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Int. J. Environ. Res. Public Health 2016, 13(8), 756; doi:10.3390/ijerph13080756

Dietary Fluoride Intake and Associated Skeletal and Dental Fluorosis in School Age Children in Rural Ethiopian Rift Valley

Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, P.O. Box 1242, Addis Ababa, Ethiopia
Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
ENGINE/Save the Children, P.O. Box 387, Addis Ababa, Ethiopia
College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada
National Institute of Nutrition and Seafood Research (NIFES), P.O. Box 185, Bergen N-5002, Norway
Author to whom correspondence should be addressed.
Academic Editors: Marlena Kruger and Hope Weiler
Received: 18 March 2016 / Revised: 8 July 2016 / Accepted: 14 July 2016 / Published: 26 July 2016
(This article belongs to the Special Issue Bone Health: Nutritional Perspectives)
View Full-Text   |   Download PDF [284 KB, uploaded 26 July 2016]


An observational study was conducted to determine dietary fluoride intake, diet, and prevalence of dental and skeletal fluorosis of school age children in three fluorosis endemic districts of the Ethiopian Rift Valley having similar concentrations of fluoride (F) in drinking water (~5 mg F/L). The duplicate plate method was used to collect foods consumed by children over 24 h from 20 households in each community (n = 60) and the foods, along with water and beverages, were analyzed for fluoride (F) content. Prevalence of dental and skeletal fluorosis was determined using presence of clinical symptoms in children (n = 220). Daily dietary fluoride intake was at or above tolerable upper intake level (UL) of 10 mg F/day and the dietary sources (water, prepared food and beverages) all contributed to the daily fluoride burden. Urinary fluoride in children from Fentale and Adamitulu was almost twice (>5 mg/L) the concentration found in urine from children from Alaba, where rain water harvesting was most common. Severe and moderate dental fluorosis was found in Alaba and Adamitulu, the highest severity and prevalence being in the latter district where staple foods were lowest in calcium. Children in all three areas showed evidence of both skeletal and non-skeletal fluorosis. Our data support the hypothesis that intake of calcium rich foods in addition to using rain water for household consumption and preparation of food, may help in reducing risk of fluorosis in Ethiopia, but prospective studies are needed. View Full-Text
Keywords: dietary fluoride; dental fluorosis; skeletal fluorosis; Ethiopian Rift Valley; calcium dietary fluoride; dental fluorosis; skeletal fluorosis; Ethiopian Rift Valley; calcium
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Kebede, A.; Retta, N.; Abuye, C.; Whiting, S.J.; Kassaw, M.; Zeru, T.; Tessema, M.; Kjellevold, M. Dietary Fluoride Intake and Associated Skeletal and Dental Fluorosis in School Age Children in Rural Ethiopian Rift Valley. Int. J. Environ. Res. Public Health 2016, 13, 756.

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