Assessing Fluorosis Incidence in Areas with Low Fluoride Content in the Drinking Water, Fluorotic Enamel Architecture, and Composition Alterations

Strużycka, Izabela; Olszewska, Aneta; Bogusławska-Kapała, Agnieszka; Hryhorowicz, Szymon; Kaczmarek-Ryś, Marta; Grabarek, Beniamin Oskar; Staszkiewicz, Rafał; Kuciel-Polczak, Izabela; Czajka-Jakubowska, Agata

doi:10.3390/ijerph19127153

Open AccessArticle

Assessing Fluorosis Incidence in Areas with Low Fluoride Content in the Drinking Water, Fluorotic Enamel Architecture, and Composition Alterations

by

Izabela Strużycka

¹

,

Aneta Olszewska

²,

Agnieszka Bogusławska-Kapała

¹

,

Szymon Hryhorowicz

³

,

Marta Kaczmarek-Ryś

^3,*

,

Beniamin Oskar Grabarek

^4,5

,

Rafał Staszkiewicz

^4,6

,

Izabela Kuciel-Polczak

⁷ and

Agata Czajka-Jakubowska

^2,*

¹

Department of Comprehensive Dentistry, Medical University of Warsaw, 02-097 Warsaw, Poland

²

Department of Orthodontics and Temporomandibular Disorders, Poznan University of Medical Sciences, 60-567 Poznań, Poland

³

Institute of Human Genetics, Polish Academy of Sciences, 60-479 Poznań, Poland

⁴

Department of Histology, Cytophysiology and Embryology, Faculty of Medicine in Zabrze, Academy of Silesia, The University of Technology in Katowice, 41-800 Zabrze, Poland

⁵

GynCentrum, Laboratory of Molecular Biology and Virology, 40-851 Katowice, Poland

⁶

5th Military Clinical Hospital with the SP ZOZ Polyclinic in Krakow, 30-901 Krakow, Poland

⁷

Trauma Centre, Department of Ophthalmology, St. Barbara Hospital, 41-200 Sosnowiec, Poland

^*

Authors to whom correspondence should be addressed.

Int. J. Environ. Res. Public Health 2022, 19(12), 7153; https://doi.org/10.3390/ijerph19127153

Submission received: 13 May 2022 / Revised: 8 June 2022 / Accepted: 9 June 2022 / Published: 10 June 2022

(This article belongs to the Special Issue Oral Health and Dental Caries)

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Abstract

There is currently no consensus among researchers on the optimal level of fluoride for human growth and health. As drinking water is not the sole source of fluoride for humans, and fluoride can be found in many food sources, this work aimed to determine the incidence and severity of dental fluorosis in Poland, in areas where a low fluoride content characterizes the drinking water, and to assess the impact of fluoride on the enamel composition and microstructure. The dental examination involved 696 patients (aged 15–25 years) who had since birth lived in areas where the fluoride concentration in drinking water did not exceed 0.25 mg/L. The severity of the condition was evaluated using the Dean’s Index. Both healthy teeth and teeth with varying degrees of fluorosis underwent laboratory tests designed to assess the total protein and fluoride content of the enamel. Protein amount was assessed spectrophotometrically while the level of fluoride ions was measured by DX-120 ion chromatography. The clinical study revealed 89 cases (12.8%) of dental fluorosis of varying severity. The enamel of teeth with mild and moderate fluorosis contained a significantly higher protein (p-value < 0.001 and 0.002, respectively) and fluoride level (p < 0.001) than those with no clinical signs of fluorosis. SEM images showed irregularities in the structure of the fluorotic enamel. An excessive fluoride level during amelogenesis leads to adverse changes in the chemical composition of tooth enamel and its structure. Moreover, dental fluorosis present in areas where drinking water is low in fluorides indicates a need to monitor the supply of fluoride from other possible sources, regardless of its content in the water.

Keywords: fluoride; fluorosis; oral health; fluorosis epidemiology; Dean’s Index; dental fluorosis; developmental enamel defects

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MDPI and ACS Style

Strużycka, I.; Olszewska, A.; Bogusławska-Kapała, A.; Hryhorowicz, S.; Kaczmarek-Ryś, M.; Grabarek, B.O.; Staszkiewicz, R.; Kuciel-Polczak, I.; Czajka-Jakubowska, A. Assessing Fluorosis Incidence in Areas with Low Fluoride Content in the Drinking Water, Fluorotic Enamel Architecture, and Composition Alterations. Int. J. Environ. Res. Public Health 2022, 19, 7153. https://doi.org/10.3390/ijerph19127153

AMA Style

Strużycka I, Olszewska A, Bogusławska-Kapała A, Hryhorowicz S, Kaczmarek-Ryś M, Grabarek BO, Staszkiewicz R, Kuciel-Polczak I, Czajka-Jakubowska A. Assessing Fluorosis Incidence in Areas with Low Fluoride Content in the Drinking Water, Fluorotic Enamel Architecture, and Composition Alterations. International Journal of Environmental Research and Public Health. 2022; 19(12):7153. https://doi.org/10.3390/ijerph19127153

Chicago/Turabian Style

Strużycka, Izabela, Aneta Olszewska, Agnieszka Bogusławska-Kapała, Szymon Hryhorowicz, Marta Kaczmarek-Ryś, Beniamin Oskar Grabarek, Rafał Staszkiewicz, Izabela Kuciel-Polczak, and Agata Czajka-Jakubowska. 2022. "Assessing Fluorosis Incidence in Areas with Low Fluoride Content in the Drinking Water, Fluorotic Enamel Architecture, and Composition Alterations" International Journal of Environmental Research and Public Health 19, no. 12: 7153. https://doi.org/10.3390/ijerph19127153

APA Style

Strużycka, I., Olszewska, A., Bogusławska-Kapała, A., Hryhorowicz, S., Kaczmarek-Ryś, M., Grabarek, B. O., Staszkiewicz, R., Kuciel-Polczak, I., & Czajka-Jakubowska, A. (2022). Assessing Fluorosis Incidence in Areas with Low Fluoride Content in the Drinking Water, Fluorotic Enamel Architecture, and Composition Alterations. International Journal of Environmental Research and Public Health, 19(12), 7153. https://doi.org/10.3390/ijerph19127153

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Assessing Fluorosis Incidence in Areas with Low Fluoride Content in the Drinking Water, Fluorotic Enamel Architecture, and Composition Alterations

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