Assessment of fluoride intake from drinking water and toothpaste in 3-year-olds: Preliminary results in Belgrade, Republic of Serbia

Background/Aim. Fluoride has beneficial effect on dental caries prevention and enables high hardness of enamel. However, fluoride intake above optimal levels can have adverse effects on teeth and bones, especially in young children during the period of intense growth and teeth development. The aim of this study was to assess fluoride intake from water and toothpaste among 3-year-old children in Belgrade, Serbia, in the municipalities of Vračar and Novi Beograd. Methods. A questionnaire for the parents (n = 40) was used to provide information on the water consumption (tap and/or bottled water) and the brand of toothpaste used by children as well as the frequency of tooth brushing and the amount of toothpaste during brushing. Fluoride concentrations in water and toothpaste samples were determined electrochemically by using fluoride-selective electrode. Fluoride intake was estimated through a mathematical model commonly used by the U.S. Environmental Protection Agency. Results. The obtained results indicate no significant difference in daily fluoride intake through drinking water and toothpaste in 3-year-old children in Vračar (n = 19) compared to Novi Beograd (n = 21) (p > 0.05). However, all estimated fluoride levels (0.089-0.625 mg/day) are significantly lower than the optimal daily intake level for caries protection (0.7 mg/day for children up to 4 years, FNB-USA National Institute of Medicine) and two to six times lower than tolerable upper fluoride level for the children of same age (1.3 mg/day, FNB-USA National Institute of Medicine). Furthermore, calculated daily fluoride intake per kilogram body weight confirm very low fluoride intake by water and toothpaste in children of investigated municipalities in Belgrade, being significantly below the recommended an adequate intake (0.05 mg/kg/day, EFSA). Conclusion. This preliminary study has shown that daily fluoride intake in 3-year-olds is lower than tolerable upper fluoride level, even not sufficient for the preve
Uvod/Cilj. Fluoridi imaju pozitivan efekat na prevenciju karijesa zuba kao i povećanje čvrstine zubnog emajla. Međutim, njihov unos iznad optimalnog može imati štetne efekte na zube i kosti, posebno kod male dece tokom intenzivnog rasta i razvoja zuba. Cilj ovog rada bio je da se proceni unos fluorida putem vode za piće i paste za zube kod dece uzrasta od tri godine u Beogradu, na teritoriji dve opštine, Vračar i Novi Beograd. Metode. Anketnim upitnicima (n = 40) za roditelje dobijeni su podaci o vrsti vode koju deca piju (česmenska i/ili flaširana), proizvodima koje koriste za čišćenje i negu zuba, učestalosti pranja zuba kao i količini paste za zube koja se koristi po jednom pranju. Sadržaj fluorida u vodi za piće i pastama za zube određen je elektrohemijski sa fluoridnom jonselektivnom elektrodom. Unos fluorida procenjen je korišćenjem matematičkog modela datog od strane Američke agencije za zaštitu životne sredine. Rezultati. Dobijeni rezultati pokazuju da nema statistički značajne razlike u dnevnom unosu fluorida putem vode za piće i paste za zube između dece uzrasta od tri godine na Vračaru i Novom Beogradu (p > 0,05). Međutim, sve procenjene vrednosti unosa fluorida (0,089-0,625 mg/dan) značajno su niže od optimalnog dnevnog unosa za prevenciju karijesa (0,7 mg/dan za decu uzrasta do 4 godine, FNB-Nacionalnog instituta medicine, SAD) i dva do šest puta niže od tolerišućeg gornjeg nivoa unosa fluorida za decu istog uzrasta (1,3 mg/dan, FNBNacionalnog instituta medicine, SAD). Štaviše, izračunati dnevni unosi fluorida izraženi po kilogramu telesne mase potvrđuju veoma nizak unos fluorida kod dece ispitivanih opština u Beogradu, čak značajno niže od preporučenog optimalnog unosa (0,05 mg/kg/dan, EFSA). Zaključak. Ovim preliminarnim istraživanjem pokazano je da je dnevni unos fluorida kod trogodišnjaka u Beogradu značajno niži od tolerišućeg gornjeg nivoa unosa fluorida, čak niži od optimalnog unosa za prevenciju karijesa.