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Made available in DSpace on 2021-06-25T11:03:17Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Objectives. To analyze changes in the dental fluorosis (DF) incidence according to a birth cohort and explore current exposure to DF in a case series. Methods. Repeated cross-sectional study of two periods: 2015 and 2018. Two standardized examiners registered DF using the Thylstrup-Fejerskov index in permanent teeth of children aged 7-18 years. Period and birth cohort frequencies were estimated by a generalized linear model, binomial family, and logarithmic link function. Period estimates are presented as prevalence ratios (PR) and birth cohort estimates as cumulative incidence ratios (RR); 95% confidence intervals and P values are reported. In a subsample of 37 volunteers (12.29 ± 2.63 years), the fluoride (F) concentration in toenails was measured using the HMDS diffusion method and an ion-specific electrode. Other samples from the local environment such as food, soil, and coal were also collected. Results. In 274 children, we found that nonsignificant increases between periods (PR = 1.17; 95% CI: 0.89-1.55) were not explained by birth cohort effects. A total of 37.8% of the subsample had a toenail F concentration ≥2 μg F/g. The salty snacks and seasoning had the highest F concentrations among local environmental samples. Conclusion. In this population with a high DF frequency according to birth cohort and the evaluated period, the study of soil, coal, and food samples indicated a continued F exposure. F concentration found in the toenails shows a moderate F exposure; nearly a third of the children and adolescents exceeded the adopted threshold of 2 μg F/g. It is important to monitor and explore changes in exposure in highly affected population. Graduate Program in Dental Science São Paulo State University (UNESP) School of Dentistry School of Dentistry CES University School of Medicine CES University Department of Biological Sciences University of São Paulo (USP) Bauru School of Dentistry Department of Morphology and Orthodontics and Pediatric Dentistry São Paulo State University (UNESP) School of Dentistry Graduate Program in Dental Science São Paulo State University (UNESP) School of Dentistry Department of Morphology and Orthodontics and Pediatric Dentistry São Paulo State University (UNESP) School of Dentistry