Irene Ramires

Fluoride intake from regular and low fluoride dentifrices by 2-3-year-old children: influence of the dentifrice flavor

This study evaluated the fluoride intake from dentifrices with different fluoride concentrations ([F]) by children aged 24-36 months, as well as the influence of the dentifrice flavor in the amount of fluoride ingested during toothbrushing. Thirty-three children were randomly divided into 3 groups, according to the [F] in the dentifrices: G-A (523 microgF/g), G-B (1,062 microgF/g) and G-C (1,373 microgF/g). Dentifrices A and B are marketed for children, while dentifrice C is a regular product. The amount of F ingested was indirectly obtained, subtracting the amount expelled and the amount left on the toothbrush from the amount initially loaded onto the brush. The results were analyzed by ANOVA, Tukeys test and linear regression analysis (p < 0.05). Children ingested around 60% of the dentifrice loaded onto the brush, but no significant differences were seen among the groups (p > 0.05). Mean daily fluoride intake from dentifrice for G-A, G-B and G-C was 0.022(a) feminine, 0.032(a) feminine and 0.061(b) mg F/kg body weight, respectively (p < 0.01). There was a strong positive correlation (r = 0.86, p < 0.0001) between the amount of dentifrice used and the amount of fluoride ingested during toothbrushing. The results indicate the need for instructing childrens parents and care givers to use a small amount of dentifrice (< 0.3 g) to avoid excessive ingestion of fluoride. The use of low-[F] dentifrices by children younger than 6 years also seems to be a good alternative to minimize fluoride intake. Dentifrice flavor did not influence the percentage of fluoride intake.

A fluoretação da água de abastecimento público e seus benefícios no controle da cárie dentária: cinqüenta anos no Brasil

A fluoretacao da agua de abastecimento publico representa uma das principais e mais importantes medidas de saude publica no controle da carie dentaria. O objetivo deste trabalho foi o de reafirmar, atraves de uma revisao de literatura, a importância e o alcance da fluoretacao no controle da carie dentaria. Um dos meios mais efetivos para manter constante a presenca de fluor na cavidade bucal, fundamental para controle da carie dentaria, a fluoretacao da agua e reconhecida como um importante fator para o declinio da prevalencia da carie dentaria. Portanto, alem de ser mantida, deve ser monitorada, a fim de que o teor de fluor seja mantido dentro dos padroes adequados para o controle da carie e prevencao da fluorose dentaria.

Avaliação da concentração de flúor e do consumo de água mineral

OBJECTIVE Considering that water is an importance source of fluoride intake, and that the consumption of mineral water and prevalence of dental fluorosis have been increasing, the aim of this study was to evaluate the consumption of mineral water and its fluoride concentration. METHODS The study was performed in residential districts of the municipality of Bauru, State of São Paulo, by means of stratified sampling via clusters. Each cluster corresponded to one residential block. For randomization purposes, the residential blocks were numbered within the 17 districts established by the city plan. One thousand homes were thus visited. Mineral water samples were collected using previously labeled 50 ml plastic flasks. Fluoride analysis was done using an ion-sensitive electrode (Orion 9609), after buffering using TISAB II. Information on the consumption of mineral water was obtained by means of applying a questionnaire. RESULTS Around 29.72% of the citys population was consuming mineral water. In the 260 samples analyzed from 29 different brands of water, the fluoride concentration ranged from 0.045 to 1.515 mg/l. For one brand, the label stated that the fluoride concentration was 0.220 mg/l, but analysis revealed a concentration of 1.515 mg/l. Moreover, some brands did not specify the fluoride concentration on the label and, for these, the analysis showed concentrations ranging from 0.049 to 0.924 mg/l. CONCLUSIONS The results demonstrated wide variation in fluoride concentrations and reinforce the importance of the control of such waters by the sanitary surveillance agency.OBJETIVO: Considerando a agua como importante fonte de ingestao de fluor, o aumento da prevalencia de fluorose dentaria e do consumo de agua mineral, o estudo realizado teve como objetivo avaliar o consumo de agua mineral e sua concentracao de fluor. METODOS: A pesquisa foi realizada nos bairros do municipio de Bauru, SP. Foram visitadas mil residencias que compunham uma amostra estratificada, obtida por conglomerados. Cada conglomerado correspondia a um quarteirao. Para efeito de sorteio os quarteiroes foram numerados dentro das 17 regioes estabelecidas no plano diretor do municipio. Para coleta das amostras de agua mineral foram usados frascos plasticos de 50 ml, previamente identificados. Na analise de fluor utilizou-se eletrodo ion sensivel (Orion 9609) apos tamponamento com TISAB II. Informacoes a respeito do consumo de agua mineral foram obtidas com a aplicacao de um questionario. RESULTADOS: Constatou-se que cerca de 29,7% da populacao do municipio consome agua mineral. Nas 260 amostras analisadas, das 29 diferentes aguas, a concentracao de fluor variou de 0,045 a 1,515 mg/l. Em uma das aguas, constava no rotulo o valor de 0,220 mg/l, mas na analise constatou-se 1,515 mg/l de fluor. Alem disso, algumas aguas nao traziam especificado a concentracao de fluor; e, na analise constataram-se valores variando entre 0,049 e 0,924 mg/l. CONCLUSOES: Os resultados mostraram uma grande variacao na concentracao de fluor e reforcam a importância do controle dessas aguas por parte da vigilância sanitaria.

