Dental Fluorosis in a Rural Nigerian Community: Is the Water to Blame?

Dental Fluorosis in a Rural Nigerian Community: Is the Water to Blame? 

ABSTRACT  

Drinking water can contain fluoride which is effective in preventing dental caries at a concentration of ≤1.5 mg/L however at concentrations ≥of 1.5 mg/L, it could lead to dental fluorosis.

Dental fluorosis is a disorder that occurs due to excessive fluoride intake during the mineralization of the teeth, resulting in an uneven distribution of brown and yellow coloration.

I assessed fluoride levels in 19 samples of natural water sources (such as boreholes, streams, and wells) and commercial drinking water sources (such as sachet and bottled water products) in Zing Local Government Area, Taraba State, northeastern Nigeria, I then determined the prevalence of dental fluorosis in 135 children, aged 10 to 17 years, who were born in Zing.

Using cross-tabulations and logistic regression modeling, I evaluated factors that might influence whether a child had dental fluoroses, such as dental care habits and drinking water source. Fluorosis occurred in 111 respondents.

Fluoride levels exceeded the World Health Organization permissible limit of 1.0mg/L for tropical environments in most borehole samples, while most stream and well samples did not exceed this limit.

The regression model showed that odds of a child having dental fluorosis were higher for vii those children who drank borehole water compared to those who do not (OR = 8.522), while the odds of having fluorosis decreases for children who drink from stream water (OR = 0.203).

Consequently, community boreholes may need to be defluoridated and there should be community awareness about the sources of water with high fluoride concentrations. 

TABLE OF CONTENTS

CERTIFICATION PAGE ……………………………………………………………………………..ii
APPROVAL PAGE …………………………………………………………………………………….iii
DEDICATION…………………………………………………………………………………………….iv
ACKNOWLEDGEMENTS …………………………………………………………………………..v
ABSTRACT……………………………………………………………………………………………….vi
TABLE OF CONTENTS …………………………………………………………………………..viii
LIST OF TABLES ……………………………………………………………………………………….x
LIST OF FIGURES …………………………………………………………………………………….xi
LIST OF ABBREVIATIONS………………………………………………………………………xii

CHAPTER 1 ………………………………………………………………………………………………..1
INTRODUCTION…………………………………………………………………………………………1
Signs of Dental Fluorosis……………………………………………………………………11
Sources of Fluoride in the Environment and Human Body …………………….11
Stages of Dental Fluorosis…………………………………………………………….21
Dental Fluorosis Correction………………………………………………………………..22
Methods of Water De-fluoridation….…….…………….…………………..23
HYPOTHESES………..………….…………………………….………………….25
AIMS AND OBJECTIVES…………………………………………………………………………..25

CHAPTER 2……………………………………………………………………………………………….26
MATERIALS AND METHODS ………………………………………………………………….26
Study Area ………………………………………………………………………………………26
Data Collection and Analysis ……………………………………………………………..26
Ethical Guidelines……………………………………………………………………….……31

CHAPTER 3 ……………………………………………………………………………………………….32
RESULTS…………………………………………………………………………………………………..32

CHAPTER 4 ……………………………………………………………………………………………….39
DISCUSSION………………………………………………………………………………………………39
Limitations of Study ………………………………………………………………………….42
Challenges………………………………………………………………………………………..43
Recommendations …………………………………………………………………………….43

CHAPTER 5 ………………………………………………………………………………………………44
CONCLUSION …………………………………………………………………………………………..44
APPENDIX I ………………………………………………………………………………………………45
APPENDIX II………………………………………………………………………46
REFERENCES…………….……………………………………………………….48

INTRODUCTION  

is a very important basic for human and that is why water is an important factor and a area of concentration in public health.

Fluoride is an important element considered to be beneficial at low concentrations and toxic at high concentrations when present in water. Fluoride is toxic as a result of its strong affinity for calcium, this gives it the ability to react with structures that are made of calcium such as teeth and bones.

The World Health Organization (WHO) guideline for permissible fluoride concentration in drinking water is set at 1.5 mg/L (WHO, 2011).

However, the WHO has emphasized the need for national authorities to set national fluoride standards taking into consideration climatic conditions, fluoride intake from alternative sources, and daily water intake (Lennon, Whelton, O’Mullane, & Ekstrand, 2005).

Common techniques used to detect fluoride levels include fluoride ion-selective electrode method, calorimetric methods, ion chromatography methods, and use of photometer (Agency for Toxic Substances and Disease Registry, 2001).

For many years, there has been a global public health debate about both the beneficial and adverse effects of fluoride in water sources (UNICEF, 1999).

This debate first came about in the 1930s and 1940s when a study revealed that fluoride concentrations below 1.5 mg/L in water are effective in preventing tooth decay, otherwise known as dental caries (Dean & Brandt Jr, 1974).

According to Jones et al. (2005), dental caries affect approximately 60-90% of school children in most 2 developed countries. In addition, Jones et al. (2005) also identified Latin American and Asia as the continents with the highest prevalence of dental caries. 

REFERENCES

Abugri, D. A., & Pelig-Ba, K. B. (2011). Assessment of Fluoride Content in Tropical
Surface Soils Used for Crop Cultivation . African Journa of Environmental
Science and Technology, 5(9), 653-660.
Abuhaloob, L., & Abed, Y. (2014). Knowledge and Public Perception of Dental
Fluorosis in Children Living in Palestine. Journal of Oral Hygience and
Health, 1-5.
Agency for Toxic Substances and Disease Registry. (2001). Fluorides, Hydrogren
Fluoride and Fluorine. Atlanta: U.S. Department of Health and Human
Services, Public Health Service. .
Akpata, E. S. (2014). Therapeutic Management of Dental Fluorosis: A Critical
Review of Literature. Saudi Journal of Oral Science, 1(1), 3-13.
Akpata, E. S., Danfillo, I. S., Otoh, E. C., & Mafeni, J. O. (2009). Geographical
Mapping of Fluoride Levels in Drinking Water Sources in Nigeria. African
Health Sciences, 9(4), 227-233.
Alvarez, J. A., Rezende, K. M., Marocho, S. M., Alves, F. B., Celiberti, P., &
Ciamponi, A. L. (2009). Dental fluorosis: Exposure, Prevention and
Management. Journal of Clinical and Experimental Dentistry, 14(2), 103-107.
Bartram, J., & Ballance, R. (1996). Water Quality Monitoring – A Practical Guide to
the Design and Implementation of Freshwater Quality Studies and
Monitoring Programmes. UNEP/WHO .
Beltran-Aguilar, E., Barker, L., & Dye, B. (2010). Prevalence and Severity of Dental
Fluorosis in the United States, 1999-2004. NCHS Data Brief, 53, 1-8.
Bhat , N., Jain, S., Asawa, K., Tak, M., Shinde, K., Singh, A., . . . Gupta, V. V.
(2015). Assessment of Fluoride Concentration of Soil and Vegetables in
Vicinity of Zinc Smelter, Debari, Udaipur, Rajasthan. Journal of Clinical and
Diagnostic Research, 9(10), 63-66.

StudentsandScholarship Team.