Risk Factors for Enamel Fluorosis in a Fluoridated Population

The purpose of this case-control investigation was to investigate the possible association between mild-to-moderate enamel fluorosis and exposure during early childhood to Infant formula, fluoride toothpaste, and/or fluoride supplements. Analysis was performed on 401 residents of fluoridated communi...

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Bibliographic Details
Published in:American journal of epidemiology 1994-09, Vol.140 (5), p.461-471
Main Authors: Pendrys, David G., Katz, Ralph V., Morse, Douglas E.
Format: Article
Language:English
Subjects:
Adolescent
Case-Control Studies
Child
Connecticut - epidemiology
dental enamel
epidemiologic methods
Female
Fluoridation
fluorides
Fluorides - adverse effects
Fluorides - therapeutic use
Fluorosis, Dental - epidemiology
Fluorosis, Dental - etiology
Humans
Infant
Infant Food
Logistic Models
Male
mottled enamel
risk
Risk Factors
Surveys and Questionnaires
Toothpastes - adverse effects
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Summary:The purpose of this case-control investigation was to investigate the possible association between mild-to-moderate enamel fluorosis and exposure during early childhood to Infant formula, fluoride toothpaste, and/or fluoride supplements. Analysis was performed on 401 residents of fluoridated communities in Connecticut, who wore 12–16 years old and born prior to 1980. The case and control subjects for this study were selected on the basis of a clinical examination given in 1991. Subject fluorosis status was determined using the Fluorosis Risk Index. Risk factor exposure was ascertained via a mailed questionnaire with a response rate of 89% and a question naire reliability of 87%. Logistic regression analyses, which adjusted for confounding variables, revealed that mild-to-moderate enamel fluorosis on early forming (Fluorosis Risk Index (FRI) classification I) enamel surfaces was strongly associated with both milk-based (odds ratio (OR)=3.34, 95% confidence interval (Cl) 1.38–8.07) and soy-based (OR = 7.16, 95% Cl 1.35–37.89) infant formula use, as well as with frequent brushing (OR = 2.80,95% Cl 1.15–6.81). A very strong association was observed with inappropriate fluoride supplement use (OR = 23.74, 95% Cl 3.43–164.30). Respectively similar associations were observed between mild-to-moderate enamel fluorosis on later forming (FRI classification II) enamel surfaces and frequent brushing and fluoride supplement use, but not with infant formula use.
ISSN:0002-9262
1476-6256
DOI:10.1093/oxfordjournals.aje.a117268