RESUMO
UNLABELLED: Few reports have investigated caries prevalence in rural areas of Brazil. OBJECTIVE: The aim of this study was to observe the caries prevalence (DMFT, DMFS) in 12-year-old children living in rural villages of Paraíba, Brazil with low and moderate fluoride levels in the drinking water and to relate it to sugar intake and oral hygiene. METHODS: One hundred and ninety four children from 13 villages were grouped according to the water fluoride levels: low fluoride (LF, <0.2 ppm F, 96 children) and moderate fluoride (MF, 0.7-1.0 ppm F, 98 children). Caries and oral hygiene (OHI-S) were scored according to WHO criteria. Sugar intake was assessed through interviews. A sub-set of subjects (n=23) from the LF group was re-examined 2 years later. RESULTS: For the LF and MF groups the DMFT (mean, SD) observed was 3.9 (3.7) and 2.5 (2.1) respectively, the DMFS was 9.2 (10.6) and 5.4 (5.7). Both indexes (DMFT, DMFS) showed significant differences (P<0.01, Mann-Whitney U-test) according to the fluoride levels in the drinking water. The mean increment of caries in the sub-set group of subjects was approximately 1.5 surfaces per subject/year. The reported sugar intake was low for both water fluoride groups (P>0.05). In a regression analysis the water fluoride levels, the use of fluoridated toothpaste and oral hygiene index were related to DMFS (R2=0.08, P< or =0.05). CONCLUSIONS: Caries prevalence was lower in MF than in LF rural areas of Paraíba. Caries and sugar intake seems to be lower in rural areas than in urban areas of Paraíba with similar fluoride levels in the drinking water.
Assuntos
Cárie Dentária/epidemiologia , Fluoretação , Brasil/epidemiologia , Criança , Índice CPO , Cárie Dentária/etiologia , Dieta Cariogênica , Sacarose Alimentar/administração & dosagem , Fluoretos/administração & dosagem , Humanos , Higiene Bucal/estatística & dados numéricos , Índice de Higiene Oral , Prevalência , Análise de Regressão , Saúde da População Rural , Estatísticas não ParamétricasRESUMO
This work was based on the hypothesis that fingernail clippings can be used as a biomarker for the subchronic exposure to fluoride. The results provide data on factors that may affect the concentration of fluoride in fingernail clippings as determined with the electrode following HMDS-facilitated diffusion. The following variables had only minor or no effects on the concentrations: (1) the surface area of the clippings (intact, minced or filed into powder) that were placed into the diffusion dishes; (2) soaking in deionized water for up to 6 h; (3) soaking in fluoridated water (1.0 ppm) for 2 h, and (4) removal of the organic material of nails by dry ashing. Fingernail fluoride concentrations were approximately 50% higher than those in toenails. A 1-month period of increased fluoride intake by one of the authors resulted in significant increases in fingernail fluoride concentrations after a lag time of approximately 3.5 months. The fluoride concentrations in fingernail clippings obtained from three groups of Brazilian children were directly related to the concentrations in the drinking water (0.1, 1.6 or 2.3 ppm). The results indicate that: (1) HMDS-facilitated diffusion completely separates fluoride from intact nail clippings, so the need for ashing or other preparative methods is obviated; (2) fingernail fluoride is derived mainly from the systemic circulation, and (3) fluoride intake is reflected by the concentrations in fingernails.
Assuntos
Exposição Ambiental/análise , Monitoramento Ambiental/métodos , Fluoretos/análise , Unhas/química , Análise de Variância , Brasil , Criança , Monitoramento Ambiental/estatística & dados numéricos , Dedos , Fluoretos/farmacologia , Georgia , Humanos , Masculino , Unhas/efeitos dos fármacos , Fatores de Tempo , Dedos do Pé , Água/farmacologiaRESUMO
The aims of this study were to determine plaque fluoride concentrations in children not exposed to topical fluorides but to different fluoride levels in the drinking water (0.1 and 2.0 ppm), and to observe whether plaque fluoride was related to plaque pH. Twenty-five children (6 to 7 years old) were selected from two rural villages in Brazil. A sub-set of subjects was examined for resting and fermenting plaque pH before sampling. A maximum of 14 sites was studied in each subject (vestibular and interproximal of first molars and central incisors). Plaque fluoride was extracted and measured with an inverted fluoride electrode under oil. Amounts of plaque were determined by protein analysis. Mean values in the 0.1 ppm village were 1.3 ngF/mg of plaque wet weight (SD = 1.1) and in the 2.0 ppm village 2.5 ngF/mg (SD = 2.1) and were not statistically different (Kruskal-Wallis test, P = 0.09). Plaque fluoride varied considerably from site to site in the same mouth. Combining sites in all subjects, plaque fluoride concentrations were positively related to resting and fermenting pH (regression analysis, P< 0.01-0.001, adjR2 = 0.12-0.31). On an individual basis the same trend was found for fermenting, but not for resting pH. In conclusion, our findings showed a moderate influence of water fluoride upon dental plaque fluoride concentrations and give some support to the theory that low fermenting pH may contribute to the release of bound plaque fluoride.
Assuntos
Placa Dentária/química , Fluoretação , Fluoretos/análise , Análise de Variância , Brasil , Criança , Índice CPO , Índice de Placa Dentária , Humanos , Concentração de Íons de Hidrogênio , Análise de Regressão , Saúde da População RuralRESUMO
The aim of this study was to investigate the relationship between nutritional status and dental fluorosis in areas with fluoride in the drinking water in Paraíba, Brazil. Rural villages of comparable low socio-economic status and stable water fluoride levels were selected. Lifelong residents (6-11 years old, n = 650) were examined for nutritional status (height-for-age index; WHO methods) and dental fluorosis of central incisors and first molars (TF index). The sample was divided into three groups according to fluoride levels in the drinking water: low (below 0.7 ppm F, n = 164), medium (between 0.7 and 1.0 ppm F, n = 360) and high (above 1.0 ppm F, n = 126). Dental fluorosis was observed in 30.5, 61.1 and 71.4% of the children in these F groups, respectively. The prevalence was significantly related to the water F concentrations (chi2 = 59.93, d. f. = 2, p<0.001). The severity of dental fluorosis ranged from TF 1 to 3 in the low F group and up to 7 in the others. Malnutrition prevalence was approximately 20% in all F groups, but was unrelated to dental fluorosis. The fairly high prevalence of dental fluorosis observed suggests that other factors may be operating.