Heterocontrole da fluoretação da água de abastecimento público em Bauru, SP, Brasil

OBJETIVO: Avaliar a fluoretacao da agua de abastecimento publico, comparando os resultados obtidos com dados previos de fluoretacao. METODOS: O estudo foi realizado de marco de 2004 a 2005, na cidade de Bauru, Estado de Sao Paulo. Mensalmente, em datas estabelecidas por sorteio, foram coletadas 60 amostras de agua nos 19 setores de abastecimento, totalizando 737 amostras. A concentracao de fluor presente nas amostras de agua foi determinada em duplicata, utilizando-se o eletrodo ion sensivel (Orion 9609), acoplado ao potenciometro. Uma vez analisadas, as amostras foram classificadas como aceitaveis ou inaceitaveis de acordo com a concentracao de fluor. A analise estatistica empregada foi do tipo descritiva. RESULTADOS: A concentracao media de fluor observada nos diferentes meses de coleta variou entre 0,37 e 1,00 mg/l. Cerca de 85% das amostras foram classificadas como aceitaveis. CONCLUSOES: Comparados com dados de estudos previos realizados na cidade, foi observada uma melhoria nas condicoes de fluoretacao da agua de abastecimento, um ano apos a implantacao do heterocontrole. A implantacao do monitoramento da fluoretacao da agua de abastecimento por sistemas de vigilância deve ser incentivada, sendo fundamental para o controle da carie dentaria.

Concentração de flúor em águas engarrafadas comercializadas no município de São Paulo

The objective of the study was to evaluate the fluoride concentration in bottled water available on the market, in comparison with the values printed on the bottle label. Two hundred and twenty-nine water samples were collected from 35 brands available in several supermarkets, grocery stores and snack bars with high turnover in different regions of the municipality of Sao Paulo, Southeastern Brazil, in 2006. Fluoride concentrations were determined by duplicate analysis using an ion-specific electrode. The fluoride concentrations ranged from 0.01 to 2.04 mg/l, with significant differences between the values stipulated on labels and those found in the analyses. These results emphasize the importance of controls over fluoride levels in bottled water enforced by the sanitary surveillance agency.

Effects of Regular and Low-fluoride Dentifrices on Plaque Fluoride

Previous studies have indicated that the use of low-fluoride dentifrices could lead to proportionally higher plaque fluoride levels when compared with conventional dentifrices. This double-blind, randomized, crossover study determined the effects of placebo, low-fluoride, and conventional dentifrices on plaque fluoride concentrations ([F]) in children living in communities with 0.04, 0.72, and 3.36 ppm F in the drinking water. Children used the toothpastes twice daily, for 1 wk. Samples were collected 1 and 12 hrs after the last use of dentifrices and were analyzed for fluoride and calcium. Similar increases were found 1 hr after the children brushed with low-fluoride (ca. 1.9 mmol F/kg) and conventional (ca. 2.4 mmol F/kg) dentifrices in the 0.04- and 0.72-ppm-F communities. Despite the fact that the increases were less pronounced in the 3.36-ppm-F community, our results indicate that the use of a low-fluoride dentifrice promotes a proportionally higher increase in plaque [F] when compared with that achieved with a conventional dentifrice, based on dose-response considerations.

