age.

In the mind of the dental public health experts - who have long declared dental fluorosis to be of “cosmetic concern” only - this translates into believing that fluoride over-exposure is not a problem for children anymore, while “benefits for caries reduction are striking”. Statements to that effect are already being made (i.e. Yewe-Dyer, 2002).

There are really two issues.

Concerning salt consumption - while while babies and toddlers might not be taking in much salt, 4 to 6 vear olds consume very much salt. Just because they don’t show dental fluorosis in their later years does not mean that their fluoride intake was or is within a “safety limit”, a fact repeatedly alerted to by UNICEF and health organizations in other countries such as India where fluoride poisoning is endemic (see UNICEF, 2001). In India the effects of fluoride poisoning - other than dental defects - are of course clearly acknowledged.

But there is something else. When the papers which claim “only neglible dental fluorosis” are investigated in-depth, a different picture emerges concerning the occurrence, and once again it becomes clear that the science is being manipulated in order to mislead the public. Two examples are given here:

EXAMPLE 1: Jamaica

The World Health Organization (WHO) has a special web page on the salt fluoridation program in Jamaica, because Jamaica was considered a “trial ground” for salt fluoridation. It cites a study which allegedly found that “ninety six percent of the children were fluorosis free, 4% had 'questionable' fluorosis and less than 1% had very mild to mild fluorosis. None of the children showed moderate or severe fluorosis.” (WHO, 2002)

However, upon closer examination one finds that the majority of children investigated were already 4 or 8 years old when the program started - well past the critical stage of enamel formation when dental fluorosis occurs!

When other researchers recently studied the children in Jamaica, they found that almost half of them showed signs of fluorosis (Meyer-Lueckel et al., 2002).

The same findings can be made when other studies proclaiming “no dental fluorosis” are investigated closer.

EXAMPLE 2: France

In France in 1991, Fabien et al, investigated 6 to 16-year-old children, stating that:

“...dental fluorosis was very uncommon; 96.1% of the 18,786 children examined in 1991 were totally free of any such lesions.”

Salt fluoridation in France started in 1986/1987. As this study was done in 1991 - only four years later - it means, again, that the vast majority of the investigated children (6 to 16 year-olds) had already long surpassed the critical age of enamel formation!

The truth lies somewhere else and will become more apparent as more proper research is conducted. A recent review from Mexico revealed that the prevalence of dental fluorosis ranged from 52% to 82% in areas where fluoridated salt is used (Soto-Rojas et al, 2004).

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PFPC Fluoridated Salt FAQ - © 2004 PFPC

REFERENCES:

Clarkson JJ, McLoughlin N - “Role of fluoride in oral health promotion” International Dental Journal 50:119-128 (2000)

EAPD (European Academy of Paediatric Dentistry) - “Guidelines on the use of fluoride in children: an EAPD policy document” (2000)

Estupinan-Day SR, Baez R, Horowitz H, Warpeha R, Sutherland B, Thamer M - "Salt fluoridation and dental caries in Jamaica" Community Dent Oral Epidemiol 29(4):247-52 (2001)

Fabien V, Obry-Musset AM, Hedelin G, Cahen PM - "Caries prevalence and salt fluoridation among 9-year-old schoolchildren in Strasbourg, France" Community Dent Oral Epidemiol 24(6):408-11 (1996)

Hernandez LP - “Prevention of dental caries through salt fluoridation in Mexico” CEDROS Newsletter Year II, N.3 (1993)

Hescot P - “Fluoridated Salt: A Measure Of Public Health In France” CEDROS Newsletter Year I, N.1 (1992)

ICCIDD - Switzerland Data

k+s Report 2000 (in German)

Kunzel W - "Systemic use of fluoride - other methods: salt, sugar, milk etc." Caries Research 27 (suppl.1):16-22 (1993)

Macpherson LM, Stephen KW - "The effect on human salivary fluoride concentration of consuming fluoridated salt-containing baked food items" Arch Oral Biol 46(10):983-8 (2001) Link

Marthaler TM- "Salt fluoridation: effectiveness against dental caries and practical results in Latin America and Europe" (2001)

Marthaler TM - “Salt fluoridation in Europe, comparisons with Latin America” 8th World Salt Symposium (2000); Volume 2: 1021-1026 (2000)

Marthaler (in German)
Under the heading: Zur Toxizität der Fluoride - derzeitiger Stand der Erkenntnis

Meyer-Lueckel H, Satzinger T, Kielbassa AM - “Caries prevalence among 6- to 16-year-old students in Jamaica 12 years after the Introduction of salt fluoridation” Caries Res 36(3):170-3 (2002)

Menghini G, Steiner M, Marthaler T, Helfenstein U, Brodowski D, Imfeld C, Weber R, Imfeld T - "Caries prevalence among students in 16 Zurich districts in the years 1992 to 2000" Schweiz Monatsschr Zahnmed 113(3):267-77 (2003)

Milner T, Estupiñán-Day D - “Overview of Salt Fluoridation in the Region of the Americas: Part II. The Status of Salt Production, Quality & Marketing and the State of Technology Development for Salt Fluoridation” Salt 2000, 8th World Salt Symposium, Volume 2, pg 1033-1038 (2000)

PAHO - General Guidelines for Drafting a Legal Framework: Mandatory Iodization and Fluoridation of Salt for Human Consumption Division of Health Systems and Services Development Regional Program on Oral Health (November 2001)

PAHO Press Release, Aug. 23, 1996
http://poisonfluoride.com/pfpc/html/paho_1996.html

Pollick H - “Questions and Answers on Water Fluoridation - Prepared by Howard Pollick, BDS, MPH (2004)

Reuters Health - “Fluoride in Table Salt Cuts Tooth Decay in Jamaica”, Aug. 21, 2001

Salas MT - Fluoridated Salt - CEDROS Newsletter, Year III,N.5 (1994)

Soto-Rojas AE, Urena-Cirett JL, Martinez-Mier Ede L - "A review of the prevalence of dental fluorosis in Mexico" Rev Panam Salud Publica 15(1):9-18 (2004)

Stephen KW, Macpherson LM, Gorzo I, Gilmour WH - “Caries, fluorosis and salt fluoridation in the city of Szeged” Fogorv Sz 91(8-9):275-80 (1998)

SVE (Schweizerische Vereinigung fuer Ernaehrung) - Streit ums Salz, Tabula 3 (1999)

Tovar LR, Guttierrez Ma E, Cruz G - "Fluoride content by ion chromatography using a suppressed conductivity detector and osmolality of bitterns discharged into the pacific ocean from a saltworks: Feasable causal agents in the mortality of green turtles (Chelonia mydas) in the Ojo de Liebre lagoon, Baja California Sur, Mexico" Analytical Sciences Vol.18:1003 (2002)

UNICEF - "Fluoride in water: An overview" (2001)

UK Food Standards - Salt & Health (Complete Report)
Scientific Advisory Committee on Nutrition (SACN) (2003)

UK Food Standards Press Release (May 15, 2003)

WHO - "Salt Fluoridation Programme to prevent dental caries in Jamaica" (2002)

WHO - “Fluorides and Human Health” Report of a WHO Expert Committee on Oral Health Status and Fluoride Use. WHO Technical Report Series, 846. Geneva: WHO, 1994

Yewe-Dyer M - "My view on fluoridation" BDJ 192(10):551-553 (2002)
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