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OBJECTIVES: To determine the pattern of fluid consumption, fluoride intake from the fluids and urinary fluoride excretion by children aged 1-9 years in Kuwait, a nonfluoridated community. METHODS: Using the cluster sampling technique, children aged 1-9 years were chosen from 2000 randomly selected households in Kuwait. Questionnaires were then administered to their mothers to determine the children's daily fluid intake. Fluoride concentrations in tap water as well as all brands of bottled water and beverages consumed by the children were measured, using the fluoride ion-specific electrode. Fluoride excretion was determined in 400 randomly selected children, based on fluoride/creatinine ratio. RESULTS: The mean daily fluid consumption by the children was high, being 1115-1545 ml. About 40% of the fluid intake was plain (tap and bottled) water and approximately 10% of the children drank bottled water exclusively. Fluoride concentration in tap water was low (0.04±SD 0.02 ppm), but was higher in bottled water (0.28±SD 0.40 ppm). Mean daily fluoride ingestion from fluids was 0.013-0.018 mg/kg body weight (bw). Even after allowing for fluoride ingestion from other sources, mean daily fluoride ingestion was still below 0.1 mg/kg bw set by the United States of America Institute of Medicine as the lowest-observed-adverse-effect level for moderate enamel fluorosis in children aged up to 8 years. Furthermore, the mean daily urinary fluoride excretion of 128-220 µg was below the provisional standard of 360-480 µg for optimal fluoride usage by children aged 3-5 years. CONCLUSION: Fluoride ingestion from fluids and urinary fluoride excretion by the children were below the recommendations for optimal fluoride usage. Thus, there is room for an upward adjustment of fluoride level in public drinking water supplies in Kuwait, as a caries preventive measure.

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OBJECTIVES: a) To correlate fluoride levels in drinking water sources with caries experience and dental fluorosis in Saudi Arabia, and suggest appropriate fluoride concentration for drinking water in the country. METHODS: Fluoride levels were determined from 3,629 samples obtained from drinking water sources in 11 regions of Saudi Arabia. Based on the fluoride concentrations, a stratified sample of subjects aged 6-7, 12-13, and 15-18 years was obtained from the regions. A total of 12,200 selected subjects were examined for dental caries according to the World Health Organization criteria, and dental fluorosis, using Thylstrup and Fejerskov classification. RESULTS: There was an inverse relationship between fluoride exposure and caries experience, but the prevalence of dental fluorosis increased with increase in fluoride concentration. There was no significant difference in caries experience or in the prevalence of dental fluorosis when fluoride levels increased from 0.3 ppm to 0.6 ppm. In contrast, caries experience was lower, while severity of fluorosis was significantly higher at fluoride levels above 0.6 ppm. CONCLUSIONS: a) Fluoride levels in drinking water sources in Saudi Arabia correlate significantly with caries experience and prevalence of dental fluorosis. b) Appropriate fluoride concentration for drinking water in Saudi Arabia may be about 0.6 ppm.

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BACKGROUND: Knowledge of fluoride levels in drinking water is of importance in dental public health, yet this information is lacking, at national level, in Nigeria. OBJECTIVE: To map out fluoride levels in drinking water sources in Nigeria. MATERIALS AND METHODS: Fluoride levels in drinking water sources from 109 randomly selected Local Government Areas (LGAs) in the 6 Nigerian geopolitical zones were determined. From the results, maps showing LGAs with fluoride concentrations exceeding 0.3 ppm, were drawn. ANOVA and t-test were used to determine the significance of the differences between the fluoride levels in the drinking water sources. RESULTS: Fluoride levels were low in most parts of the country, being 0.3 ppm or less in 62% of the LGAs. Fluoride concentrations were generally higher in North Central geopolitical zone, than the other zones in the country (p<0.05). In a few drinking water sources, fluoride concentrations exceeded 1.5 ppm, but was as high as 6.7 ppm in one well. Only 9% of the water sources were from waterworks. CONCLUSION: Most of the water sources in Nigeria contained low fluoride levels; but few had excessive concentrations and need to be partially defluoridated, or else alternative sources of drinking water provided for the community.

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PURPOSE: To compare post-operative sensitivity from posterior composites lined with bonding systems that utilize either a self-etching primer or phosphoric acid conditioner. METHODS: Occlusal cavities on homologous contralateral posterior teeth in 28 selected subjects were lined with either One-Step Plus (a bonding system that utilizes phosphoric acid conditioner) or Clearfil SE Bond with a self-etching primer, and then restored with a hybrid resin composite. Post-operative sensitivity was assessed subjectively by asking the patient to classify pain from the restored tooth into none, mild or severe; and objectively by measuring the time it took for the patient to feel cold sensation when standardized ice stick was placed against the mid-buccal surface of the tooth. RESULTS: Subjective assessment showed that post-operative sensitivity was mild with either of the bonding systems; and marginal homogeneity test showed no statistically significant difference in the prevalence of post-operative sensitivity (P> 0.05), although there was a trend towards decreasing sensitivity with Clearfil SE Bond as post-operative period increased (P= 0.027). In the objective assessment, repeated measures of ANOVA showed that cold response measurements increased significantly with postoperative period only in the teeth lined with Clearfil SE Bond (P< 0.05), indicating decreasing post-operative sensitivity. However, paired t-test showed no significant difference between the cold response measurements obtained for the two bonding systems (P> 0.05).

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BACKGROUND: This study was designed to assess the fluoride levels in drinking water in the Central Province of Saudi Arabia. MATERIALS AND METHODS: A total of 817 water samples were collected from 260 locations in Central Saudi Arabia. An atomic absorption spectrophotometer [HACH instrument, model DR 3000] was used in the analyses of water samples for fluoride levels. RESULTS: The results showed that fluoride levels vary between 0.00 and 6.20 ppm. About 75% and 6% of the population in Riyadh and Qassim regions, respectively, were exposed to very low fluoride levels (0.00-0.03 ppm), while less than 3% of the population in both regions were exposed to fluoride levels ranging from 0.61 to 0.80 ppm. A higher percentage of the population in Qassim than Riyadh region were exposed to high fluoride levels (>0.81 ppm); 28.63% than in Riyadh with 9.24%. CONCLUSION: The findings of this study can serve as a baseline data for water fluoridation and other dental preventive programs in the area.