101186/1471-2458-11-768Received: Alimentary Fluoride Intake In Preschool Children

DOI. 101186/’1471245811768′

Received. 14Marc 011

The knowledge of background alimentary fluoride intake in preschool children is of utmost importance for introducing optimal and safe caries preventive measures for both individuals and communities.

The aim of this study was to assess the daily fluoride intake analyzing duplicate samples of food and beverages. An attempt was made to calculate the daily intake of fluoride from food and swallowed toothpaste. Daily alimentary fluoride intake was measured in a number of 36 children with an average age of 75 years and an average weight of 2069 kg at baseline, by means of a double plate method. This was repeated after six months. Parents recorded their child’s diet striving to maximize the benefit of fluoride in caries prevention and to minimize its risk, these results showed that in preschool children caution gonna be exercised when giving advice on the fluoride containing components of child’s diet or prescribing fluoride supplements.

Over the last 15 years, there are a few studies of alimentary fluoride intake in younger preschool children. Fluoride supplementation in areas with low fluoride content in drinking water can be planned at appropriate doses because Alimentary fluoride intake is studied in children from 6 months to 10 years in cross sectional and longitudinal studies with intention to determine basal fluoride intake from food sources. The reason why pre school age children been selected for the study of fluoride intake is that at this age an early secretory stage of development of the permanent anterior teeth enamel takes place and is very sensitive to increased fluoride intake. Fluoride intake has usually been calculated indirectly, on the basis of the records of food and drinks consumed any day and to the known fluoride content of the most frequently consumed kinds of food types and beverages. As a result, the authors referred to the initial estimate that the optimum fluoride intake in children ranged from 05 to 07 mg/kg of child’s weight/day. The range of the optimal fluoride intake had been revised, repeatedly with regard to the possible total percentage of fluoride intake from food and swallowed toothpaste.

More recent studies have shown that opacities of the permanent anterior teeth might develop even when increased intake of fluoride occurred in children is attributed to the inappropriately high intake of fluoride supplements and has led to the decision that the original optimal range of daily intake was set at the upper limit. The method of indirect calculation of fluoride intake on the basis of diets and table values of fluoride content in the essential components of child’s diet became unsatisfactory and it was replaced by a ‘socalled’ doubleplate method. A well-known fact that is. This method consists of collecting equivalent quantity of food and beverages received by a child in the course of the day and after all analysing the resulting homogenate to determine the fluoride content directly.

In children aged 3 to 4 years, daily fluoride intake had been found to be in the range from 05 to 31 mg with an average of 15 ± 06 mg, calculated to 008 ± 0003 mg/kg bw/day. The study of the alimentary fluoride intake in children in the Czech Republic has focused so far on determination of fluoride content in instant milk products, and bottled water. Certainly, bottled water for infants is very popular, even in families of preschoolers, for its low content of nitrates, nitrites and sulphates. Among bottled spring water lots of us are aware that there is one brand with 6 ppm There is also a bottled table mineral water with a fluoride content exceeding 7 ppm, that must be obligatorily labelled as not suitable for children up to 7 years, still bottled Czech water usually contains 0412″ ppm F. Normally, sea food, blackish tea and similar food sources higher in fluoride are rare in the current diet of Czech preschool children.

Look, there’s no fluoridation of drinking water in the Czech Republic, fluoridated toothpastes for children are available ‘country wide’ and fluoride tablets are administered rarely and no detailed data are available, as to other sources of fluorides.


The prevalence of dental fluorosis was monitored until 1989 when water fluoridation was stopped and since therefore no data are available. The longitudinal study of tooth decay increment, fluoride intake and parental behaviour and attitude regarding oral health of pre school children is conducted with following baseline data.

The aim of this study was to assess the daily alimentary fluoride intake analyzing duplicate samples of food and beverages in a smaller group of individuals recruited from the foregoing larger children’s group. An attempt was made to calculate the daily intake of fluoride from food and swallowed toothpaste. Besides, the daily alimentary fluoride intake in duplicate samples of food and beverages was assessed in this study.

The Ethics Committees of the 1st Faculty of Medicine in Prague and the Faculty of Medicine in Hradec Kralove approved the study and the parents of children involved in the study signed the appropriate consent form.

The study involved 36 children and their parents from a wider group of children who were throughout the study or before. All children were provided with toothpastes of quite similar brand containing 500 fluoride ppm and parents were instructed to put only a small pea size of toothpaste on toothbrush. The average age of the children at baseline was 75 years. As a result, whenever as pointed out by local Czech dietary habits, from the forms used in the Iowa fluoride intake study, when they have been in the apartments all day with their child/children, parents recorded their child’s the weight and the volume of food and beverages their children consumed over the course of 24 hours on prepared forms modified. Certainly, the parents also collected equal portions of food and beverages consumed by the child. Furthermore, liquids directly measurable potentiometrically for the fluoride content and solid or ‘semiliquid’ food not directly measurable for fluoride content were collected separately. Although, the parents were advised, via the study protocol, as to what dietary components of were to be described as liquids or solids and were asked to estimate percentage of food and beverages their child actually received as precisely as possible.

The contents of containers with liquids and solid or semi solid food were weighted and homogenized in a kitchen blender and the fluoride content was measured subsequently from aliquot sample volumes. In samples of liquid components TISAB II solution was added for the pH adjustment. Fluoride content was measured directly by potentiometric method using fluoride ion selective electrodes described below.

Aliquot samples of solid and semi solid food components with an added known volume of deionised water were also homogenized and processed by the quantitative extraction of fluoride by a micro diffusion method as indicated by Taves with a detection limit of 02 fluoride ppm per pH meter InoLab pH/ION 735P whilst stirring continuously in an electromagnetic stirrer. Values in mV were read after stabilization of measured potential. In any sample, the measurement was performed in triplicate. The concentration of fluoride in mg/l was calculated on the basis of calibration values of sodium fluoride solutions at concentrations of 02, 05, 1, 2, 5, 0, 5 and 0 mg/fluoride per litre.

If at baseline and after that again right after a sixmonth interval, Determination of daily fluoride intake in children was conducted twice. In any sample, the measurement of fluoride content was conducted in triplicate and the average values were calculated from the results. Of course, the following factors were taken into account, when calculating the daily fluoride intake. Fluoride content was expressed in mg per 1 consumed kg food and beverages and in the calculations of daily intake in mg/kg bw/day.

Such conclusion corresponds to the results obtained by the authors of this method and modifications of this method, Baby formula Sunar Complex Premium Validation studies of the fluoride extraction method used in the current study showed that in the expected range of the fluoride content in duplicate food samples, 2 to 4 loss of fluoride in the extraction was acceptable.

Other authors who used the extraction method also took the potential fluoride loss into account.


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