Fluorosis Experience among South Australian Children in 2002/03

Background: Fluorosis prevalence requires monitoring to evaluate population preventive programs and update guidelines on fluoride use. Objective: To examine population prevalence and risk factors of fluorosis among South Australian (SA) children. Methods: A random sample of SA children born in 1989-1994, stratified by fluoridation status and urban/rural residence, was selected in 2002/2003 to form three successive birth cohorts: born in 89/90; 91/92; and 93/94. Residential and fluoride exposure history collected by a mailed questionnaire were used to estimate lifetime exposure to fluoridated water from birth to age 6 years, patterns of toothbrushing practice when children first started brushing and other fluoride exposures in childhood. One dentist examined 677 children for fluorosis using the TF Index. Data were re-weighted to represent the SA child population. A case of fluorosis was defined as having fluorosis on upper central incisors. Population Attributable Risk (PAR) was calculated using logistic regression models' estimates. Results: TF scores 1, 2 and 3 were observed among 14.4%, 9.5%, and 1.8% of children respectively, a total prevalence of 25.7%. Fluorosis prevalence of the three birth cohorts 89/90, 91/92 and 93/94 were: TF 1+: 34.7%, 25.4% and 22.1% (Chi-square, p<0.05); TF 2+: 17.9%, 10.7% and 8.3% (Chi-square, p<0.01). Exposure to fluoride in water, having an eating/licking toothpaste habit and use of standard 1000-ppm fluoride toothpaste when children started brushing were significant factors for fluorosis. Adjusted PAR estimates of those risk factors were 53%, 36% and 22% respectively. Conclusion: Very mild to mild fluorosis affected a quarter of the SA child population. However, fluorosis prevalence decreased significantly across successive birth cohorts. Exposure to fluoridated water and toothpaste use were the main risk factors for fluorosis in this population. Supported by NHMRC, ADRF, and The University of Adelaide.

Do L*, Spencer JA

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Presented at the 45th Annual Meeting of the ANZ Division of the IADR, 25-28 September 2005, Queenstown, New Zealand

Note: * indicates presenter