Justyna Opydo-Szymaczek

Dietary fluoride intake from infant and toddler formulas in Poland

Risk of enamel fluorosis associated with excessive fluoride intake during infancy and early childhood has been widely reported in literature. Results of several studies indicate that infant formula consumption, especially in the form of powdered concentrate, may appreciably increase childrens fluoride exposure in optimally fluoridated communities. The aim of the study was to measure fluoride content of infant and toddler formulas available in Poland and to discuss implications of the results. Twenty nine brands of powdered formulas were evaluated. Analyzes were performed with the use of ionselective fluoride electrode (09-37 type) and a RAE 111 chloride-silver reference electrode (MARAT). Results revealed that concentration of fluoride in all products was low (mean 29.0 μg/100 g), and that the formula itself is not a significant source of fluoride exposure. However, when reconstituted with water containing more than 0.5 ppm of fluoride, starting formulas and follow-on formulas may provide a daily fluoride intake of above the suggested threshold for fluorosis. Thus, fully formula-fed infants consuming mother milk substitutes prepared with optimally fluoridated water may be at increased risk of dental fluorosis.

Fluoride content of beverages intended for infants and young children in Poland.

Results of the studies indicate that fluoride content in beverages may be highly variable and children can consume substantial amounts of fluoride with these products. Ingestion of excessive fluoride during infancy and early childhood may cause dental fluorosis of permanent maxillary central incisors--the most aesthetically important teeth. The aim of this study was to determine the fluoride content in Polish beverages designed for infants and young children nutrition. Forty-three brands of juices and juice-flavored drinks and 23 instant teas were evaluated. Analyses were performed with the use of ion-selective fluoride electrode (09-37 type) and a RAE 111 chloride-silver reference electrode (MARAT). Fluoride concentrations in most beverages did not exceed 0.3 ppm. However, in three beverages containing tea extract levels of fluoride were higher (0.35-1.14 ppm). Consumption of these beverages could significantly increase childs fluoride exposure. Therefore, the need exists for continuous monitoring of fluoride levels in products intended for children. Listing fluoride content on beverages would be desirable. Knowledge about possible fluoride ingestion from dietary sources permits the clinician to recommend the safest schedule of fluoride treatment so as the optimal caries preventive effect can be obtained and the risk of dental fluorosis reduced.

Salivary Fluoride Concentrations and Fluoride Ingestion Following Application of Preparations Containing High Concentration of Fluoride

The aim of the study was to assess salivary fluoride concentrations and ingestion of fluorides after five different techniques of topical fluoride treatment. Ten volunteers received applications of fluoride gel, toothpaste, and foam. Fluoride concentrations were determined using ion-selective fluoride electrode in the samples of unstimulated saliva before and after procedures. The amounts of fluoride applied, recovered from the mouth, and retained in the mouth were calculated for each treatment. It was proved that fluoride ingestion following tray application of fluoride foam was significantly lower than ingestion following tray applications of fluoride gel (p < 0.01). The use of limited amounts of fluorides on a tray resulted in similar fluoride retention and lower ingestion comparing to the method which involves a large portion of fluorides followed by rinsing. Tooth brushing resulted in high salivary retention rates per amount of fluorides used in the procedure. These data provide initial concept about the possible advantages of some methods of topical fluoride application over others.

Child sexual abuse as an etiological factor of overweight and eating disorders — considerations for primary health care providers

Despite the recognition of the clinical importance of child sexual abuse, primary health care providers are often not ad-equately prepared to perform medical evaluations and diagnose child sexual maltreatment. Paper presents basic symptoms and signs of CSA, which may suggest the need for further patients diagnosis and referral. Since the great majority of sexually abused children do not have any abnormal physical findings, special attention is paid to the silent warning signs of CSA, such as changes in attitude towards own body and eating habits. Numerous studies suggest that victims of CSA may develop obesity or eating disorders of various forms and intensities.

Enamel defects and dental cariesamong children attending primary schools in Poznań, Poland

BACKGROUND Both positive and negative associations between developmental enamel defects (DED) and dental caries have been reported in the literature. OBJECTIVES The aim of this study was to assess the prevalence of DED of permanent dentition and its association with dental caries in schoolchildren living in Poznań (Wielkopolskie Voivodeship, Poland). MATERIAL AND METHODS A total of 2,522 6th grade children and 3,112 1st grade children were examined. Developmental enamel defects were described using the modified Developmental Defects of Enamel Index. Dental caries experience was assessed in accordance with the number of decayed, missing and filled teeth (DMFT). RESULTS The study revealed 475 children (9.6%) to have at least 1 enamel defect of permanent dentition. In 6th-graders, statistical analysis confirmed significant differences between DMFT, DT (decayed teeth) and FT (filled teeth) numbers of various DED groups with subjects affected by diffuse opacities having generally the lowest caries indices and subjects with enamel hypoplasia and/or demarcated opacities having the highest caries indices. In both age groups, dental caries prevalence was statistically significantly higher in subjects with hypoplasia and/or demarcated opacities as compared to subjects without DED or with diffuse opacities (p < 0.05). CONCLUSIONS The prevalence of DED in the examined population was low and comparable to those reported in regions without fluoridated water. The study confirmed that children affected by diffuse enamel opacities were less susceptible to dental caries, while demarcated opacities and hypoplasia should be considered important dental caries risk factors.