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Influence of Population Exposure to Fluoride on Oral Health

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Environmental Health".

Deadline for manuscript submissions: closed (1 April 2025) | Viewed by 3388

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Guest Editor
Department of Politics, Management and Health, School of Public Health, University of São Paulo, 05580-080 São Paulo, Brazil
Interests: population-based oral health policies; use of fluorides in public health strategies; dental services research; oral epidemiology

Special Issue Information

Dear Colleagues,

Population exposure to fluorides can be either beneficial or harmful to oral health. Therefore, its inclusion in both scientific and policy agendas driven by public health surveillance authorities around the world is paramount. Nearly 100 years ago, the Oakley City Women’s Civic League and McKay were crucial in changing a water source and stopping an endemic dental fluorosis. Two decades later, the benefits for dental caries from adjusting the concentration of fluoride in water was demonstrated. Since then, a consistent body of epidemiological evidence has been produced on the relationship between fluoride, caries and dental fluorosis, in which adjusted or naturally fluoridated water is considered the main independent variable for these outcomes. Other methods of population exposure to fluoride (e.g., fluoridated salt, milk and dentifrice) and comparisons in areas with multiple fluoride sources have also been investigated. Growing interest has been directed to investigate such methods as dependent variables showing inequalities in access and the coverage of public health interventions within and between countries. Investigating these population-based interventions as intersectoral public policies that depend on a virtuous arrangement of the political system; economic conditions and the health, sanitation, education and food systems of each country is a current and future task of health services and policy researchers in order to produce supporting information for spreading these upstream measures. This Special Issue of International Journal of Environmental Research and Public Health (IJERPH) seeks to focus on the above-mentioned topics.

Prof. Dr. Paulo Frazão
Guest Editor

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Published Papers (2 papers)

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Research

14 pages, 1284 KiB  
Article
Dietary Fluoride Exposure During Early Childhood and Its Association with Dental Fluorosis in a Sample of Mexican Adolescents
by Gina A. Castiblanco-Rubio, Emily C. Hector, Jose Urena-Cirett, Alejandra Cantoral, Howard Hu, Karen E. Peterson, Martha M. Tellez-Rojo and E. Angeles Martinez-Mier
Int. J. Environ. Res. Public Health 2025, 22(5), 689; https://doi.org/10.3390/ijerph22050689 (registering DOI) - 26 Apr 2025
Viewed by 148
Abstract
Dental fluorosis indicates past fluoride intake. People living in Mexico City are exposed to fluoridated salt, which contributes significantly to fluoride intake. This study aimed to (1) estimate fluoride intake during early childhood and fluorosis prevalence in permanent teeth in adolescence and (2) [...] Read more.
Dental fluorosis indicates past fluoride intake. People living in Mexico City are exposed to fluoridated salt, which contributes significantly to fluoride intake. This study aimed to (1) estimate fluoride intake during early childhood and fluorosis prevalence in permanent teeth in adolescence and (2) identify intake windows associated with higher fluorosis scores in upper central incisors (UCIs). We included 432 participants from the ELEMENT project (Early-Life Exposures in Mexico to Environmental Toxicants), with data on fluoride intake at ages 1–5 and fluorosis (TFI) at adolescence. Median intakes ranged from 0.56 at age 1 to 1.14 mg/day at age 5, exceeding recommendations. All adolescents had some level of fluorosis, predominantly mild (62% with TFI 2). For every 0.1 mg of daily fluoride intake at age 1, the odds of higher TFI in UCIs were 1.08 [95% CI: 1.00–1.17]. At age 2, the odds were marginally significant [OR: 1.07; 95% CI: 1.00–1.16]. In conclusion, for participants of ELEMENT: (1) fluoride intake during early childhood exceeded recommendations and the prevalence of mild fluorosis in adolescence was high, and (2) fluorosis in UCIs was associated with dietary exposure during the first two years of life and may be used in future ELEMENT studies as exposure biomarkers. Full article
(This article belongs to the Special Issue Influence of Population Exposure to Fluoride on Oral Health)
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16 pages, 904 KiB  
Article
The Use of Fluorides in Public Health: 65 Years of History and Challenges from Brazil
by Paulo Frazão
Int. J. Environ. Res. Public Health 2022, 19(15), 9741; https://doi.org/10.3390/ijerph19159741 - 8 Aug 2022
Cited by 5 | Viewed by 2524
Abstract
Untreated dental caries is the most common disease globally and fluoride use at the population level is crucial for its control. To investigate the economic and political conditions under which the trajectory of population-based fluoride use has occurred is key for a more [...] Read more.
Untreated dental caries is the most common disease globally and fluoride use at the population level is crucial for its control. To investigate the economic and political conditions under which the trajectory of population-based fluoride use has occurred is key for a more comprehensive view on its current and future challenges. The objective was to give a brief history and summarize the information on the use of fluorides at the population level in Brazil from 1952 to 2017 and to point to current and future challenges. A critical overview was undertaken based on country-level analyses comprising political and economic conditions. The analytical approach adopted a set of premises applicable to the study of capitalist democracies. Fluoride methods of systemic and topic use began to be employed in Brazilian public health programs in the 1950s and in a combined way from 1974. Differences in political and economic contexts were highlighted for four periods: the first interventions from 1952 to 1974, when the fluoridated water law was approved; the expansion after 1974 until 1988, when a new constitution was enacted; the following time until 2010; and the final period. From the 1980s to 2008, water fluoridation coverage increased progressively, consolidating as a major strategy of systemic use in spite of inequalities among territories. Activities aimed to promote access to topical fluoride use increased and maintained stability until 2014, when they dropped sharply. Regulation of fluoride dentifrice’s quality remained insufficient. It was hypothesized that the strengthening of conservative liberalism and the increase in fiscal austerity observed in recent years might produce serious constraints on public investment and limit access to fluorides. To reduce inequities and promote benefits for all, including the most vulnerable groups, policies based on egalitarian and social justice theoretical perspectives are needed more than ever. Full article
(This article belongs to the Special Issue Influence of Population Exposure to Fluoride on Oral Health)
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