Fluoridation of the public water supply and prevalence of dental fluorosis in a peripheral district of the municipality of Bauru, SP

Objectives: The objectives of this study were to assess the fluoride concentration in the public water supply and the prevalence of dental fluorosis in schoolchildren between 7 and 15 years old, living in a peripheral district of the municipality of Bauru. Material and Methods: For this, fifty two water samples were collected on three different days of one week. These samples were analyzed for fluoride by means of the ion-sensitive electrode method (Orion 9609) coupled to a potentiometer (Procyon, model 720). In this method, 1.0 mL of TISABII (Orion) was added to 1.0 mL of the sample. For the epidemiological survey of fluorosis, 52 schoolchildren of both genders, aged between 7 and 15 were assessed, with prior authorization from their caretakers. Only one person examined the children, after supervised toothbrushing and drying with cotton wool rolls. The TF index was used. Results: The fluoride concentrations in the water samples ranged from 0.62 to 1.20 mg/L, with a mean of 0.9 mg/L. The prevalence of dental fluorosis was 33%, with severity ranging from TF1 to TF4 (Kappa of 0.73 and concordance of 83.33%). Conclusions: The results from the analysis of water samples indicated a fluoride concentration greater than recommended for Bauru. The fluorosis levels found were higher than expected for a peripheral district, in which water is one of the few sources of fluoride.

Fluoride concentration in water at the area supplied by the Water Treatment Station of Bauru, SP

Objective: to analyze the fluoride concentration in the public water supply at the area supplied by the Water Treatment Station of Bauru and classify the samples as acceptable or unacceptable according to the fluoride concentration. Material and methods: samples were collected from 30 areas at two periods, October 2002 and March 2003. The fluoride concentration in the samples was determined in duplicate, using an ion sensitive electrode (Orion 9609) connected to a potentiometer (Procyon, model 720). Samples with fluoride concentration ranging from 0.55 to 0.84 mg F/L were considered acceptable, and those whose concentration was outside this range as unacceptable. Data were analyzed by descriptive statistics. Results: the fluoride concentration of the water samples varied between 0.31 and 2.01 mg F/L. Nearly 56% of the samples were classified as acceptable. Conclusion: the variations in fluoride concentration at the area supplied by the Water Treatment Station reinforce the need of constant monitoring for maintenance of adequate fluoride levels in the public water supply.

Fluoride concentrations in industrialized beverages consumed by children in the city of Bauru, Brazil

The increasing consumption of juices, soft drinks and teas among children has increased significantly fluoride ingestion at the age range of risk for development of dental fluorosis. Objective: The purpose of this study was to evaluate fluoride concentrations in some brands of industrialized beverages consumed by children in the city of Bauru, SP, Brazil. Material and Methods: 98 brands of beverages were analyzed, divided into 3 lots, comprising 36, 32 and 30 brands, respectively, for the first, second and third lots. Fluoride concentrations were determined by HMDS-facilitated diffusion, using a fluoride ion-specific electrode (Orion 9409). Results: Fluoride concentrations ranged between 0.04 and 1.76 μg F/mL. It was observed a wide variation in fluoride concentrations among the different brands, as well as the different lots of the same brand. There was no information on fluoride concentrations on the labels of any product. Conclusions: Some of the products analyzed could contribute significantly to the total fluoride intake and, thus, be important risk factors for development of dental fluorosis, which indicates the need of controlling the production of these beverages with respect to fluoride concentration.

Conhecimento dos médicos pediatras e odontopediatras de Bauru e Marília a respeito de flúor

A proposta deste trabalho foi verificar o conhecimento dos medicos pediatras e odontopediatras, a respeito dos compostos fluoretados. Para tanto, foram visitados 91 medicos pediatras e 72 odontopediatras dos municipios de Bauru e Marilia, que ao concordarem em participar da pesquisa receberam um questionario com 22 questoes. O preenchimento e a devolucao foram imediatos. Os dados obtidos foram analisados por meio de estatistica descritiva, utilizando frequencias absolutas e relativas, representadas atraves de tabelas. Mediante a analise dos questionarios, verificou-se que alguns polivitaminicos que contem fluor sao usualmente prescritos pelos medicos pediatras, ao passo que os geis, vernizes e solucoes para bochecho sao bastante empregados pelos odontopediatras. Nao foi estabelecida relacao entre o conhecimento e tempo de formado, a idade do profissional, a universidade de origem, a cidade em que trabalha e a area de atuacao (particular, rede publica ou em ambos) desses profissionais. Os resultados obtidos sugerem que o conhecimento dos medicos pediatras e odontopediatras, das cidades de Bauru e de Marilia, a respeito da presenca de fluor em varias fontes de ingestao se mostrou insuficiente e, em algumas situacoes, preocupante, com relacao a prevencao de fluorose dentaria.